This time of year, we see an increase in people coming to see us for new episodes of back pain. These often follow a similar sort of story- carrying heavy bags of Christmas shopping, twisting awkwardly bringing the decorations down from the attic, or falling off ladders putting up festive lights.
If you’re struggling with back pain at Christmas, there are a few simple things that you can do to help yourself recover from an acute episode of back pain.
Why do so many of us have back pain?
We (as a society) throw huge amounts of money at back pain. There’s new gadgets, research, more effective drugs, better surgeries and dozens more practitioners out there all touting to be the next big thing in curing back pain, yet back pain remains as prevalent as it ever was. In fact, it seems to be getting worse.
As a really simple demonstration of this, do me a favour- Google “Cervicogenic headache.” Done it? What does it say? That it’s pain referred to the head from structures (i.e. soft tissues and joints) in the neck. So as you see, you could take a paracetamol or sit with an icepack on your forehead but as this isn’t the source of the pain, it’s not going to do much good in the long term. A good clinician needs to look further afield to find out what’s actually causing that pain.
Have a look at the image below- see how forward head carriage can cause dysfunction in your back and thoracic extensors?! What a waste of time it would be just treating the back and not addressing the forward head carriage (i.e. the issue that’s actually causing the pain!)
1) Get in touch with mother nature. No, we don’t mean making skirts out of hemp and running naked through the wilderness (although feel free, if that’s your thing). We mean take your shoes and socks off and feel the ground.
The nerves in your lower back run all the way down to your feet for a reason! Your feet provide feedback to your brain that not only tells your brain where you are in space, but they also provide invaluable feedback to help stabilise your body. Stick some bulky trainers on to stop your feet from being able to feel the ground and those feedback signals sent to your brain get confused, which leads to instability. When the brain feels unsafe, or unstable, it’s going to make things hurt and reduce the amount of movement in the area.
(While we’re on the subject, where most people go wrong is that at this point, right when they have less movement, they strain against it to push the body beyond that threshold. As soon as you go beyond where your body is happy to go, the body has a habit of going into shutdown- it tenses up and produces pain to stop you from doing it again!)
Simply put- the more skin in touch with the ground, the more sensory input your brain gets, which it in turn feeds forward to your spine, giving you more stability and in turn reducing pain.
You’d think, given it’s something you’ve been doing your whole life, that you’d know how to breathe by now. But I bet you don’t! Do yourself a favour- for the next 24 hours, try and pay attention to how you’re breathing when you’re moving. My bet is that you hold your breath when you’re performing dynamic movements. Why? Read on, dear friends and all shall be made clear.
Breathing is closely related to spinal stability. If you think of your body as a barrel, the diaphragm is the top, and the pelvic floor the bottom. The diaphragm regulates our intra-abdominal pressure and contributes massively to our spinal stability. So when our spine is unstable and weak, we hold our breath to perform movements. This is an ill-informed attempt by our brain to increase our intra-adnominal pressure and maintain spinal stability because it’s worried that if we don’t, we’ll become unstable and get injured. Pull that belly button in towards your spine and breathe OUT as you perform dynamic movements- this will engage the good ol’ core musculature and take the pressure of your diaphragm and stop relying on the diaphragm alone to provide spinal stability. 24 hours, focusing on your breathing, that’s all I ask. Being mindful and aware is key to changing your habits.
In a nutshell, part of your treatment programme is going to involve teaching you how to breathe!
Now you understand why back pain can be such a nuisance to treat. Fortunately, you’ve got those two simple steps to reducing your back pain. Doesn’t that sound like a great catchphrase?! Honestly though, if I could give one (okay, two) pieces of advice to every person I see in clinic, it would be those. Create some healthy habits to help your spine and I guarantee you’ll see an improvement.
Until next time…
Want to know a secret? There is no other activity that delivers so many benefits with little effort then sleep. Restful sleep is one of the five pillars of health and getting a good night’s sleep should be at the top of your to-do list this month. Everyone knows there’s nothing like a good night’s sleep for feeling refreshed and alert in the morning. Let’s take on 2017!
Emma’s sleep workshop is on Saturday 28th from 10-12pm at Acorn Health. Tickets must be booked in advance and are £25.00 cash on the day of the event. Please call 01243 379693 to book. We are a small group tackling the common problem so many of us have: how to get a really good night’s sleep.
Are you interested in finding out more information on hypnobirthing, and how it can help you and your partner have the best birthing experience possible?
Hear it from one of Diana’s clients below with her video testimonial.
If you are keen to get started with a full course, Diana runs a 6 week workshop for parents-to-be. Find out more about these workshops here.
Chronic shoulder tension. Knots in your upper back. Stiffness, headaches, neck pain. Sounds familiar? Yep- we see chronic shoulder tension a lot in clinic- but allow us to explain why simply treating the shoulder isn’t going to solve the issue.
Our body moves and functions through a combination of movements in a coordinated group of muscles, ligaments, fascia, tendons and joints. Back pain is our bread-and-butter as chiropractors, and we know from both research and experience that pain in the back doesn’t necessarily mean a problem in the back. That pain could be caused by a problem somewhere completely different- something that often causes a bit of confusion when you come to see us for pain in one area and we end up treating somewhere completely different.
Let us paint you a picture. You work in an office. You’re stuck at a desk all day, sitting on your behind, slouched and worn out by 5PM. Your shoulders are tight and sore, and you can feel the knots building up in your upper traps, giving you a thunderous headache by the end of the day. Now, you know those knots and tense muscles are going to cause problems of their own, so you had an upper back massage two days ago and they should be feeling better… but they’re not. So is the problem the upper traps and shoulders, or is it something else?
It’s a muscle that originates from the spinous processes of T7-L5, the iliac crest around the top of the pelvis, the thoracolumbar fascia in the middle of our back, the lower border of the shoulder blade and the lower 3/4 ribs. (Yep, it’s massive!) All those fibres attach to the humerus (the long bone in the top of your arm). Why are we talking about a muscle in the lower back? Surely a muscle in the lower back controls the lower back, right? Wrong. The lat dorsi actually serves to extend, adduct, flex and internally rotate the shoulder, and lends a mere helping fibre or two to extend and laterally flex the spine. (In case you’re interested- it also helps with our lung function and breathing. Safe to say, it’s a pretty important muscle.)
You’re slouching, your lumbar spine is curved and unsupported, so your latissimus dorsi is stretched beyond the norm and the fibres can’t fire properly. As a result, the muscle can’t complete the role it’s supposed to, the upper trapezius steps in to help and is left to do all the hard work controlling the shoulder itself (Just like that last project your boss asked you and Jane to do together and Jane left it up to you to do all the hard work- thanks Jane….) This leads to imbalance and weakness in both the lats and lower traps not to mention a very grumpy upper trapezius. You’ve tried treating the site of the pain (with that amazing back, neck and shoulder massage) and it feels better for a day or two afterwards but then it comes back.
So we have to look elsewhere- we look at your lower back and find that your latissimus dorsi is, surprise surprise, not happy with life. Now we’ve found that we also need to look at the Posterior Oblique Sling.* The POS includes the latissimus dorsi, glut med (in the back of the hip) and the thoracolumbar fascia (in the middle of our back.) *NB When we talk about one of the “slings” in the body, we’re talking about a specific group of muscles, fascia and ligaments which all work together to stabilise and mobilise the body.
Your lat dorsi isn’t firing properly, which is throwing off the stability in the posterior oblique sling. Your lower back is stiff and restricted, and you can’t laterally flex properly- further compounding the problem with the latissimus dorsi (remember us saying it helps with lateral flexion of the lumbar spine?) So you can see how you’re caught in a vicious circle of dysfunction creating more dysfunction, and, in your case, leading to chronically tight shoulders that just never seem to get better!
Now, there are approximately 640 muscles in the human body, all intricately involved with the others in a chain of movement, that can have a chain of consequences if something in that chain misbehaves. To state the obvious again- each person we see is an individual, and the way dysfunction comes about is different for each person, as is the way in which the body adapts to that dysfunction.
As chiropractors, our job is to work out what’s going on and why (and then work with you to get it better) and this often involves looking at areas that might be quite far afield from where the actual pain is felt- but as you can see, there’s a reason for that.
So where to begin? How can you improve your posture and reduce pain and problems? We’d suggest starting with some simple exercises, and downloading your copy of “Understanding Pain” which will help you get to grips with chronic pain, what’s going on in your body and how you can take back control!
Alternatively, and perhaps best- is to seek professional help and get a diagnosis and treatment plan put in place. You can get started by booking your appointment today.