Causes of back pain and the various treatments to help relieve it
I was reading through the June issue of Nutrition Action and focused on an article about back pain. I used to tell my classes in rehabilitation that you really can’t describe the discomfort and often great pain of a bad back unless you have had problems with your back. I hurt my back in high school football. Being a quarterback and having to bend down to get the snap of the ball, the problem was after getting the ball, I couldn’t straighten up fast enough to avoid getting crushed by some big lineman. Getting in and out of the car was a real challenge and took some concentrated effort to manage with a minimum of pain. The article mentioned that the problems with backs have many causes and just about as many treatments to correct the bad back. The problem with the various treatments listed for possible relief of the pain was that most of them were only temporary and often do not work. The article mentioned that about 90% of the time, the cause could not be found as the specific reason for the pain.
I have seen many runners with an anterior pelvic tilt and sway back or an unusual gait trying to get a run in without too much pain. One of the treatments for a bad back is exercise. Many professionals treat a bad back with stretching exercises since many of the problems create muscle spasms in the low back. I went against some of these practices and added strengthening exercises so that after the vertebrae are in alignment, stronger muscle structure would keep the correct alignment. The starting exercises were often isometric exercises that used the muscles of the back as stabilizers and not movers. It seemed to help a good number of people that had minor back problems.
There are several varieties of back stretching apparatus that help release the pressure on the nerves coming out of the spine. The one that seemed to be a big favorite was the gravity boots that hooked to a bar in a door jam and the person hung upside down to let the vertebrae stretch out. The problem with this treatment was getting out of the hanging position since you had to reach up to the bar and unhook the boots. Another problem was the blood rushed to the head and ended with the person having bloodshot eyes. I tried hanging by my knees and holding a weight to add extra pull on the back. The problem with any of the apparatus that has you hanging by your feet or knees is that the cause may be in the hip and low back area. The iliopsoas muscle runs from the low back and pelvic girdle to the upper femur bone in the leg. When it is tight, it causes a sway back and this, in turn, causes some pinching of the nerves in the back. I found one apparatus that had me hang from my upper thigh muscles and bent forward at the hips. This took the tight iliopsoas muscle out of the equation and really stretched the muscles in the back. This worked best for me.
Added problems come from the discs between the vertebrae that start to bulge and put pressure on the nerves. Discs in some older people start to degenerate and cause pain. Then there are problems from bone spurs that are irritating the nerves. Add inflammation to the facet joints (the bones that come out the sides of the vertebrae) and this brings more problems. The causes of back problems are many and often complicated with several sources causing the pain.
Treatments are as many as the causes of back pain. Surgery, muscle relaxants, steroid shots, pain relief medicine from over-the-counter pills to major prescription dosages and exercises that stretch and strengthen the muscle of the spine are some examples. Some runners have tried acupuncture and others have tried spinal manipulation from a therapist or chiropractor. Most have some sort of temporary relief but usually do not work for the long-term, pain-free back. There is no single treatment that gives relief to a person and a person needs to give several methods a try to see if one works better than the others. The one point the article mentioned is that the practice long ago of rest and limited movement is not recommended. The advice now is to keep moving as much as you can without limiting your lifestyle. Running seems to be a good treatment when the person levels out the pelvic girdle and strengthens the muscles in the core area. The upright posture helps with less pain in many cases. Causes and treatments are varied and often after a time, the pain may go away by itself.