The research is in and movement, more than surgery, pills, or adjustments, is the number one way to heal your lower back pain. No procedure in the world is more efficient than focused back pain exercise for treatment, done well, in a progressive program that prioritizes quality movement.
In August 2017, Vox compiled a comprehensive guide to treating lower back pain. Vox reviewed the research of over 80 studies and found overwhelming evidence that movement, more than any other form of treatment, is the answer to solving lower back pain.
Your Movement Matters
You need to move, and move well. Movement is critical to your survival and longevity.
Practitioners have known for ages but recently, science has come to the party. The evidence is mounting and Vox has spearheaded a systematic review to uncover the truth of low back pain.
Systematic reviews are a syntheses of research evidence that bringing together the highest quality studies to come to a fully supported conclusion.
As a certified strength and conditioning specialist, doctor of physical therapy, author, and speaker with MobilityWOD, I have reached over 10,000 athletes and coaches worldwide. As a former Marine Corps officer, professional athlete, and an eternal academic, I have witnessed human movement and mindset play out at the highest levels.
With the top researchers, scientists, and thousands of hours of practical knowledge behind me, I have uncovered the top five pieces of evidence to healing lower back pain.
1. No One Dies of Low Back Pain! They Die From the Treatment
Thankfully, no one dies of back pain.
But, how in the world do people die from the treatment?
“Mainstream medicine is failing people with chronic (more than three months) of back pain. Low back pain is one of the top reasons people go to the doctor and if effects 29% of adult Americans, according to surveys. It’s also the leading cause of missing work anywhere in the world. The US spends approximately $90 billion a year on back pain more than the annual expenditure on high blood pressure, pregnancy, and postpartum care, and depression – and that doesn’t include the estimated $10-$20 billion in lost productivity related to back pain. “1
85% of low back pain is diagnosed by a medical doctor as, “nonspecific low back pain.” From a physical therapist standpoint this only means doctors do not know the cause. They leave it to the anatomists and movement experts to figure it out. When I receive a patient with this diagnosis, my focus is figuring out where the cause of the injury, pain, impairment, and tenderness is coming from. To truly heal, you need to find the root cause of the problem. Without treating the cause, like most chronic injuries, the pain will return.
“About 90 percent of the time, low back pain is short-lived (or in medical lingo, “acute”) and goes away within a few days or weeks without much fuss. A minority of patients, though, go on to have subacute back pain (lasting between four and 12 weeks) or chronic back pain (lasting 12 or more weeks).
Chronic nonspecific back pain is the kind the medical community is often terrible at treating. Many of the most popular treatments on offer from doctors for chronic nonspecific low back pain — bed rest, spinal surgery, opioid painkillers, steroid injections — have been proven ineffective in the majority of cases, and sometimes downright harmful.
Consider opioids. In 2017, more than 30,000 Americans will die from opioid overdoses. Opioid prescribing is common among people with back pain, with almost 20 percent receiving long-term opioid prescriptions. “1
This seems difficult to fathom, but unfortunately, due to the conflicting info on pain, how to treat pain, and lower back pain specifically, rest and drugs become the answer. In my CPR and First Aid class there is an entire section on treating opioid overdoses. This was not the case two years ago.
2. Without a Brain You Wouldn’t Have Pain
The Scarecrow from Wizard of Oz wished he had a brain. Little did he know, without a brain, he could not feel pain.
Our brains are the control centers for movement, experiences, perceptions, and pain.
The evidence shows back pain is a complex, biopsychosocial condition. Our anatomy and physiology play some role but so do psychological factors.
The brain-body connection directly determines your resiliency and recovery when injuries happen.
“When you compare people with the same MRI results showing the same back injury- bulging discs, say or facet arthritis, some experience terrible chronic pain while others report no pain at all. People who are under stress or prone to depression, catastrophizing, and anxiety tend to suffer more, as do those with history of trauma or poor job satisfaction.”1
Your brain-body connection matters to your healing. Evidence shows a healing practice of connecting these two things is key.
3. Why Does my Back Pain Seem to be Spreading?
“I feel like I have rested enough, but now my back pain seems worse and is spreading.”
I get this statement a lot in my clinic.
“A new understanding of pain called “central sensitization” is also gaining traction. The basic idea is that in some people who have ongoing pain, there are changes that occur between the body and brain that heighten pain sensitivity — to the point where even things that normally don’t hurt are perceived as painful. That means some people with chronic low back pain may actually be suffering from malfunctioning pain signals.”1
In my practice, to retrain these malfunctioning pain signals, you need to slow your movement and mind down to change the faulty signals.
While this seems easy in theory, it is hard to do. People appreciate guidance in this area on how to slow down and connect.
Sitting still and following the breath is a simple tool that allows you to slow down and create this connection. The benefits of the breath are felt throughout the nervous system, helping relieve stress, and also in the intra-abdominals that support the spine throughout the day.
4. Alternative Therapies for Treating Low Back Pain – Useful or Quackery?
Common alternative therapies such as acupuncture, chiropractic, and massage are often met with many opinions but very little science.
Without going to go into detail on every therapy, I want to talk about active versus passive therapies.
Active therapies (exercise, Physical Therapy) involve teaching movement or having someone perform movement themselves.
Passive therapies include manipulation, massage, needling, etc. They do not require the client to move. Instead, in passive therapies, clients relax and experience the work being done for them.
“Research has mounted suggesting active therapies (exercise programs, Pilates, movement based physical therapy, yoga, tai chi) can really help people work through back pain, and alternative approaches (massage, spinal manipulation) can be effective, too — with the caveat that they’re often no panacea and the effects tend to be short-lived and moderate. “1
So, does spinal manipulation (a passive therapy) by a chiropractor, osteopath, or physical therapist help?
“Spinal manipulation, the cranking and tweaking on offer when you visit a traditional chiropractor, is among the most popular approaches to back pain. Practitioners lay their hands on the patient and move their joints to or beyond their range of motion — a technique that’s often accompanied by a pop or crack.
There is some evidence the approach can help people with chronic back pain — but not any more than over-the-counter painkillers or exercise.
Avoid practitioners who routinely make X-rays or do advanced diagnostics for low back pain because this adds nothing to the clinical picture, particularly in the case of nonspecific low back pain. Patients should also beware of practitioners who put them on extended programs of care (i.e. where you are needing to see a health professional 2-3 X a week for a year). “1
Using diagnostic tools such as imaging devices is often unnecessary. Due to the lack of understanding by the consumer or patient, a doctor or practitioner can use this as a means to educate the individual as to why they need to be on a program for an extended period of time. The only extended program a person should be on is a low back pain exercise program that is strength based.
Active therapy such as “exercise is helpful for a number of reasons: It can increase muscle strength, which can help support the spine; It can improve flexibility and range of motion in the back, which can help people’s functional movement and get them back to their normal living; it can boost blood flow to the soft tissues in the back, which promotes healing and reduces stiffness. These are the reasons why researchers who study back pain suggest opting for low back pain exercises before some of the passive therapies like acupuncture or massage.”1
So, to save your spine and your pocket book, put yourself on a low back pain exercise treatment program.
5. Back Whisperers Exist
We know active, therapeutic exercise with resistance training, flexibility, and a mindfulness approach is the most beneficial.
“Studies comparing exercise to no exercise for chronic low back pain are consistently clear: Physical activity can help relieve pain, while being inactive can delay a person’s recovery. Those researchers suggested that a combination of exercises — strength training, aerobic exercise, flexibility training — may be most helpful to patients. Further, according to a recent systematic review (a top dawg of research studies), “core stabilization programs have been shown to significantly reduce chronic low back pain by 39-76.8% and a muscular strength program significantly reduces back pain by 61.6%”1
To simplify; movement, mindset, resilience, mobility, and stability all wrapped into one program, you need a back whisperer. You also need a low back pain exercise treatment program.
Lucky for you, like Tim Ferris, we have a 4-hour body approach. Dr. Theresa Larson and movement & strength coach Anders Varner (aka back whisperers) are providing you a four hour per week training program called The Low Back Fix. This program is not a one size fits all and is customized to your specific limitations. This program will teach you the nuts and bolts of breathing more efficiently with your diaphragm, treating you for your mobility or stability restrictions, and finally working on movement patterns you will need to be efficient in life.
To get you started, Dr T. and Coach Anders have created a short, 6-minute morning routine to jump starts your day with less pain, less stress, and quality movement.
Gain Access to your free morning routine below!
1 Belluz J. A comprehensive guide to the new science of treating lower back pain. Vox. https://www.vox.com/science-and-health/2017/8/4/15929484/chronic-back-pain-treatment-mainstream-vs-alternative. Published August 4, 2017. Accessed October 8, 2017.