Rick Mowles

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That Aching Low Back

by Rick Mowles, BS, DC, DICAK, DABCO
Vietnam Veteran 1968-1970. 1st Battalion 9th Marines, 3rd. Marine Division

Throughout history man has been plagued by low back pain. In recent times, low back pain has become so common that many authorities relate that nearly everyone at some point in their life will have low back pain that interferes with work, routine daily activities, or recreation. Americans spend at least $50 billion each year on the problem, and it is the most common cause of job-related disability and a leading contributor to missed work. Back pain is the second most common neurological ailment in the United States - only headache is more common. and the second most common ailment that Americans see their doctor - second only to colds and flu.

The spinal column in the human body is made up of individual bones called the vertebra. These blocks of bone are stacked on top of each other to form the spinal column. The spinal cord is enclosed by this stack of vertebrae for protection. At each vertebral level, nerves branch out from the enclosed spinal cord to different parts of the body. This stack of vertebrae are separated at each level by a spongy material called an intervertebral disc. The disc allows the column of vertebra to move relative to each other. These discs also provide a shock absorption mechanism for the entire spinal column. The spinal column is also supported by ligaments and muscles to maintain it’s vertical stability. This could be compared to a tower with supporting ties to maintain stability in an upright position. If there is weakness on one side of the tower then it will lean toward the stronger side. Man can be described as an upright, bipedal animal. The weight of the body is supported by the skeleton, and the upright spinal column with its ligaments and muscles.

  There are many causes of low back pain. The causes are so diverse that it far exceeds the space of this article. We will focus on some very common causes of low back pain. These would all fall under the description of mechanical causes of low back pain. The number one cause in this category would be obesity. 

  Over the past decade, obesity has become recognized as a national health threat and a major health challenge. In 2007-2008, based on measured weights and heights, approximately 72.5 million adults in the United States were obese. It is no coincidence that cases of low back pain have increased proportionately. Human males tend to accumulate fat in the abdominal area whereas females accumulate fat in the hip areas. This increased weight drastically changes the weight bearing forces placed on the spinal column. The intervertebral discs act as shock absorbers. Increased weight bearing stress from obesity puts added stress on these discs. This leads to them degenerating at a much accelerated rate. As the discs lose their structural integrity, the entire spinal column loses its flexibility. Loss of flexibility and the excess weight accelerates the most common type of arthritis called osteoarthritis. This is often called “the wear and tear” arthritis normally associated with the aging process. Mechanical stresses on the vertebra make the body lay down excess calcium which is concentrated on areas of the vertebra with most stress. Over time this can lead to bony deformities in the vertebra and formations of accumulations called bone spurs. These bone spurs are jagged, and pointed. Sometimes these bone spurs form in places along the spine to cause nerve compression and/or irritation. This may be so severe as to warrant spinal surgery to alleviate the nerve involvement.

Obesity can lead to all sorts of compensation of the spinal column with resulting low back pain. This complex problem could be drastically reduced or eliminated by just maintaining proper weight. This is most effectively done by exercise and diet. The exercise should be aerobic and raise the heart rate  for at least 30 minutes a day. The most common and simple way is by just walking. Walking will raise the heart rate to a sufficient level to burn excess fat, help in lowering blood pressure, blood sugar and blood pressure. Exercise also strengthens muscles throughout the body. Muscles that have good tone will do their job of supporting the spinal column. This will keep muscles and ligaments from being easily strained when doing just trivial physical tasks.

Another common factor in low back pain is not wearing the proper shoes. The tallest tower is only as structurally stable as its foundation. The human body is no different. Shoes that properly support the foot structures help in the stability of the spinal column. The most common foot problem leading to low back pain is foot pronation. This condition is described as a flattening of the arch of the foot when weight bearing forces are placed on it. The arch normally helps absorb shock. When the arch is not strong, it flattens and shock from the ground into the foot is transmitted up through the skeleton into the spine. This causes micro trauma to the spinal column structures which eventually will lead to low back pain. The pronation problem can be effectively treated by just wearing good supportive shoesthat have  a strong heel counter. This is the heel part of the shoes that enclose the heel. This part of the shoe should be almost rigid not being able to be moved when pressure is put on that part of the shoe. A lace up type of shoe is the best as it keeps the foot properly positioned in the shoe. Athletic shoes such as Nike have been built to deal with foot pronation by giving a strong instep support in the shoe. Individuals can also be fitted for orthotics. These are orthopedic supports made from a cast of the foot. They fit into the shoe to maintain the proper support of the arch.

So, now you know, something as simple as wearing good shoes, diet and exercise may alleviate or reduce a lot of cases of low back pain. The exercise should be aerobic in nature such as walking, or swimming for 30 minutes a day 3-4 times a week. Prevention is always a better approach than invasive procedures such as surgery for low back pain.

Rick Mowles
Rick Mowles
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