Low back pain affects up to 25% of adults in Canada (primarily after the age of 30), occurring in both men and women equally. This costs taxpayers between 6-12 billion dollars annually, often, with very little effect or relief from symptoms or cure of the underlying condition.
Inevitably, having practiced Traditional Chinese Medicine & Acupuncture for over 20 years has brought me deep into the world of pain and injury, low back pain being a majority of my cases (i.e. sciatica, SI joint pain, slipped/herniated discs, osteoarthritis, facet joining syndrome, vertebral degeneration, piriformis syndrome, etc). Contrary to common belief, in my experience, in most cases there is much that can be done to relieve and manage these conditions. I wanted to share my basic approach, as I feel these general steps are usually not followed, and therefore the pain continues or worsens.
In summary, here is my basic approach to treating, managing, and overcoming low back pain;
~ STEP #1: FIND MOVEMENTS AND POSTURES THAT CAUSE THE PAIN, & STOP DOING THEM.
Then find and repeat pain-free motions and postures, as this will help reset overactive pain signalling and healing is more likely. This simply involves learning to move differently to complete normal everyday tasks. In other words, stop picking the scab.
In General, stop movements that involve spinal flexion/extension (bending forward/backward using low back instead of hips) and twisting (anything that rotates the spine). Toe touches, sit/curl ups, knee to chest (unless done very mildly where lumbar spine does not extend), superman, cobra, oblique twists, etc.
Take some time to learn about your lower spine, how it works, and the potential problems that it could be, then see your medical professional. This will ensure that you receive a proper assessment and more detailed explanation of the basic injury and the pain mechanisms, resulting in enhanced clarity on your journey to solutions.
~ STEP #2: STRUCTURAL STABILITY
Rather than striving for increased lower spinal mobility, structural stability is most often the path to being pain free. The spine does not want to bend or twist repeatedly or with load, especially when injured.
In addition, when, and only when, your injury is out of the acute phase and well into the recovery phase (meaning your body is ready), proper (without twisting/curling of the spine) strengthening exercises should be commenced. With low back pain, this means strengthening the core (abdominals, obliques, low back, and hip rotators). Main movements being bird dog, planks (regular and side), glute bridges, & clam shells.
~ STEP #3: WALK, DAILY
Start in small intervals of 5-10 minutes, low intensity walking, and SLOWLY build up from there. If it ever feels too much, then it is. If the next day results in worse pain, walk less. *See Step 4.
~ STEP #4: BE PATIENT
Trying to expedite healing and racing from the recovery phase to the strengthening phase too quickly often results in increased healing time and potential re-injury, potentially back to the acute phase if we aren’t careful. I find this to be the most difficult step for most. Of course we want to be back to normal ASAP, but if there is one thing I consider fact, is that one of the hallmarks of aging, is that healing from physical injury takes longer. It’s that simple.
STEP #5: TREAT
Of course I am biased to ACUPUNCTURE as I have seen its miraculous effects over and over, not in all cases, but in the majority. I also see much relief with a good Chiropractor (I have seen many patients with great results from Dr. Logan Smythe at Salt Spring Sport & Spinal), especially when done in tandem with regular acupuncture treatments. Another tool I believe to be a bit of a Holy Grail for maintaining mobility, is properly done foam rolling (I recommend Jerome Acosta’s teaching of the MELT Method at Ganges Yoga and Salt Spring Wellness Centre).
STEP #6: INFLAMMATION
Reducing inflammation is the basic mechanism of most pain relievers that you will be recommended (i.e. Ibuprofen, Tylenol, ASA). These medications can be a double edged sword; on one hand they can give you some relief from the pain, on the other hand, your body needs inflammation both to heal the injury, and alert you (via pain messages to the brain) so that compensation and adaptation to movement and other moment to moment choices support protection and healing. I cannot count how many times I have seen people rely on pain medications, feel better, and repeatedly re-aggravate their injury. My only caveat here, sometimes, is if it can help you get a good sleep. This is usually a time when people don’t re-injure themselves, and the healing power of sleep is unmatched.
STEP #7: FINALLY,…
Proper guidance should also be given on diet, stress management, the use of hot and cold, supplementation, environmental toxins to avoid, topical creams, self-massage, Chinese herbal medicine, and various options for injections (sodium chloride, B vitamins, peptides, cortisone).
