Low back pain seems nearly unavoidable with roughly 80% of Americans experiencing some form of low back pain in their lifetime (1). As a Physical Therapist, treating patients with back pain is a daily occurrence. Although low back pain comes in many forms and varies based on the individual, there are common trends that I see. There are certain lifestyle choices, daily habits, and movement patterns which many of my back pain patients have in common.
Let’s take a brief look at the anatomy of the lumbar spine. The lumbar spine consists of five vertebrae (L1-L5). Between the lumbar vertebra are intervertebral discs which act as shock absorbers and cushion the joints. Discs allow for weight to be distributed through the spine and provide support. The intervertebral disc is made up of 85-90% water, but as we age this amount decreases to 65% (2). At every level of our spine we have nerves exiting on both sides. Each nerve throughout the lumbar spine branches out and helps control the different muscles and sensation in our lower extremities. There are also many large, deep spinal muscles that surround the spine for protection and aide in movement of the trunk and limbs.
What Causes Low Back Pain?
85% of lumbar pain is often of unknown etiology. Meaning, most patients do not suffer a serious injury preceding their pain. I commonly hear “I don’t know what I did, I just woke up one morning and the pain was there.” Many patients have a difficult time understanding the WHY behind their pain. “Why did this happen to me?” Insidious onset of pain is often a result of our lifestyle choices, the repetitive movements, and high loads we place on our spines over time.
Let’s use repetitive bending for example. Bending and lifting increases the pressure placed on our spine by 200% (2). Repetitively bending with these types of loads is not sustainable throughout our lifetime. You have been bending over the same (likely incorrect) way for the past 35 years. All it takes is one time too many and your spine says “I am done with this!” and suddenly becomes painful. You are the camel, and the bending is the straw that finally broke down your back.
We live in a society where technology has become a dominant factor in our lives, making prolonged sitting more common than ever. You have heard us therapists beat this to pulp already; however I cannot stress the importance of movement enough. Unsupported sitting increases the pressure on the spinal discs by 50% (2). If you work at a desk for eight hours a day, five days a week you have accumulated forty hours of increased pressure on your spine. This is followed by a car ride home (sitting), eating dinner (sitting), and ending the day off with watching some TV…MORE SITTING!
Although sometimes sitting is unavoidable, there are certain techniques we can adapt that can help. If possible through your work, consider a work station with a standing desk. If a standing desk is not an option, sit in a chair with good lumbar support and be mindful of your posture. Change positions frequently by interrupting sitting every 20-30 minutes. Lastly, minimize your sitting at home by going for a walk or change the position which you watch TV.
Common Risk Factors for Developing Low Back Pain
- Increasing age correlates with low back pain (greater than 30 years old).
- Lack of exercise and immobility allow for weakening of deep spinal muscles and core stabilizers leaving the spine at risk for injury due to lack of support.
- Increased weight will increase the pressure on the discs and other supporting connective tissues.
- Sitting, sitting, and more sitting (no more explaination needed here).
- Repetitive bending and twisting through the spine without proper mechanics.
Although aging is inevitable (sorry to bearer of bad news) we can be proactive and try to slow down the aging process of the spine. It is imperative to become proactive about your health. Let’s focus on PREVENTION. Learning little tools and making small changes in our lives can help preserve the health and longevity of our spines.
If you want to learn more about ways to prevent or decrease back pain, click the link below to schedule your free discovery visit with a physical therapst.
1. Hoy, D., et al. The epidemiology of low back pain. 2010; 24 (6); 769-781.
2. Luoto, S., et al. Static back endurance and the risk of low back pain. Clinical Biomechanics, 10: 323-324. 1995.
3. Magee. Orthopedic Physical Assessment. 5th Edition. Saunders. 2007.