Low Back Pain: Brief overview of the causes, self-care and chiropractic management
“I can’t golf because I will hurt for a week.”
“I’m not picking up my kids because it makes my back ‘flare up’.”
“I will have to call into work again.”
These are things I hear from new patients all the time. Low back pain is common. Really common. 31 million Americans experience low back pain at any given moment. It is the number one cause of workers disability in the United States. Most of us will experience back pain in our lives (myself included).
From a diagnostic standpoint, low back pain really doesn’t describe anything other than ‘ouch’. Let’s be clear: Low back pain is a monster with many heads, coming in many different forms from different structures. Facet syndrome, Spinal Stenosis, Disc Disorders, Degenerative Joint Disease, Sacroiliitis, Sciatica, Piriformis syndrome and many more diagnoses all end up with different forms of back pain. There are some other disorders that can cause back pain and mimic the above: Ovarian cysts, kidney stones and gastrointestinal disorders to name a few. Of course, these must be ruled out by the chiropractor before starting treatment.
One of the really cool pieces of the low back pain riddle? Joints and discs can heal! With chiropractic care and therapeutic exercises together, it has been shown to be the most effective treatment for low back pain. That’s what we do. In addition to the above treatments, we cannot neglect the musculature. We partner with our massage therapist to help with trigger points (knots, tender points with referral patterns) and perform in-house myofascial release and instrument-assisted soft tissue mobilization (IASTM), which are forms of muscle work.
Once the cause of the low back pain is identified, the doctor will start treatment. At Patten Family Chiropractic, treatment begins as soon as possible and usually on the day of the first visit. Radiology is typically not necessary unless trauma was present or if the basic neurological and orthopedic exams aren’t adding up. X-rays to show degenerative joint disease hardly seem important when it is a ‘normal’ finding. See the figure below and compare your age to find out what ‘normal’ is for your spine.
Home Exercises for Low back pain
There’s a bunch, but we’re going to focus on the ‘Big 3’ by Stu McGill. These are basic exercises that will help most people with low back pain, but not everyone. Of course, consult your chiropractor or medical professional first before starting any exercise plan. If the exercises cause pain, stop. If pain is shooting down your legs or up your spine, stop. These exercises should be simple and comfortable. Don’t forget to breathe normally throughout and warm up with a quick 10-minute walk. No handstands.
The Big 3
The big 3 are made up of the Modified Curl-Up, Bird Dog, and Side Bridge.
- Modified Curl-Up
Start lying on your back, place one leg flat on the floor with the other bent. Place your hands under the small of your low back to ensure a normal arch is maintained during the movement. Begin by slightly flexing your abdomen, breath normally. If you have difficulty maintaining the brace while breathing, this is where you start. Now, pretend your neck, upper back, and low back are locked together and cannot move independent of one another slowly, lift your shoulders blades off the floor and return to the floor in a smooth pattern, only coming off the ground 2-3 inches. Calm and controlled. Do 3 sets of 12.
- Bird Dog
Start on ‘all fours’ (use a pillow or padding to brace knees if necessary); hands under shoulders and knees under hips, both about shoulder-width apart. Brace your stomach while maintaining a straight spine. While maintaining this posture, breath normally, squeeze your glutes and begin moving your right arm up to a point position while also bringing your left leg to a straight position. Be careful not to allow rotation of the spine, stay straight, be the bird dog and point the location. Carefully and controlled, return to the starting position and then perform with the opposite arm and leg. Perform 3 sets of 12, three times per week.
- Side Bridge
Start by lying on your side on a firm surface, prop yourself up on your elbow, and stack your knees on top of each other with a 90-degree bend. Hold a strong shoulder directly over the elbow on the ground, lift your hips up and push them forward, bringing your spine to a straight position. Hold for a 5 count and then slowly return to the starting position. Be aware of your posture and your breathing. 3 sets of 12 on each side, 3 times per week.
Think of these three exercises as a yes/no questionnaire or a flow-chart. Did they help? Yes? Keep doing them. No? Come see me. I will most likely advise some of these in addition to treatment because they work! You may be sore 24 hours later, and this is normal. Increased pain is NOT normal. In this case certain pharmaceuticals (medicines or drugs) should be prescribed.
If they did not work, make an appointment and we will figure out a few things:
- What is wrong with you.
- How we can help you (treatment or referral if necessary)
- How long it will take.
I hope these exercises help you. We will be adding some video demonstrations and some more information in the very near future. Thank you very much for reading.
Dr. Patten, Chiropractor
Patten Family Chiropractic
15335 Community Road
Gulfport, MS 39503