Lower back pain is a leading cause of pain in the United States. In fact, lower back pain is a leading cause of disability worldwide. According to the American Chiropractic Association (ACA), back pain is the leading cause for missed work and second most common reason for a doctor’s room visit. The ACA also states that 80% of the public will experience some form of back pain at least once in their life, mostly from mechanical problems. Why do so many people experience lower back pain? In this post, we are going to explore these questions and shine some light on this problem.
Lower Back Pain And The Economy
According to the Centers for Disease Control (CDC), the United States spends a lot on health care. In 2014, the total health care cost was approximately $3 trillion (17.5% GDP). If you are brave enough to do the math, that comes out to $9,523 per person. The exact proportion of the health care budget spent on lower back pain varies from source to source. The ACA lists $50 billion and the American Academy of Orthopedic Surgeons (AAOS) estimates around $200 billion. Either way that is a lot of money.
The Low Down On Lower Back Pain
The multi-billion dollar question is: why are so many people suffering from back pain? In order to answer this question, we must first understand how the lower back works. The lower back is a section of the spinal column that consists of five vertebrae. They are labeled as L1-L5, L1 being the highest and L5 the lowest. In between each vertebrae is a fibrous disc filled with gelatinous fluid. These discs act as shock absorbers and help to provide mobility for the spine.
When excessive pressure is placed on the vertebral discs, they become misshaped. When this happens, some part(s) of the disc may start to bulge out excessively. If the pressure is too great then the disc may actually move out from between the vertebrae. This is referred to as a slipped disc. When more than half the disc starts to slide out, the problem becomes much worse and is referred to as a herniated disc.
The entire spinal column consists of fibrous discs. Why do the lumbar vertebrae take most of the damage? It all has to do with the leverage being exerted on the discs. In a lever system, the moment of force (torque) an object exerts is greater if it has a longer lever. The lower back is the area of the body an external object exerts the highest leverage on. In particular, the exact spot is the space between L4/L5. This is also where the most back injuries occur.
How The Spine Is Supposed To Work
If there is some master creator who designed our bodies, why did the creator design the spine so poorly? Well, if you want the truth don’t blame the creator, blame the creation! The human body is one hell of a creation. It was designed with the best intentions and has survived the test of time. We are the ones who go and mess it all up.
In any given situation, the human spine is in its safest position when it is neutral. This means that is maintains it’s natural S-shape. If it rounds too much, then we call this kyphosis. If it is caught in too much extension, then it is called lordosis. Much of these two incorrect positions can be brought on by the pelvis. The pelvis determines the balance of the upper body. If the pelvis is tilted anteriorly then you are more likely to suffer from kyphosis and lordosis. Posterior tilt is also a problem for lifters as well, but most cases of pelvic misalignment are from anterior tilt.
As we can observe, the spine merely acts as a connecting bridge between the upper and lower body. It is not designed to be a primary mover for major movements (i.e. squat and deadlift). It’s chief function is to stabilize. The muscles that should be movers for most of these exercises are the muscles in the hips and shoulders. Therefore, most lower back pain can be attributed to muscular imbalances and poor motor patterns with regards to big core lifts.
Piecing Together The “Core”
The core has been misunderstood and misidentified for the past several years. Thanks to mass marketing and advertising we have labeled the core as the abdominal region of the body. Although this has some validity to it, it is not true. The core of the human body contains many muscle groups. These groups are:
- Rectus Abdominus
- Transverse Abdominus
- Erector Spina
- Iliopsoas Complex
- Gluteus Maximus
As we can see the core is much more complex than once thought. Optimal functioning depends on the balance of all of these muscle groups. Some of these muscle groups are more prone to imbalance than others. These include the gluteus maximus and the iliopsoas complex. Lower back pain will be more likely to occur if these muscles are out of balance.
Fix Lower Back Pain By Fixing The Hips
The iliopsoas and glutes malfunction as a result of sitting down for too long. Let’s face it we live in a pretty sedentary lifestyle. We sit for an hour on our commute to work, then sit for 8 hours, sit for another hour on our way home from work and then sit on the couch to watch TV. Not exactly the picture of health.
All of this sitting does take its toll on the body. The iliopsoas gets short and tight and the glutes become weak and inactivated. When the iliopsoas gets tight it pulls the pelvis into anterior tilt and eventually leads to a forward head posture. Without the glutes to balance them out, the hip flexors have free reign over the pelvis. As a result, exercises that are heavily glute dependent, such as squats and deadlifts, will be greatly affected. The hips contain the most powerful muscles in the body. When there is an imbalance here, there is an imbalance throughout the body. Not only will the lower back be affected but so will the shoulders.
To correct this problem, stretch the hip flexors first and then use glute activation exercises to revive the glutes. Then practice perfect posture throughout the day to prevent the problem from happening again. Limit sitting to 30 minutes max. If you work in an office, try to get up and walk around every 20-30 minutes. Just hold some random papers to make it look like your doing something. Your lower back will thank you.