Editor’s Note: Join Dana Santas for a four-part series to learn how to recover from and prevent low back pain. Known as the “Mobility Maker,” Santas is a certified strength and conditioning specialist and mind-body coach in professional sports, and is the author of “Practical Solutions for Back Pain Relief.” Here’s part I.
If you suffer from or have struggled with low back pain in the past, you are not alone.
As many as 577 million people worldwide had low back pain in 2017, according to a 2020 study cited by the International Association for the Study of Pain. According to the US Centers for Disease Control and Prevention, low back pain causes more disability worldwide than any other condition.
In the US, it is estimated that 80% of Americans will experience low back pain at least once in their lifetime, with an additional 50% chance of recurrence within a year.
If you have low back pain, it is understandable that you feel powerless. An acute attack can leave you feeling immobilized for days or even weeks, wondering if you’ll ever feel better again.
With multiple hernias in my back, I understand that feeling. But as someone who has cured my own low back pain and now lives a pain-free, active lifestyle, I’ve made it my goal to provide people with the information and resources they need to recover and live pain-free too. That’s why I’m sharing this four-part series.
Working in professional sports as a mobility coach, part of my job is to establish treatment and prevention protocols for back pain. As such, my advice in this series of articles is based not only on medical research and my own journey into back pain, but also on my work experience that has helped hundreds of professional athletes overcome and prevent low back pain over the past two decades.
In this first article, I’ll help you gain a better understanding of your own personal experience with back pain, why proactive techniques are more effective than passive approaches, and how to find relief now and a path to avoid future pain. The second piece looks at exercises for lasting relief and strength recovery, while the third article focuses on soothing sciatica. In the latest episode, I’ll help you create your own back pain prevention plan.
If you’re ready to get rid of the pain and stay outside, join this series.
Back pain is a very personal problem with myriad causes and presentations that affect your recovery and prevention strategies.
The good news is that most cases of back pain are not caused by serious conditions, such as fractures or cancer, and improve 90% without surgery, according to the American Association of Neurological Surgeons. Below I have included a list of common causes. Consider which ones may be related to your lifestyle and contribute to your pain.
Because your rib cage is attached to your spine and your primary respiratory muscle, your diaphragm, attaches to your lumbar spine, how you breathe affects the position of the spine, overall posture, and consequently back pain.
Your low back is designed to be more stable than mobile, so if our hips are tight and have no rotation, trying to compensate with your low back during twisting movements can lead to muscle and disc injury.
A “broken back” with spinal fractures is rare, but it can happen as a result of significant trauma from things like a severe fall or a car accident. In general, these incidents lead to hernias and/or muscle injuries, as opposed to fractures.
Back pain is not a normal part of aging. However, after age 30, as bone density and muscle mass begin to decline, intervertebral disc health also improves, which can lead to lower back pain, especially if you don’t exercise regularly.
As mentioned above, regular exercise is key to the health of our muscles and bones. Our bodies are designed to move, so sitting creates stiff, weakened muscles and reduced joint lubrication, including drying of the intervertebral discs – all of which can lead to lower back pain.
Extra weight in the abdominal area increases the risk of low back pain by putting extra pressure on the spine, which can result in muscle tension, pinched nerves and hernias.
When you’re chronically stressed, your body’s stress response contributes to back pain by creating muscle tension and increased sensitivity to pain.
Low back pain is usually classified by duration as acute, chronic, or subacute:
• Acute lasts less than four weeks.
• Chronic is longer than 12 weeks, even if it is intermittent.
• Subacute is between four and twelve weeks.
Understanding the possible cause or causes of your pain and understanding its classification can help you have more effective conversations with your doctor and other health care professionals.
Research is increasingly supporting that exercise is key to healing and prevention. A 2016 meta-analysis published in JAMA, covering treatment modalities for more than 30,000 patients, found that the proactive use of exercise showed greater reductions in back pain and risk reduction than commonly prescribed passive methods, such as medications, support belts, orthotics and bed rest. And combining education with exercise reduced the risk of recurrence of back pain by an additional 10% compared to exercise alone.
When your back pain first starts or if you’ve had chronic pain that gets worse, just thinking about exercise can hurt. Do not worry. In future articles in the series, I’ll share safe exercises to help you relieve your specific type of low back pain. For now, here are two approachable, science-backed techniques that you can easily use to get some relief, as neither is contraindicated for any condition.
Mindfulness meditation is effective in relieving low back pain, especially a chronic condition, numerous studies have shown. A recent meta-analysis published in the journal Pain Medicine found that meditation is a safe and effective method of managing back pain by reducing pain intensity and improving quality of life, more so than nonmeditation therapies.
Practicing good diaphragmatic breathing is the foundation of all my treatment and prevention programs for back pain in professional sports. That’s because deep breathing not only helps reposition the rib cage and pelvis to relieve pressure on the spine, it also calms the stress response by activating the parasympathetic “rest-and-recover” aspect of your nervous system that facilitates recovery. . Try this simple 5-7-3 breathing exercise to relieve tension to get started.
Other options for pain relief include massage, acupuncture, and chiropractic care. Consult your doctor before trying these treatments to make sure they are not contraindicated for your condition.
When you visit your doctor, you should share your personal experiences and thoughts about possible causes of your pain and your lifestyle goals after you get rid of the pain. Listen carefully, take notes and ask questions as an active participant in your care plan. For example, if your doctor orders an imaging scan, such as an MRI or CT scan, don’t be afraid to ask what he’s looking for. Once your doctor has made a diagnosis, ask why your condition indicates that diagnosis and what the prognosis is. If your doctor recommends extreme measures, such as bed rest only or surgery, ask him to explain why he thinks this is the best approach and get a second opinion.
Finally, if your doctor prescribes an opioid pain reliever, ask if there are non-narcotic alternatives and, if prescribed, ask for permission to refill. As of 2017, the American College of Physicians has issued new guidelines urging physicians to prefer exercise-based treatments and exhaust all other treatment options before prescribing opioid medications for non-radicular low back pain.
When working on recovery, remember that words and thoughts have power. Too often, when someone has an acute attack of low back pain, they describe it as “going out” their back. This kind of negative, passive phrasing conveys a lack of understanding and responsibility that can get in the way of healing. That’s why it’s important to be armed with the right information and resources to be positive and proactive.
Our bodies are amazing vehicles that we are blessed with to navigate our lives. We have a duty to care for them, and the only way we can do that effectively is by educating ourselves, using the resources of healthcare professionals and taking action. By reading this article you are already on a proactive path. Look for the next article in the series to guide you in determining the best exercises for creating long-lasting relief.