HEALING LOW BACK PAIN

By Bryon Holmes

Low back pain is a common condition affecting many people at some point in their life. It is one of the top ten most expensive health care costs in America and it is the number three reason, behind skin disorders and joint pain, for doctor visits.

Back pain is often attributed to soft tissue, including muscles, tendons and ligaments. Most low back injuries occur during an "unguarded movement." This movement occurs when an individual has to suddenly react to his or her environment. Injuries also occur when an individual turns, twists or bends in an unusual manner. All injuries occur because some external load exceeds structural capacity.

Back pain can be categorized into two phases: acute pain and chronic pain. Back pain is considered acute during the first six weeks. Most low back pain, 80 percent, will resolve itself within six weeks regardless of the intervention.

Back pain that continues beyond six weeks is considered chronic. When an individual is suffering from low back pain, it is natural to splint or guard any movements that cause pain. Pain leads to disuse, disuse leads to muscular atrophy and atrophy leads to weakness. Weakness decreases our structural capacity and predisposes an individual to injury. This continuous cycle is referred to as the "chronic deconditioning syndrome." Because back pain limits all of our daily activities like walking, sitting, standing and lifting, the whole body becomes weaker.

Loss of strength and range of-motion are a common denominator for all causes of low back pain. Primary treatment goals should focus on increasing strength and range-of-motion of the lumbar spine, also considered the weak link. The lumbar spine moves primarily in flexion and extension, or forward and backward bending.

Isolating this movement is a very effective way to target the weak link for exercise. Isolated movement serves to reduce the guarding and splinting one experiences with back pain by re-establishing the brain to muscle connection needed for normal function.

The movement also maintains a healthy disc environment by moving fluid across the disc space. The small facet joints in the spine respond to movement by increasing the production of synovial fluid, which allows for smoother movement. The connective tissue responds to movement by aligning the cells that make up the ligaments and tendons and increasing their strength. The skeletal system also responds to strength training by increasing the bone density of the spine.

Isolated low back exercise will increase the structural and functional capacity of the lumbar spine. A comprehensive treatment plan will also include general conditioning exercises for upper and lower body muscles and cardio-vascular endurance. Remember the deconditioning syndrome has impacted the entire body.

Most low back pain is preventable with specific strengthening exercises. It can be treated and managed successfully with a well designed exercise program that isolates the weak link, provides an overload stimulus to strengthen it and addresses the whole body deconditioning that occurs with chronic pain.

This type of treatment approach will positively affect the psychologically depressing effect of chronic pain by empowering the client with the ability to participate md be directly responsible for the positive outcomes that )ccur from their efforts.


Bryon Holmes, MS, completed his graduate research in spinal exercise at the University of Florida. He was co-director of the spinal research clinic and certification program at the University of California, San Diego. He continues to do spinal rehabilitation certification prorrams and has been the co-owner of MedX of Estes for 20 years.

Isolated movement serves to reduce the guarding and splinting one experiences with back pain by re-establishing the brain to muscle connection needed for normal function.

Back pain can be categorized into two phases: acute pain and chronic pain. Back pain is considered acute during the first six weeks. Most low back pain, 80 percent, will resolve itself within six weeks regardless of the intervention.