The lower back can literally be a real pain. It is estimated that a majority of the world’s population will develop lower-back pain in some form at some point during their life. In New Zealand, a 2011 study by the National Health Committee found that 9.1% of the New Zealand population are suffering from long term chronic back pain. Here we explore the issue of lower back pain and the most effective ways to deal with it.
First of all, why do we get back pain?
Well, evolutionarily speaking, we’ve only been an upright species for a short while. Mostly, it’s been great – freeing up our hands for all sorts of useful things. There is, however, a tradeoff involved. Given that for most of our history as a species our backs were closer to horizontal, they haven’t yet developed to fully accommodate the force of gravity. This, coupled with far longer lifespans and the wear and tear involved in all those extra years leads to back pain.
The high prevalence of lower back pain could also be exacerbated by the eight-hour work day and modern sedentary lifestyles. A breakthrough study by the University of British Colombia in the 1960s found that many indigenous populations around the world suffered from little to no back pain and didn’t show as significant degeneration as they aged. Researcher Esther Gokhale, who spent many years studying indigenous populations in relation to western people, found that the main reasons they had such healthy spines was because they were constantly moving their bodies, were fairly lean, and had good posture. Even if you’re not experiencing back pain now, taking note of these three factors could drastically reduce your chances of getting back pain later on. Because, once you get back pain, it becomes much harder to exercise and hold good posture, and the increasing difficulty of being physically active also makes it harder to stay lean. These facts are stressed by health organisations worldwide, such as the National Health Service in the UK.
So what can be done for these poor backs of ours? Let’s look at some options.
While medication has been found to help people cope with back pain, it does not fix the core issue and can produce other problems. Worse, research shows there is an increased risk of cardiac arrest when taking common anti-inflammatory drugs such as Ibuprofen and Diclofenac. A study a study conducted this year by the European Committee for Cardiology found that the risks of cardiac arrest with these drugs were significant: 31% with Ibuprofen and 50% with Diclofenac. Other risks were said to include higher instances of internal bleeding and kidney damage.
Acupuncture, Chiropractic treatment and Osteopathy are also common treatments that can have some positive effects on lower back pain and back function. However, they have been shown to be less effective than simple posture alignment training and careful exercise.
The Alexander Method
The Alexander Method is a routine focusing on posture exercises to help align the head neck and spine muscles. A University of Southampton study in 2008 found that it was one the most effective ways of treating lower back pain. Participants in the study who practiced the routine 30 minutes a day, five days a week for 24 sessions reported significant improvement in their pain. People that combined the technique with exercise showed improvements between 40-45% in pain and mobility.
Practicing yoga requires a focus on precise and controlled movements with an emphasis on correct posture. This contributes to balanced, healthy muscle growth in the abdomen and lower back. As a result, you also tend to pay more attention to posture in day to day life. The results from three separate 2011 NCCIH studies (1,2,3) with 631 participants over a period ranging between 3-6 months found that yoga can significantly reduce lower back pain and improve mobility more effectively than some regularly prescribed medical treatments.
Yoga is effective because it combines a lot of the known ways of treating back pain into one package, but if yoga isn’t your thing, you can take up any of a variety of other sports, such as swimming, cycling or even just walking (maybe not rugby). These sports can be very effective at combating lower back pain, so long as you’re doing them at an appropriate intensity, as they keep you physically active and help to strengthen the muscles in the back. But be sure to pay attention to form and posture, or you won’t reap as many of the benefits.
Another, perhaps counter-intuitive solution is one that goes hand in hand with yoga. Mindfulness, a modern permeation of millennia-old eastern spiritual practices, has been shown to help reduce lower back pain over time. In 2016, an integrated health care system clinical trial in Washington State treated participants with chronic lower back pain with a combination of CBT (training to change pain-related thoughts and behaviors) and MBSR (training in mindfulness meditation and yoga).The study compared mindfulness to regular treatment for lower back pain and found that there were greater improvements in perceived pain and mobility with participants that were treated with CBT or MBSR.
So, sometime during the busy western workday, it might be a good idea to look east to ease your back pain with some yoga and/or mindfulness. At some point, unless you’re proactive with keeping on the move, staying lean and having good posture, it’s likely you could suffer from lower back pain. So be proactive, poke your tongue at evolution and get that spine straight and true!