Misconceptions On Low Back Pain
There are plenty of resources & remedies available to all when it comes to the issue of low back pain. It is always important to note that low back pain can be a complex matter and has to be treated individually on a case by case basis. There is no secret method to resolving back pain, one method may work for someone but may be ill fitted for another.
We hope to shed some light on the common advice given out.
Strengthening the core will improve low back pain?
Too often we hear about individuals receiving this advice from their health practitioners. The patients who take these advice often resolve to strengthen their core via sit-ups and other common abdominal exercises. In fact there are some research that indicates that performing excessive numbers of sit-ups actually increases the compression in the lumbar spine.
For certain individuals with chronic low back pain directly strengthening the core may be the worst advice possible. Chronic low back pain with central sensitization severely affects the way an individual moves, perceives pain and their body. These individuals are in a highly sensitized state and may have altered motor control present.
An approach by directly strengthening the core could lead to
- hyper vigilance and
- excessive pressure exerted on the already sensitized back structures.
It is true that core stability & strength may help, but not in all cases.
Tight Hamstrings Leads to Back Pain?
It may seem logical to think that tightness originating from hamstrings would lead to a torque rotating the pelvis back that could give low back problems. This train of thought has driven may clinicians over the years as tight hamstrings would result in poor hip flexion and mobility. However there is little evidence that this may be the case. Poor hip mobility which originates from the hip joint may play a role in back pain however there seems to be little link between tight hamstrings and low back pain. Unfortunately for the population already struggling with back pain, just stretching your hamstrings may not be of much help.
A Spine Stability Program will help with back pain?
Spinal stability exercise regimes have become really popular recently. Often times coaches & gyms may promote their method of training single muscles to improve on spinal stability. This originated via research that was intended to promote motor control and re-education for individuals to avoid movement patterns that have let to injuries. Unfortunately once the exercises shown in the research reached the masses, it has been largely misinterpreted that the exercises are the best low back pain rehabilitation exercises.
Muscles in the back are important, but their importance largely relies on the activity and task at hand. The muscles around the trunk are dynamic and are able to adapt themselves to fit the physical demands. While it may be true that damage to spinal muscles may result in unstable joints leading to back pain; it is also evident that back pain may be multi-factorial and that sources of pain and symptoms may be linked together in many ways.
The variety in back injuries would often mean that a simple rehabilitation approach will often fail to work. Stability alone may not be helpful if mobility is required. Likewise could a patient require stability first while working on mobility as a secondary rehabilitation goal? In some complex clinical cases, spine stability may be required however hypertonicity in certain muscles are the root cause of pain.
Remember that the spine is made to move. Re-enforcing brute stability and rigidity often times will result in poor outcomes.
It is important to approach each low back pain case individually.
Yoga & Pilates are Good for Back Pain?
In short, yes & no.
Each case of low back pain is different. Some rehabilitation principles may overlap with those found in Pilates and yoga. Often times with Physiotherapy, these principals are adjusted to fit the needs of the patient.
When done appropriately and approached from the right angle, Pilates and Yoga may address the issue and aid with back pain.
When done inappropriately – could exacerbate a back condition, especially if a particular movement or maneuver is provocative.
Physiotherapy in low back pain aims to
- Locate sources and drivers of pain.
- Manually treat and/or address the sources and mal-adaptive pain behaviors.
- Empower individuals with knowledge regarding their condition.
- If required – rehabilitate the back via a systematic individualized approach.
- Maintain progress and attempt to prevent future recurrence.
By Wayne Sun
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