Back to Basics- dealing with back pain.

I have observed a worrying increase in the number of people seeking help for back and neck pain in the last few years -on top of a problem that is already epidemic. Economic pressures; even more time spent at desks, stress, and less time spent exercising may be to blame.

Back pain most commonly originates from muscle imbalances. (There are more serious causes and if your pain/symptoms are persistent then you should see your GP). This is where some muscles become weak and others too active. Muscle imbalance usually occurs due to poor, sustained postural habits. These imbalances alter normal movement, resulting in stresses through the joints of the spine, overload and vulnerability to injury.

Studies vary, but suggest that on average, we spend between 5- 14.5 hours sitting during the day. And even for those who are standing which is preferable, their posture is rarely gold standard.

I have a plan for those who suffer from back pain.

1. See a professional (my biased recommendation is a Physiotherapist or Osteopath with a sports rehab or pain specialism background) to identify your particular habits and imbalances. You may need some loosening of the tight, stiff bits and will definitely need some specific exercises. You need to learn how to activate your postural ‘core’ muscles specifically and at a very low level – the brain must be engaged in this process. Beware of tensing your lower abdominals too much as is often wrongly encouraged. This results in more, not less dysfunction and pain.

2. Integrate these now wide-awake muscles into normal activities- walking, running, Pilates, Yoga, swimming- all good. You don’t need lots of expensive equipment. Just you and your body are fine.

3. When you have to sit or stand- pay attention to your posture. Make those muscles work for you! They de-train if they are not used.

4. If you are in the early, acute stages of a painful episode try to avoid too much rest. Inactivity will make you stiffen and your pain worse in the long term. Short periods of sitting /standing or lying interspersed with gentle stretches, exercises and walking are recommended.

5. In general- Move! If you don’t have to sit still- don’t !! Walk whenever you can. Walk whilst on the phone. Walk and talk when you have a meeting. Take the stairs, your bike. Motion is lotion.

6. De-stress. Easier said than done- I know. But stress causes muscle tension and also makes the brain more sensitive to strain on your body and more likely to elicit a pain response.

7. Don’t ignore the brain! Pain comes 100% from the brain (not the body) in response to stress and strain. The brain becomes sensitive to the danger it perceives the back is in, and it shouts ‘ no, don’t do that!’ by generating pain. Fear of movement occurs during that very first painful episode and becomes embedded the longer the pain persists and the more painful episodes you have. The fear area of the brain, the Amygdala, connects with the region that deals with movement, therefore contributing to the movement imbalances I have already described. A circle of dysfunction and pain response is established and it is this that often needs dealing with, through a mind-body approach.

For those of you that have chronic (long-term, persistent) pain- all of the above still apply. The term ‘Pain management’, frequently used to describe a treatment approach to chronic pain, to me creates the impression that it is unresolvable. For a large percentage of people this is not true. Yes it takes time, patience, diligence and creativity- but recovery is achievable.