What Ails You? Lower back pain

Illustration by Kate Feiffer.

As the bittersweet days of an ending summer near, we prepare for what’s ahead. Fall projects. The Vineyard shuffle. Back to school. Yardwork. The new season offers a menu of backbreaking work, a lot of which we dive into without thinking about the strain on our bodies. Whether you’re boxing up summer clothes, hauling a boat from the water, raking a yard full of leaves, moving from one house to another house, or back in class sitting at a desk all day, your lower back takes a lot of heat. In fact, it’s where we store most of our stress. And unless we do something about it — stretch it out, counteract, lift from the knees, it’s going to scream at us one day, if it hasn’t already. 

So we asked a panel of wellness experts to give us their take. 

Cathleen Jasper, Five Season Acupuncture 

Firstly, one needs to figure out what type of pain is happening. Is it sore and achy? Sharp pain or dull pain? Is it intermittent or constant? Is it severe and requires pain management? Does the pain keep you up at night? Is there a trauma associated with the pain (like a car accident, for example)? Is it worse with movement/exertion or better with movement/exertion? What helps the pain go away (rest, ice, heat, changing positions, medication, nothing)?

All the answers to those questions will tell you what range the imbalance may be coming from — muscle strain, nerve pain or impingements, fascia problems, bone changes, possibly trapped emotional pain, or more.

Treatments: Acupuncture tends to be an excellent way to allow tension and stuckness within the body to be relieved. Almost everyone who receives acupuncture for a low back pain finds some amount of relief. 

You deal with low back pain by minimizing it as best you can, and that can happen in many ways: bodywork, medication, surgery, postural changes, inversion boards, exercises, and even some dietary changes.

As a practitioner of Chinese medicine, the things I have used to help rid back pain are acupuncture, electric stimulation, massage, topical pain salves (like Tiger Balm or arnica), CBD oils (both topical and internal), and recommending stretches/yoga/Pilates (depending on the person).

Posture: Keeping the spine as aligned and tension-free as possible is the name of the game for back/spine health and minimizing low back pain. The No. 1 tip is to listen to your body. If your back is screaming at you that it hurts, don’t push it beyond its limits. Usually when that happens (you push beyond the limits of what your back wants to do), then you are guaranteed to involve a doctor or acupuncturist or chiropractor or massage therapist or products or anti-inflammatory medications, or all these things, to help you on the road to healing. 

Tips for heavy lifting: Never lift and twist! Bend knees to support low back. And if the lifting is just too heavy, get help! 

 

Susan Sanford, president and CEO of Vineyard Complementary Medicine

Prevention and movement is the key to managing and preventing back pain and sciatica [which refers to pain caused by a problem with the sciatic nerve, a large nerve that runs from the lower back down the back of each leg]. Pain — especially sciatic pain — is always preceded by stiffness. Most of us spend most of our day in a bent-forward position, either sitting, bending, lifting, or reaching. We lose the natural inward curvature of our lower spine, and problems result because we push our disc fluid from the center of our disc space to the back (like squeezing a jelly doughnut). When the jelly (your disc fluid) is pushed out, it results in stiffness, can progress to localized pain, and if it gets worse, may cause radiating pain into your hips, buttocks, and leg. 

Treatments: If you have no history of cancer, no weakness, numbness, or bowel and bladder changes, we recommend conservative treatments, including a mechanical diagnosis and treatment program (The McKenzie Method is an internationally acclaimed method of assessment and treatment for spinal and extremity pain), along with acupuncture and chiropractic. Red-flag symptoms can indicate a more serious problem that needs immediate medical attention. 

Strengthening exercises: Perform 10 pushups or standing extensions four to five times per day, especially if you sit all day or bend and lift frequently. 

Posture: The position of your lower back and pelvic affects your entire spine. Ideally, your spine resembles an “S” curve. If you slump you now become a C instead of an S. For sitting, I coach my clients to “do the wiggle back” (wiggle your buttocks as far back into the seat as possible then fill the space created by the curve in your lower back with a lumbar roll).

Tips for heavy lifting: 

  1. Activate your bottom. Draw up your pelvic floor muscles, the foundation of your spine (also known as Kegel exercise).
  2. Draw in your belly.
  3. Keep your box open and square (the area between your ribs and front pelvic bones).
  4. Pull shoulder blades down and back.
  5. Bobble head. Be sure head and neck are loose and relaxed.
  6. Breathe.

My motto is, Do something every day. Even if it’s small, do something to take care of your spine — it’s the center of your immune system. If you take care of it, then it will take care of you. 

 

Sherry Sidoti, FLY Yoga School 

When the body is in great pain, there are many things it can be trying to teach us. Best to look at the whole self when seeking ease in our physical body. We do want to address the physical, yes, in all the ways; skeletal, muscular, our diet, hydration, our stressful movement patterns, how we tend to deal with an overstimulated nervous system — AND we also want to address our life-stuff in the process: possible mental and emotional holding patterns, or where we may be ignoring some of our needs, storing resentment, stress, and blockages. Low back pain is often accompanied by feelings of being unsupported, unsafe, or carrying too big of a life load. We want to seek all the ways we can switch our mind-body connection from the sympathetic “fight-flight-freeze” to the parasympathetic “rest and digest” systems of the central nervous system. 

Prevention: Sometimes we need to “undo” in order for something to be done physically. Take rest or restorative postures when we can. Practice intentional breathing practices where we slow the breath and exhale longer than inhaling. Make amends with those with whom we have conflict. Ask for help from others. There can be great strength in allowing our vulnerability to come through when we are hurting. The body will respond to the person admitting that sometimes the way we’ve been living our life may need a change. Be willing to self-examine, see where change is needed, and heed the body’s calling.

Treatment: Highly recommended is active rest to release the psoas muscle, which is often the culprit of low back pain: Lie on ground with calves and feet up on a chair at 90° for 20-plus minutes twice weekly or more. 

Form your support team of professionals: chiropractor, acupuncturist, body workers, yoga therapists, energy healers, mental health therapists, doctors, physical therapists, etc. You do not have to do this alone.

Breath work, and making sure to stretch the spine in all directions daily: extension (bending backward), flexion (bending forward), lateral flexion (side bending), rotation (twisting), and stabilization (core-strengthening). These can be gentle movements done seated, standing, on back, or on belly. Just three to five minutes daily of stretching the spine can do wonders! Look to create more spaciousness inside, so the body can re-regulate, versus using our muscles to “bully” bones around. Stack the skeleton. Always use whatever part of the body is touching the ground to press down and lengthen up, and then use muscle to support the bones. Just like building a house, foundation first (whatever is on the ground), then the frame (skeletal body); the rest of the house can be layered on top of those two (muscles).

Tips for heavy lifting: Lift by pressing feet firmly into the ground, use your “root” to support your “rise.” It may seem counterintuitive, but lift on an inhale. Focus on drawing the sides of the waist and low ribs away from the center, or spinal line. As you lift, exhale and draw everything into the spine, and into your feet once you are up, before the next movement.

Pain remedies: Dr. Shultz’s Deep Tissue Oil was a magic pain reliever for me when I herniated discs in my spine and my pain was acute. Put it on, alternate hot and cold water in the shower. A minute hot, a minute cold, three to four times each. Careful not to touch your eyes — this stuff is spicy! Follow shower with active rest psoas release (legs up the chair exercise), if possible.

 

Susie Nedley, clinical herbalist, BeeWell MV

A lot of people get depleted over the summer, and I recommend taking good, nourishing herbs to boost your immune system and overall health and vitality. A lot of times, inflammation in the body is what’s going to cause back pain. 

But also make sure you’re getting enough rest, sleep, self-care, and not forcing your body to do more than it’s physically capable of. People starting to do yard work after doing what they’ve been routinely doing throw the body off. Ease into things, and take your time. 

Prevention: Work on strengthening the immune system and reducing inflammation. Adaptogenic herbs are great this time of year. If there’s inflammation of disharmony in the body, adaptogenic herbs go right to it to help. I recommend taking powder adaptogens and mixing them into smoothies. 

Nettles are also super-nourishing if you’re feeling depleted. They’re great, if you can get some dried. Boil water at night and pour over nettles, cover it, and let it steep all night. Drink it in the morning. This is called an infusion, and it’s the best thing. 

Exercises: Lie on the back and pull knees toward chest — it’s good for stretching out hips and lower back, and aligning the spine. 

Remedies: St. John’s wort oil is amazing for muscle pain, soreness, and tightness.