Causes of Lower
Back Problems
we’ll take a look at why so many people develop
back problems. As you will discover, there are many reasons why
back problems can occur, some of which are out of our control and some of which we actually have a lot of control over, such as lifestyle factors. In the next chapter, we will give you a brief overview of anatomy so you can get a clear picture of what is happening on the inside when you have
back problems.
Accidents
One of the major causes of
back problems is
accidents. Take a moment to think about the ways
accidents might happen:
Slipping and falling down
Tripping over the dog
Missing a step on the stairs and falling down
Climbing down from a ladder and missing the last rung
Having a minor car accident…that little bump in a parking lot
Having a major car
accident
Sports injury
Bumping into a door or a wall
Stepping off a curb the wrong way
Lifting a heavy package the wrong way
These are just a few of the more common
accidents we hear about, but the way people have
accidents is almost as diverse as people themselves.
The reason why
accidents often lead to low back problems is that forces of the accident push the normal healthy functioning of your muscle-skeleton system out of balance. This imbalance may show up right away as
excruciating pain, or it may not show up for weeks or months down the road.
Have you ever noticed a person walking with his or her leg in a cast? The added height of the cast will raise the hip on the side of the injury. Let’s say you injured the right leg. The raised right hip will cause the spine to list to the left side away from
vertical. You won’t walk around bending to the left for very long because the muscle of the lower
back will begin pulling your upper
body back to the right, so that your eyes will be level. However your spine will now be twisted
back to the right.
The muscle and ligaments of your spine will conform to the new position which will, in actuality, further cause strain and sprain. This will become your new “normal.” When you get the cast off after a few weeks, your leg length will be level, however your spine will now be curved to the right. The ligaments and muscle will now have to adapt to the new position. Many times this can cause new or additional ligament and muscle
pain. Proper rehabilitation of this area is essential and can be accomplished by a regular practice of yoga which will help provide a balance to the musculature.
Many people have an underlying problem that goes unnoticed for a long time until an
accident does occur, exacerbating the condition and thus making itself known usually through pain or discomfort of some sort.
Lifestyle
Lifestyle choices also directly affect the health and functioning of the lower
back. This is both bad news and good news. The bad news is that many of us are unwittingly doing things that contribute to or cause low back problems. The good news is that these lifestyle issues can all be addressed — with just a little effort.
Here are some common lifestyle issues that affect the health of the lower back:
Sleeping
Sitting
Your choice of shoes
Existing/Chronic injuries
Pregnancy
Lack of activity or
exercise
Carrying too much weight
Wearing your wallet in your back pocket
Let’s look at how these lifestyle factors affect your lower back:
SLEEPING ON YOUR STOMACH:
Sleeping on your stomach will cause you to rotate your hip in such a way that you can actually strain your lower
back, and it can lead to hip and knee
pain. If you are sleeping on your
stomach, we strongly advise either sleeping on your
back or on your side with a pillow between your knees. This may feel weird at first, but give it a few nights and you will find it becomes familiar, and your
back pain might just go away!
SITTING: What is your posture like when you watch television or sit at a computer? Do you sit upright with your torso over your hips and your feet flat on the floor, or do you slide down into your chair or sofa and put your feet up on the table? These positions put a lot of strain on the lower
back.
Another
position that many people slip into when at the computer is rounding their upper body forward and craning their neck forward. Sitting in this position for many hours every day puts a lot of strain on the lower back. Even with proper position, sitting for long periods of time can cause a lot of compression in your lower
back.
This is true for sitting in cars as well. You may be surprised to learn that most car seats are poorly designed to support your lower
back.
If your job or lifestyle involves long periods of sitting, we highly recommend that you take a break every hour, go for a short walk, or do some gentle stretching.
NOTE: In the
back of this book you will find a link for two FREE downloads: Exercises You Can Do at Your Desk and Tips For Reducing Back And Repetitive Motion Injuries At Work; especially good those who spend long hours on the computer!
SHOES: The kind and style of shoes you wear can greatly affect your
back. Flats such as a ballet slipper style shoe for women (a minimal heel) or a boat/deck shoe for men often do not have a built-in arch to support your foot. Walking in this type of shoe will cause your foot to pronate while walking. This gait alteration will cause your hip to rotate excessively which causes your back to compensate and twist.
Shoes with heels higher than one inch will cause the pelvis/hips to rotate forward causing the
lumbosacral joint to “jam together.” This jamming together of the facet joints causes tissue injury resulting in swelling, muscle spasm and tenderness in the low
back. A person will usually have to sit down or perform low stretches to relieve the
pain. As the
body continues to experience this kind of recurring injury, early onset
arthritis or more serious
back issues can occur.
Wearing and walking in shoes with small pointed heels can also impede your normal gait because it produces a wobbly gait which interrupts the normal heel-toe movement that we all should have.
Wearing a shoe or shoes with excessively worn heels is another factor which produces low
back pain. The wedging or wearing of the heel can alter your gait by causing an excessive roll in the normal heel toe portion of the gait. This will cause the affected hip to drop to the side, possibly jamming the sacroiliac joint and/or the lumbosacral joint.
EXISTING/CHRONIC INJURIES: Existing or prior hip, knee, foot, or ankle injuries can also contribute to low
back pain. Injuries of these types can result in an abnormal gait which causes the hips to turn and the spine will compensate resulting in injury. A surgery that has become more and more common is hip replacement. Before the hip surgery the pelvis is usually out of alignment and the
body has created a new normal position; the muscles and ligaments have adjusted to accommodate the altered structure.. After surgery, the pelvis is returned to a level position. Now, the lower back has to adjust to another new normal
position. Related muscles and ligaments that were compensating for the chronic weak/injured hip now have to readjust and learn a new posture. A similar process takes place after any type of foot, ankle, or knee surgery.
Prior injuries to the lower
back, resolved with or without surgery or proper rehabilitation, are another factor in recurring low
back pain. Muscle and ligament tissue should be actively engaged for at least 120 days to allow proper rehabilitation. Many people think that once the pain is gone that everything is alright. In reality the healing process is only partially complete, and you are very vulnerable to re-injury during this phase of recovery. Sadly, we see all too many cases like this.
PREGNANCY: During
pregnancy most women add an extra 10, 20, 30 or more pounds which adds a lot of stress to the musculoskeletal system. As the abdomen extends forward and down, the low back/lumbar spine curves forward. This extension causes the lumbar and
lumbosacral facets to jam together. As the baby continues to grow and begins to turn, pressure can also be put into the pelvis area causing the
sacroiliac joint to spread and the hips compensate. Many times the sacrum will also rotate and the hips twist causing the sciatic nerve to become involve.
Once a woman gives birth, a whole new series of factors can influence the low
back. The baby is now carried around in the arms of mom or dad. New upper body weight distribution (carrying the baby) causes the lower
back to compensate and work harder as mom or dad gets used to lifting the baby in or out of the car seat, crib, or carrying the baby in the
back pack. Every day household activities such as resting the little one on the mother’s hip while cooking, vacuuming, doing the dishes, talking on the phone, all put tremendous strain on the lower
back.
For the mother,
sacroiliac joints on both side of the sacrum can be very “loose” at this time as well. As a woman’s
body begins to recover from
pregnancy, the
ligaments and muscle of the lower back/pelvis and abdomen begin to tighten and return to their pre-pregnancy state. If the bones are not in proper alignment with the
ligaments and muscles, they may heal in an abnormal
position. Early attention to the area with yoga can help bring this balance to the lower
back.
LACK OF EXERCISE/ACTIVITY: Perhaps one the most effective way to keep your spine healthy and
pain free is with regular movement which introduces flexibility and strengthening. It also helps to remove stress which helps the
body regain balance. We were born to move! Lack of
exercise has the opposite effect: the
body becomes weaker, less flexible, and imbalances stay in the
body — all of which sets you up for injury.
We are not suggesting that you need to engage in two hours of aerobics and
body building every day to get the benefits of movement. On the contrary, some gentle yoga and walking will do the trick. Shoot for 20 – 30 minutes four to five times per week.
And a word to weekend warriors: be sure to take time to warm up before your activities and cool down after. Doing a few of the yoga postures in this book before or after your activity is a great way to prevent injuries.
MAINTAINING A HEALTHY WEIGHT: Study after study shows that people who are overweight are at greater risk for back pain, joint pain, and muscle strain than those who are not. There are a number of reasons for this. First, extra weight can pull on the spine and surrounding structures causing them to tilt or become stressed unevenly. This adds strain to the joints, muscles, and
ligaments of the spine and surrounding areas. Over time, the
back can lose its support and functioning, and an unnatural curvature of the spine may develop.
Secondly, for every extra pound of weight on the
body there is a corresponding increase in load on the joints of the body. Too much load results in wear and tear of these joints, leading to serious complications such as the wearing away of cartilage, bulging discs,
arthritis, and increased pain. Simply put: extra weight puts extra stress on your
body.
Thirdly, most people who are overweight or obese are not engaging in enough exercise or enough activity to keep their weight down. As far as
back care goes, this is tragic because, as mentioned above, the right kind of physical activity is both the prevention and cure for most
back issues.
Additionally, people who are overweight are more likely to feel pain in their
body due to systemic
inflammation associated with extra weight and a diet high in inflammatory foods. So not exercising and being overweight in and of itself can have a spiraling down effect on a person’s overall health and, as well, their spine.