Disclaimer: This blog post is for informative purposes only, and not offering medical advice. Always consult your doctor when in doubt.
If you have low back pain, so anywhere under your ribs and above your glutes, you’re not alone. About 80% of the population of developed countries has episodes of non-specific low back pain. Non-specific means there is no structural damage or condition you can attribute the pain to, it’s mainly your muscles and spine acting up.
For some people, the pain comes and goes. For some, it becomes chronic and part of their lives.
In the UK, back pain is the second most common reason why people miss work days, the first one being mental health (stress, anxiety, depression).
Risk factors and possible causes for Low Back Pain
1. Lack of physical activity and muscular weakness
The spine needs support from the muscles and ligaments around it. If these become lazy and stop doing their job, the bones alone are not very good at carrying weight. There will be more compression between the vertebrae or muscles pulling in wrong directions.
2. Smoking
It’s not yet clear how smoking affects our body when it comes to back pain, but the theory is that it prevents nutrients from reaching the tissues.
3. Obesity
When there is extra weight around the belly, there’s more pressure on your body forward in space. The natural curve of the lower spine (the lumbar region) becomes excessive – that’s called lordosis.
The same situation appears for women in pregnancy and the risk increases with each extra baby.
4. Stress
Chronic stress tenses up the muscles by continuously triggering the fight or flight response.
5. Posture and muscular imbalances
Since I qualified as a Pilates instructor, I’ve done quite a few postural assessments. And no one has a perfect posture, though I really thought that some will be more neutral than others.
There is always something – tight hamstrings, a hip lower than the other, a shoulder lower than the other, a leg that’s more flexible than the other, lordosis or kyphosis (excessive curvature of the upper back).
All these imbalances have the potential to trigger back pain. As I mentioned before, the spine needs support but sometimes some muscles are too tight or some muscles are too weak. And it’s very interesting to see when it’s only on one side!
Alin’s right shoulder is lower than the left and the shoulder blades are very noticeable 
The line should go up from the ankle through the knee, hip and shoulder. Alin’s body is forward
6. Awkward movement patters
Am I the only one who heard about people hurting their backs at the gym moving weights around?! Probably not. There is a proper way to lift weights from the floor.
The back also doesn’t like repetitive twisting and bending, so some manual labour jobs will present more risk than others.
7. Prolonged sitting or prolonged standing
Both of these add pressure on the vertebrae, so it’s good to move around and maybe stretch a bit. Lying on the side is also a nice way to release the pain.
When it comes to compression of the vertebrae, the worst combination is sitting down with a bent spine.
Management of Low Back Pain
1. Exercise
The worst thing you can do is to stop moving. Both Yoga and Pilates will help, but you do have to adapt some movements, I’ll give you some examples below.
According to current research, none of the other self-care strategies you can adopt is as efficient as exercise. Either look for classes specifically for people with low back pain or an instructor who has the proper qualifications. In the UK, Level 3 Exercise Referral and Level 4 Back Pain Management instructors have the knowledge to help you out (I have both of these, just saying! 😉 ).
However, in time, you get to learn what you need to modify during class so that everything feels good for your back.
2. Improving your posture
Working on some of your specific muscular imbalances and increasing core strength might just be what you need to reduce or eliminate the pain.
3. Others
- Massage
- Physiotherapy
- Ergo-dynamics adjustments at work and home (sleep position, seat height, desk position, etc.)
- Anti-inflammatory medication
Exercise recommendations if you have Low Back Pain
- Yoga, Pilates, walking and cycling are all good
- Include core stability and strength
- Include spine mobility, but avoid excessive twisting
- Include varied movements in multiple directions
- Stretch and strengthen all muscles around the spine and hips (that’s most of them haha)
- Avoid high impact activities (jumping)
- Avoid loading the spine (back squats)
- In positions when you’re on your back with the legs lifted, keep the knees bent
When not to exercise with Low Back Pain
- If there is any sign that the pain is due to nerve damage (the pain radiates down on the leg, numbness)
- If there is any sign that you need to see a spinal surgeon (recent trauma, past tumours, feeling unwell all the time, constant and progressive pain even on medication)
- If your doctor says not to
What not to do if you have Low Back Pain
- Stop moving
- Start catastrophizing and allowing negative thoughts about the pain take over
- Avoid doing things you love due to the pain
Yes, pain is not an ideal companion to live with, but when it comes to back pain, feeling some discomfort doesn’t mean that you shouldn’t be doing something.
Keep in mind that pain can be retroactive – you might feel the effect today of something you did yesterday but wrongly blame the current activity.
Let me know if this was useful to you. I’ll be back soon with some movement classes online for back pain specifically, so stick around if that’s of interest to you.
Any questions? Let me know in the comments.
