Back pain. If you’ve had it, you understand. If you haven’t experienced it, you really cannot know how painful and frustrating a back problem can be. It ranges from a dull ache that comes and goes to a searing pain that completely immobilises you, one that you simply cannot push through and “get on with it”. To make matters worse, without the bleeding, bruises, bandages or crutches that accompany other injuries, back-pain sufferers rarely get the sympathy they deserve.
I know it well, and not just from the seventeen years I’ve spent working with the thousands of clients that presented at my Health Matters clinic with spinal issues. It is by far the most common injury, accounting for approximately 70% of my patients and one which does not discriminate between gender or age. About ten years ago, I developed a “Back to Health” programme to educate sufferers on the causes, preventative measures and treatments available, such was the prevalence of back pain.
My greatest teacher, however, was more personal. I first encountered serious back pain in my early twenties while walking down a stairs. Did I slip, trip or fall? No, it was far simpler than that. I was halfway down, took another step, and felt a stabbing pain in my lower back. It came out of nowhere and caught me by surprise especially since, as a full-time fitness instructor, I was quite fit at the time. A few years later, it “went” as I twisted while moving a small ladder out of my way. Another time, mid-squat at the gym, I felt a slight click in my lower back, so ended my workout and went home. The next morning it took five minutes to inch my body out of bed and as long again to navigate my way downstairs, relying more on the banisters for support than the steps.
While these situations were by no means pleasant, they gave me a valuable insight into what it is like to feel like you’re a hundred years old, to be as weak as a kitten and to expect every move to send a lightning bolt through your lower back.
When clients arrive with back-pain, I know what they’re going through and I also know the vast majority can be improved. I’ve been there and back myself and seen thousands return to full health. We discuss their symptoms, what hurts and what helps because it’s not exactly the same for everyone. I talk them through the most likely causes, what we are going to do to restore health and how long it is likely to take. I also provide alternative options in case Neuromuscular Therapy isn’t enough on its own to resolve the issue. Thankfully, very few need alternatives with an average of only one per year requiring surgical means.
Demystification of their condition is of great importance to reduce fear and confusion around back pain as misinformation is common. Every man and his dog seems to be an expert with well-intentioned advice gained through a relative, friend or neighbour that was cured or healed somehow or another.
How many times have you heard of someone getting a slipped disc put back in despite the fact there’s no such thing as a slipped disc? Discs do not slip! Joints can get stuck in misaligned positions and overtight muscles can spasm or cause tendonitis by constantly pulling on their tendon attachments. Muscles, bones or flattened and bulging discs can impinge our nerves causing localised or referred pain to other areas, as is the case with sciatica. Despite all these possibilities, the most common touted cause i.e., slipped disc, is the one that is always incorrect.
Why is this important? Because to treat and prevent a problem, we have to identify the actual cause, otherwise we are working under the wrong premise. We also must identify what led to the situation. Discs don’t just bulge from a single heavy lift. It takes months or years of excessive pressure for a disc to flatten and spread out enough to press on the spinal chord or exiting nerve roots. This is often a result of a misaligned or twisted pelvis which occurs when its supporting muscle groups are off-balance i.e., too tight and too weak on one side.
How do we find these imbalances? By observing posture, gait and by feeling the muscles themselves. How a client walks in the door, sits or lies on the treatment bed and the elasticity, or lack thereof, of their muscle tissue reveals a multitude. I’m a big fan of MRI scans for assessing nerves trapped by bulging discs and torn ligaments but an image cannot show the tension levels in muscles no more than a photograph of a steak can tell you if it’s tender. A trained pair of hands is far more effective in this case.
The in-session conversation reveals even more. Their jobs, hobbies and habits. The everyday activities that engage certain muscles but don’t activate others, leaving them weak. The stresses, responsibilities and emotional baggage they carry that add to the physical tension held within their muscles. “Issues in your tissues” is a very real phenomenon. Long-term use of painkillers or anti-inflammatories allows people to carry on doing what their body is telling them they are not able for. That will inevitably lead to greater issues.
There is no “one size fits all” approach to back pain but there are common causes and general advice that helps most people. When in pain, do whatever is most comfortable. Don’t fight the pain or try to push through it. Remember that your body is using pain to tell you what it can and cannot safely do. Painkillers mask this warning signal, they don’t fix the problem. If your pain doesn’t resolve itself within two weeks, outside intervention is warranted. If it lasts more than six to eight weeks, you certainly need help. That’s how long it takes to heal a fracture, so your injury is worse than a broken bone!
Upright, relaxed posture when walking, sitting or standing and a good firm mattress to sleep on help too, as does a regular, balanced exercise programme. Drink water and plenty of it. Your intervertebral discs will dry out otherwise and become more prone to degeneration and damage. Your muscles, when dehydrated, stiffen and tighten, are more likely to get strained. Eat a variety of wholesome foods so your body has access to the range of nutrients essential for growth and repair. Balance the time you spend working and resting, we need to move regularly for mobility but also to rest so we don’t overdo it.
Whether it stems from physical, mental or emotional issues, it takes many straws to break the proverbial camel’s back. A holistic approach, and the most effective way to address back-pain is to tease out the physical tension, offer means to unload some of the mental and emotional pressure and encourage the adoption of regular self-care through balanced exercise, mindfulness and maintenance treatment if required. Most clients when relieved of discomfort promise themselves to book in every six weeks for keep it right. Very few do as they simple don’t need it and it gives me a great sense of satisfaction when I meet them months and years later to find they’ve been good ever since…