Not all back pain is created equal. In fact lower back pain is one of the most challenging conditions to treat given the multitude of factors at play. Not only are there many challenging biomechanic challenges at play but there are also deep routed psychosocial factors that impact healing and recovery. Taking care of your low back and your low back injuries is extremely important and should be done under the care and guidance of professional.
One of the biggest misconceptions about back pain and recovery is the time it takes to recover. Most health professionals will often advice that uncomplicated lower back injuries should heal or resolve within 6 to 12 weeks. Unfortunately, this just isn’t true. Most of the research to support this was done in animal studies and does include many of the complex tissue loading we see in humans. In fact, many studies show that damage to ligaments in the lower back can take years to properly heal and most low back pain patients will report continued pain in their back a year after the onset.
This is why I can’t stress enough the importance of consistency and frequency of your care with a health care provider, specially a chiropractor. Pain is not the guiding factor in progression of resolving your issue.
Let’s now look at and discuss some of the common recommendations for lower back health and where some of their short falls lie.
1. When lifting, bend with knees not the back
This is one of the most common pieces of advice to avoid a lower back injury - bend at the knees and keep the lower back flat or straight. Many ergonomic guidelines follow this advice but the research on whether it is better to bend at the knees or through the lower back is inconclusive. Remember that your body is going to strengthen in the way that you strengthen it. The way you lift things will depend on your personal strengths and weaknesses, the number of times the lift needs to be repeated etc. There is no one proper way to move something especially if that object is different from what you've moved or lifted in the past.
2. Strengthen your back muscles to protect the back
Many clinicians will focus on strengthening of the back muscles to protect against injury or re-injury of a lower back complaint. Increasing the strength of the muscles doesn’t help predict if you will have back troubles in the future. Looking at muscle endurance of the back muscles (as opposed to strength) is far more protective. An optimal exercise therapy program should emphasize improved overall health and not simply the enhancement of performance or strength.
3. A Sit-up is a good exercise for your back health
A sit-up is a common exercise used in many fitness classes and by trainers to help increase abdominal strength. A sit-up is actually one of the less favourable activities you can do for lower back health. It causes compression of the lumbar spine (lower back) and puts excessive pressure throughout the discs in your back. Sit-ups will cause damage to most people and increase the risk of a lower back injury.
4. A single exercise or program is beneficial in all cases of lower back pain
It is popular, especially on social media, to promote the exercise or exercise program that can cure all and fix all your problems if you “click here.” Increasing exercise and fitness will positively benefit your spinal health but the WAY your fitness is increased is critical. Developing stability in muscles is generally the approach to developing exercises in the lower back. However, almost every muscle can be important depending on the changes with demands of each task or activity. The problem is that where you feel the pain is poorly correlated to where the actual injury or instability lies. Do you focus first on mobility at the expense of stability of a joint? Do you focus on stability first and then enhance mobility later? The answers to these lie in the understanding of the mechanical issues causing the injury in the first place and will vary from individual to individual. No simple or single approach will produce the best result in all cases.
I can’t stress enough the complexity of lower back pain or injuries and how important it is to have a knowledgeable health care provider in your corner to help you through the process. Be weary of anyone who promotes a quick fix or a magic exercise to correct everything. It takes time, consistency and work on your end to effectively fix your low back pain. Your body is an incredible, adaptable healing machine. Give it the tools and environment it needs to heal and your results will be incredible!
Dr. Alfredo is a health enthusiast who’s goal is to help people and families live healthier, happier lives. My philosophy on health is simple - our body’s have the amazing ability and potential to self-adapt, self-regulate and THRIVE in this world.