Low Back Pain - Why is it so common?

Low back pain – As common as rain in the UK!

But why?

Well, there are many reasons why somebody could be experiencing low back pain. From my clinical observations at Farnham Chiropractic Wellness Centre, the reason why the vast majority of my patients are suffering with low back pain, is that their buttock muscles are not working properly. The main buttock muscle involved is the gluteus maximus - affectionately known as “the glutes”.

Low Back pain - muscles
This muscle makes up the bulk of your buttock and is responsible for the power and stability generated when walking, going up stairs and lifting.

When the glutes are not working, the workload of your activities has to go somewhere. The body thus has to compensate. The most common muscles that are used in this compensation pattern are the low back muscles and hamstrings.

The low back muscles are designed for tone and posture, not for power and strength. Soon they fatigue. This can lead to these muscles being strained (torn), and the joint capsules and discs being sprained (like a twisted ankle, but in your back). This can come on gradually and worsen with time, or it can happen suddenly. This sudden pain can strike when doing seemingly irrelevant tasks, like picking up a pencil, putting your socks on or spitting out toothpaste.

This is only possible in a body that has been compensating for a long time. Fatigue and poor control lead to the injury.

Why is this so common in our society? By “our society”, I mean those living a Western (industrialised) lifestyle. Studies on low income rural populations in Africa, and Asia, have revealed that while 80 – 90% of workers are laborers (working well into old age) they have 50 – 70% less incidence of low back pain (1).

Lifting
These people have very physical lifestyles. Pushing, pulling, lifting, twisting and digging all day. So why is their back pain prevalence so much lower? The most obvious difference is HOW they move. They hinge with their hips, straight backs, with their knees straight or slightly bent.

“Hang-on Grant! You are crazy. You are supposed to lift with your knees.”

That may have been what you have been told by your parents, and / or taught in a manual handling course. I am here to tell you that what you have been taught only strains your knees and doesn't allow you to move the way you were designed to move.

We’re supposed to hinge from our hips. Watch a toddle pick up something which is heavy for them. They keep their knees and back quite straight and use their hips to bend. This allows the big gluts and large ball and socket joints to do the job.

So why don’t we do this? We were all once toddlers. What made us lose our way?

I believe that sitting is the main culprit. When you sit, you crush your gluts. This switches them off. You also shorten and activate your hip flexor muscles. This also switches your glutes off. Just like when your bicep muscle contracts, your tricep muscle relaxes. There is a mechanism at play between opposing muscles. One gets activated, the other gets deactivated.

Lifting
So what can you do about it? In my experience, an efficient way to “switch a muscle back on”, is to improve the input from that muscle to your brain (proprioception). Again, I speak from my own experience, adjusting the spine can quickly reactivate inhibited muscles. 

You can also do "DIY" muscle activation by rubbing the glutes as fast and as deeply as you can for 10 seconds. Add a few hip hinging deep squats as well as some hip flexor stretches, and you should wake them up enough to help protect your back. 

Once you have been adjusted and the muscles are now working properly, it is then important to keep them working. Stretch out the hip flexors, sit less, do core stability exercises, use the "DIY muscle activation, and get regular chiropractic check ups.

Also by hip hinging, you lift and bend correctly. This rehabilitates the problems as you force your gluts to work, while stretching your hamstrings and stabilising your spine.

I hope that this gives you a better understanding about low back pain.

Reference:

1)         Volinn, E. The epidemiology of low back pain in the rest of the world: A review of surveys in low and middle-income countries. Spine. 1997;22(15):1747-54