I hear people complain about low back pain all the time.  Among the things people talk about trying or have tried, I do hear the word Pilates come up from time to time.  Can you tell me a bit about how to incorporate in Pilates for low back pain sufferers?

What is low back pain?

Low back pain, the lumbosacral region, may be triggered by a combination of overuse, muscle strain, injury to muscles, ligaments and discs supporting the spine. Over time muscle strain may lead to overall imbalance in the spinal structure leading to constant tension on the muscles, ligaments, bones and discs making the back more prone to injury or reinjure. For example, after straining muscles, lower back muscles in this case, you may walk more in a different way to avoid pain using muscles that aren’t in pain. This can cause strain on other muscles that don’t usually move in that way. 

Common causes of low back pain 

  1. Overuse of muscles, ligaments, facet joints and sacroiliac joints 
  2. Pressure on nerve roots in the spinal canal. 

Causes of Nerve root compression

  1. A herniated disc: can be brought on by repeated vibration or motion or by sudden heavy strain or increased pressure to the low back 
  2. Osteoarthritis: typically develops with sage. Affects small facet joints in the spine. When osteoarthritis develops in other joints such as the hips, it can cause you to limp or change how you walk which may also lead to back pain. 
  3. Spinal stenosis: narrowing of the spinal canal typically develops with age. 
  4. Fractures: of the vertebrae caused by significant force such as an accidents or direct blows to the spine, or compression to the spine by falling on the head or buttocks. 
  5. Spinal deformities: spinal curvature problems such as severe scoliosis or kyphosis State of mind can also have an effect on a person’s level of pain and whether it becomes chronic. Those who are depressed or under stress, unhappy with work are more likely to develop chronic back pain.

Symptoms of back sprain or strain 

  1. Muscles spasms, cramping, stiffness 
  2. Pain in the back and glutes. Pain may develop quickly or slowly over a longer period of time. The pain can be aggravated by weight bearing or specific movements and is relieved by rest. 

Symptoms of nerve-root pressure 

  1. Leg pain. Pain extending below the knee is more likely due to pressure on a nerve than due to a muscle problem. More commonly the pain starts in the buttocks and travels down the back of the leg as far as the ankle or foot. This pain is more commonly known as sciatica. 
  2. Nerve related problems such as tingling, numbness or weakness in one leg or in the foot, lower leg or both legs. Tingling may begin in the buttocks and extend to the ankle or foot. Weakness or numbness in both legs, and loss of bladder and/or bowel control are symptoms of cauda equina syndrome which requires immediate medical attention. 
  3. Cauda equina syndrome is caused by significant narrowing of the spinal canal that compresses the nerve roots below the level of the spinal cord.
  4. Symptoms of arthritis of the spine include pain and stiffness that are worse in the hip and back region. Arthritis pain starts slowly, gets worse over time and can last longer than 3-6 months. It’s generally worse in the morning or after a prolonged period of inactivity. Arthritis pain gets better when you move around. Symptoms due to a back injury and arthritis are similar.

Other symptoms or conditions that may occur with lower back pain 

  1. Depression 
  2. Drug or alcohol abuse 
  3. Unexplained weight loss 
  4. Fever 
  5. History of cancer 
  6. Bladder of bowel problems. 

What increases the risk of low back pain? 

Risk factors that cannot be changed: 

  1. Being middle aged (risk drops after age 65) 
  2. Being male 
  3. Family history of back pain 
  4. Previous back injury 
  5. Pregnancy 
  6. Compression fractures of the spine 
  7. Previous back surgery 
  8. Congenital spine problems

Risk factors that can be changed through lifestyle changes and/or medical treatment 

  1. Not getting regular exercise 
  2. Doing a job or activity that requires long periods of sitting, lifting heavy objects, bending or twisting, repetitive movements and constant vibration such as using a jackhammer or driving certain types of heavy equipment. 
  3. Smokers are more likely than nonsmokers to have low back pain. 
  4. Excess body weight, especially around the waist, may put strain on the back. Being overweight often means being in poor physical condition with weaker muscles and less flexibility all of which can lead to low back pain. 
  5. Poor posture, however slouching alone may not cause back pain. However, after the back has been strained or injured, bad posture can make the pain worse. 
  6. Stress and other emotional factors are believed to play a major role in low back pain, particularly in chronic low back pain. Many unconsciously tighten their back muscles when they are under stress. 
  7. Long periods of depression.

Low Back Pain Prevention 

Nearly everyone experiences low back pain at some time. While there is no clear evidence that you can prevent low back pain there are some things that can be done to help prevent low back pain. They can also prepare you for faster recovery if you do have low back pain. 

  1. Exercises to keep you back healthy and strong. An exercise program that includes aerobic conditioning and strengthening exercises. 
  2. Lift heavy objects safely to protect your back.  
  3. Protect your back while sitting and standing. Ears, shoulders, hips and knees when standing, should be in line with one another. 
  4. Try different sleeping positions that protect your back. If you sleep on your side, try a pillow between your knees. If you sleep on your back, try a pillow under your knees. Try using a small rolled up towel under your lower back for support. 
  5. Wear low-heeled shoes. 
  6. Maintain a healthy weight to avoid excess strain on your lower back. 
  7. Don’t smoke. Smoking increases the risk of bone loss and increases sensitivity to pain. 
  8. Eat a nutritious diet. Getting plenty of calcium, phosphorus and vitamins D may help prevent osteoporosis which can lead to compression fractures and low back pain. 
  9. Manage stress in your life both at home and work.
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