Low back pain is common. In our office we see plenty of people with low back pain. Sometimes they are acute injuries to people who have not had back pain before, such as "I was carrying groceries and tripped going down the steps." Most times they are less exciting, "It is my usual pain in the back. Muscle spasms, dull pain, and occasional sharp pain when I get out of bed or a chair. The usual pain that hurts right here."
Chronic low back pain can severely affect one's life and activities. It causes people to avoid home, work, and recreational activities. They stop doing things with the family or need to take more breaks to rest their back.
Often times their pain could be improved by incorporating a few lifestyle changes. Sometimes if people could focus on a few basic exercises and stretches their pain would significantly decrease. There are several research studies that show if people can perform certain exercises then their risk of back pain decreases. Low back pain is often the cause of certain muscle pattern coordination dysfunctions. The muscles are not working together as well as they should, which exposes the joints to extra stress and strain.
The more dysfunction these people have the more episodes of pain they will have a year, and the longer each episode will last with greater intensity of pain. When people improve their muscle pattern coordination, they are less likely to have pain, episodes will be shorter, and they won't be as severe.
Everybody agrees with the concept in theory, but it is difficult to put into practice. People have good intentions to do the things they need to do to get better, but life and motivation get in the way.
We have a protocol in the office called the "Ron Rule." Ron is a friend who has a history of chronic low back pain. Whenever he runs longer than 10 miles he has more pain. Sitting or sleeping in different beds can aggravate his back, which is problematic because he travels for work often. With a little treatment he feels better, until the next episode.
He doesn't like stretching or doing therapeutic exercises. We have shown him several times and he doesn't do them. Maybe he will once or twice the first week, but definitely not after that. Each time he comes in we know he won't do the exercises, but we are going to give him a reminder demonstration. We know he isn't going to stretch, but we review them anyway. He knows he should, but he also knows he isn't ready to change his habits yet.
The Ron Rule is that we show someone the appropriate exercises once each very time he has a flare up. Even if he says he knows they will help but he won't do them. We will be brief, polite, and encouraging. He only has to see it once each flare up.
Each pain episode I will give the "30 second reminder that muscle pattern exercises would really reduce your chances of pain." We do this because we want to give him the tools to reduce his back pain. We feel it is our job and responsibility to provide the best information possible and let the patient decide what they want to do. After all, you are going to do what you want anyway. We are not going to make a big deal out of it or try to shame you. When you are ready and motivated we will be there to help.
Someday he will be motivated to work through the exercise pyramid and reduce his back pain. Until then he will keep having flare ups, and we will keep showing him what can be done to improve his back pain.
You can lead a horse to water but you can't make him drink.
For more information on Low Back and Sciatica here.
Disc herniations information can be found on the Lumbar Disc Decompression page.