Patients often visit our office with reoccurring back pain. The problem will come on “out of the blue”, by doing simple activities such as putting on socks, sneezing, or getting out of a chair. People often "have been everywhere" and only received short term relief from the acting therapist or Chiropractor. Most people with this history simply resign to the fact that they have arthritis or a “bad back”.
What is really going on is that the person probably has an unstable spine in one or more areas. An unstable spine results from muscles and/or ligaments around a joint segment that do not have the ability to reinforce the joint and properly support it. The most common cause of an unstable spine is previous injury. The spinal joint segment is sprained, leaving the joint with too much laxity and movement. Other reasons for joint laxity include pregnancy, degenerative arthritis, repetitive spinal stretching, abdominal injury, surgery, hernias, and simply being born with a very flexible spine.
Another common cause of instability, rather than trauma, is repetitive strain to the spine over time. The most common cause of this is prolonged sitting. This especially occurs with jobs that involve sitting in a vehicle for long periods, allowing the tissues to slowly decondition over time, known as "tissue creep".
Spinal instability can lead to chronic back pain or sometimes nerve involvement such as sciatica.
What to do:
If a spinal joint is very unstable due to major trauma or severe arthritis, surgery might be necessary. However, one of the best treatments to correct spinal instability is to tighten up the injured joint. This is not an easy task, and does take a lot of effort and time. The best action is to get a proper assessment of your spine, measuring your range of motion and your strength. A health care professional in the field of physical medicine should be consulted to get the best advice. A graduated, pain free, exercise program will be implemented to best suit your condition. These are the steps involved getting your spine back into shape:
1. Range of Motion
The first goal is to gain good range of motion from the joint. This means get moving! Simple low back stretches and massage can help loosen the muscles that are guarding the unstable area. Joint mobilization or manipulation can be very effective as well. Activities such as walking, swimming, biking and other low impact exercises are good in this stage.
It is important to achieve good range of motion before moving into strength work as you don't want to strengthen dysfunction.
2. Body Weight Exercises
A good assessment by your health care provider will determine what muscles are weak, and help you to target these areas. An example is the core muscles that strengthen your low back. They include the lumbar extensors and the smaller spinal, pelvic, and abdominal muscles that stabile the low back and spine. Working muscle pairs around a joint can help balance the joint and improve stability.
Starting with simple body weight-bearing exercises at this stage, with activities such as Yoga and Pilates, is appropriate. Body-weight exercises (the squat, the bridge, the plank, back arches, and hip hinges) are other exercises that may be prescribed for your spine. Be careful not to load the spine too much, moving into positions of pain. Your back can react to this with muscle spasm.
3. Loading the Spine
The second stage is to strengthen the muscles. This is the stage where you add weight to your rehabilitation exercises. Start slow and again everything should be pain-free.
If you are one of those people that has chronic low back pain or your back will get sore from doing a simple movement, you might have an unstable spine. Get a proper assessment and start your program to wellness. You should strengthen the muscles around an unstable joint in order to tighten it back up. Simple exercises involving inexpensive equipment can be the answer for stabilizing an unstable joint. Just put in the effort, and you will see the results.
Activity Fact: According to the Global Burden of Disease Report, spinal pain is the number cause of disability in the world!