9 HELPFUL BACK PAIN FACTS



1. Most back pain is not a serious, life-threatening condition.

2. A weak core does not cause back pain, ever. Really.

3. Feeling like you won’t get better and avoiding moving around can make the pain last longer.

4. Imaging of the back (Xray, MRI) do not determine outcomes or how long pain lasts. Often they are not helpful at all.

5. Graduated exercise and movement in all directions is safe and healthy for the spine.

6. Spine posture during sitting, standing and lifting does not predict back pain or its persistence.

7. Pain flare-ups are more related to changes in activity, stress and mood rather than structural damage.

8. Spine movement and loading is safe and builds structural resilience when it is done regularly and properly.  Effective care for LBP is relatively cheap and safe. This includes: education that is patient-centred and fosters a positive mindset, and coaching people to optimise their physical and mental health (such as engaging in physical activity and exercise, social activities, healthy sleep habits and body weight and remaining in employment).

At Elevation Physiotherapy & Wellness, we are very good at helping people through their back pain to get to the source of the problem and getting them back to full life!

Get better, faster.

Back to basics: 10 facts every person should know about back pain. Peter B O’Sullivan et al. British Journal of Sorts Medicine. Editorial. Dec 2019

Your Spine is Stronger Than You Think!

Low back pain is the leading cause of pain and disability worldwide. Statistically, the prevalence of lower back pain is increasing, so what are we doing wrong? Historically, people have often been told to rest or to strengthen their core muscles, and for many, that is not helpful advice to get to the root of the problem.

We need to change that message.  The structures in the back that cause pain, and the biomechanics of spine do not seem to be as important as we once thought they were.  We need to stop thinking that someone will break when their spine is put under load.  Our bodies are much more resilient than that, and it is never helpful to promote fear.  The spine is designed to move in all directions, and it is important that it does.  Telling someone NOT to move in a certain direction as it will damage the spine is both wrong, and can change their brain over time.  If someone is scared to move into flexion and tries to avoid it at all costs, when they have to move into flexion to tie their shoes, they will consistently be thinking that they could damage themselves.  Is tying up a shoe really dangerous?  No it’s not.

We can train ourselves to do almost anything, and the risk of injury is dependent upon much more than how we move.

Several studies have shown that spinal flexion cannot be avoided, even when trying to keep the spine in a “neutral” position with activities like squats, dead lifts, or a multitude of ab exercises.  If such movement cannot be avoided, no matter the loads or conditions, why do we teach people this will result in low back pain?  Fear and limiting beliefs about the fragility of the spine are hurting us more than actual movements.

People with low back pain need to hear reassuring, positive and empowering language.  A person who has lower back pain WILL get better; they WILL get back to what they love to do.  Almost everybody does.   As a Physiotherapist, it is important to ensure people with lower back pain are empowered to stay active and strong in ways that they enjoy.

One of the most important messages to convey to someone who is suffering from lower back pain is to remind them that they are strong, their spine is robust, and they will recover.  Each person needs to keep moving in ways that feel good, and temporarily avoid positions that seem to create pain.  The big word here is temporarily—once pain settles down, there should be no restrictions in movement.  Get back to everything!

Your Journey to a Better Back: Part 5- Back strengthening exercises

Once you’re feeling better and don’t have particular pain, you can try these two exercises that target the deep back muscles.  They shouldn’t be painful, but rather just challenging for your muscles to do several repetitions or hold for awhile.  If either exercise is creating pain, check with your Physiotherapist to make sure they are appropriate exercises for you!  Enjoy!

Your Journey to a Better Back: Part 4- Your back muscles are not that weak

It is surprising to many people to learn that your back muscles are likely not the cause or driver behind back pain.  Your brain recognizes that pain is not normal and can go into “protective” mode and the muscles can spasm or not work normally as a result, but they are not often the cause of the issue.  Check out this video below to explain more:

Your Journey to a Better Back: Part 3- The “Sloppy” Push Up

We all know that there isn’t likely one movement or exercise that is appropriate for everyone, but the “sloppy” push up can be helpful for many people.  People tend to sit slouched and spend WAY too much time with their spine rounded forward, so this is a nice movement to get out of that, and nothing you happen to do in your day puts your back near there unless you make a point of it!

Remember, the “sloppy” push up should not be painful.  If it is, it’s best to consult with your Physiotherapist to see if this exercise is appropriate for you at the moment.

 

What is the McKenzie Method & Why Should You Care?

Physiotherapists often use a method of assessing and treatment called the McKenzie Method for people who have back pain and physical limitations– I highly recommend you check out information from their website here. In a nutshell, The McKenzie Institute International began several decades ago with Robin McKenzie, a Physiotherapist in New Zealand who developed a new way of assessment and treatment in the 1950s and advanced this thinking over the next several decades. It focuses on a thorough examination of each person individually by looking at various repeated movements and sustained positions to see how they move or their pain changes, and educating the person on exactly what to do and how often, so that progression moves along efficiently. I have found it to be an elegant system, and very helpful for many people who are suffering not just from back pain, but really any musculoskeletal issue. The McKenzie Institute International describes the system like this.

Within this McKenzie system, there is a term called “directional preference”, which is really determining if the person with back pain has one direction of movement that they can do repeatedly that will consistently decrease their pain or increase their movement. This sounds quite basic, but often the person in pain doesn’t know the direction of movement that could be helpful. Think about it—if you have a lot of back pain, you sure don’t want to do anything that might make it worse, or make the location spread out, so you tend to not move much. If your physiotherapist can help you determine if you have a directional preference that helps your pain or movement, then research shows that is a really great sign that your situation should move right along.

There is tons of research that supports the validity and reliability of the McKenzie System of MDT, and regardless of if you are suffering from a new issue or you’ve had pain for awhile, you should consider seeing a trained practitioner in this system. You can find a clinician who is either Credentialed or has a Diploma (even further education) in this system through this link.