How many times have you heard someone casually say, “I have a bad back–it flares up pretty often” or “I’ve had low back pain for 15 years”? While it may feel “common” to have back pain, it’s not normal or good–and you don’t end up with that kind of chronic pain overnight. 

When my patients come to see me, I walk them through some questions that help me understand their day-to-day lifestyle. Why? The best predictor of low back pain is previously experienced low back pain.

The bad habit of back pain

My patients want to understand where their pain came from especially if there wasn’t a big event that triggered the pain (like a car accident or a particularly hellacious CrossFit workout). The reality is, most cases of low back pain are not caused by a single instance outside of specific trauma. Typically, pain is caused by a habit of movement that an individual uses to carry out their normal activities throughout the day. The problem is that the path of least resistance for the body to complete a given task– such as bending down to tie your shoes– may not be the most biomechanically advantageous. 

Let me give an example: when you bend down to tie your shoes how do you do it? Do you think to yourself, “Self, let’s do this right. Bend at the hips, soft knees, push the butt back while keeping the back nice and straight. Engage the hamstrings.” My guess is, you probably don’t. Instead, you create a shortcut like rounding your back to get to your shoes as quickly as possible. We get away with the “shortcut” for a while because the body is incredible at adapting to stresses placed on it. But after a while the cumulative effect of taking these small shortcuts everyday lead to an exhaustion and break down of whatever piece of anatomy has been pulling the most weight in the group project titled “tie the shoes.” And to be clear in this analogy–that’s usually your lower back. 

How do I fix it?

Eventually this pain gets to be so impactful on your everyday function that you come see a chiropractor, physical therapist, or the like. After a couple treatments the pain begins diminishing. The natural cycle of inflammation has passed and you go back to your normal activities. The body was given a break from its shortcuts and then it got some well-needed attention to get worked on. The catch is that this was just a bandaid. If the movement habits remain unchanged in everyday life, it will be just a matter of time before the same issue resurfaces again–and often with a vengeance. This becomes a vicious cycle of “flare-ups” throughout the year. 

The good news is, there’s a different way to treat your pain other than repeating this pain-temporary relief-pain cycle. 

Address the inflammation

To begin addressing your inflammation start with a visit to a chiropractor or physical therapist to allow the natural inflammation to pass. Usually this takes about 3 days if we don’t continue to irritate it. Your practitioner might give you an adjustment, some rehab and mobility work and a set of simple exercise or movement patterns to repeat at home.

Modify your patterns 

Then the next step is to modify our autopilot movement patterns. Each time we bend forward to tie our shoes we pick the scab. What if we use a different method to achieve the same result? Instead of bending down from a standing position you might prop your foot onto a chair. Maybe you drop into the bottom position of a lunge. Both of these alternatives shift the emphasis of stress from the low back into more of a hip dominant movement. The hips were made to have a large range of motion–the low back is not. Now all body parts stay happier because we varied the process. Less stress is put on one specific thing and instead is dispersed throughout the body. It may feel laborious or foreign at first but moving in a conscious way overtime is one of the best ways to correct bad habits and replace them with healthy movements (and, in turn, less pain!)

If we don’t change the activities that got us in pain in the first place, we are doomed to end up back in the same place down the road. Break the mold by moving mindfully instead of gravitating back to more of the same habits.

Suggested low back maintenance exercises

Below are some of my favorite go-to’s for low back pain. Each video offers an explanation of the movement and its benefit. Note: these videos will open in a new window on Instagram. If you have issues viewing the videos you can find them here and here. 

Disclaimer: The content in this post is for general educational and entertainment purposes. Every human body is different and unique and may require a custom approach or modification. This content should not be seen as medical or health advice. You should not self-diagnose, please see me or another licensed practitioner for individual healthcare needs. 

This blog post was originally published on Dr. Zack’s personal blog.

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