Commentary - Low back pain prevention, rehabilitation

  • Published
  • By Bill Goins
  • 8th Medical Operations Squadron
KUNSAN AIR BASE, Republic of Korea --  Back pain, especially in the lower back (lumbar spine), is a problem most people experience at some time in their lives.

The muscles supporting the spine are in constant use. Even while simply sitting, the muscles are in use to keep you from falling over. The spine also bends, straightens and twists. Because of this constant stress on the back and the dynamic range of motion of the spine, injuries to the back are very common and can be fairly debilitating.

Lower back pain caused by strained muscles or ligaments is the most common type of back pain (sometimes referred to as lumbago). There are, however, other causes such as damage or injury to spinal nerves, bones or discs.

Generally, if back pain persists for more than three months, it is considered chronic back pain. That doesn't mean wait three months to see a doctor. An aching back can be a symptom of something that requires immediate attention such as a kidney infection.

Back pain lasting several days should be diagnosed and treated by a provider. If the pain is severe or is accompanied by numbness or pain down the leg, a doctor should be seen immediately.

So, if one is experiencing back pain, what should they do? First, see their provider. If they did a lot of heavy or awkward lifting (i.e. moving) or participated in an activity that involved a lot of impact (i.e. doubled their running mileage in one day), they may have strained the muscles in their back. They should avoid doing those activities for a couple of weeks until the pain subsides and are able to move pain free.

If the back pain is more chronic in nature, they should follow a program designed to re-teach the back muscles and the body to work properly and in a safe manner. There are four steps involved: release, lengthen, activate and integrate.
  • Step 1: Release refers to myofascial release using a foam roller. This can be done at home, but one should follow the direction of their provider or physical therapist on proper techniques. This will help to relax the strained muscles.
     
  • Step 2: Lengthen the strained area. This is most easily accomplished using static stretching. The static stretches will re-engage both mechanical and neural adaptations resulting in increased range of motion.
     
  • Step 3: Activate the muscles affected by the strain as well as muscles that may be contributing to the strain. This stage is not intended to result in hypertrophy or substantial strength gains. It is simply intended to appropriately "fire" the involved muscle groups again and do so without excessive strain.
     
  • Step 4: Integrate the muscles in to other activities and exercises. This final stage is intended to re-introduce the rehabilitated muscles of the back in to additional exercises that will utilize the back's stability and strength.
Once the rehabilitation process has been completed, it is time to implement additional core exercises in to the daily fitness routine to avoid future low back strains. For additional guidance on exercises that can be done and/or resources for dealing with low back pain, please visit the Health and Wellness Center.