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The Low-Down On Low Back Pain

If you are like most people suffering from chronic low back pain, you probably have been experiencing pain and discomfort for some time.


Many in this boat say that treatment works for a while, but the pain always seems to return. And there’s a reason for that. Often, the pain comes back with a vengeance because sufferers do not truly change what is causing the back pain in the first place.


Unfortunately there is no magic pill to ‘cure’ back pain, but after many years of working with clients suffering from various degrees of the condition, I have seen firsthand how such pain can be managed and alleviated. While exercising and stretching under the guidance of a knowledgeable practitioner plays a huge part in this, I believe that understanding your back pain is of utmost importance.


While I could discuss this subject for weeks, I’ve identified four core concepts to help provide you with a better understanding of low back pain, the cause of your symptoms and the steps to developing a successful treatment plan.


1. Recognize that you may never get a definitive diagnosis.

Over 80 percent of back pain has no identifiable cause. Often times with a diagnosis of HNP (Herniated Nucleus Pulposus) the herniated disc may not be what is causing your pain at all. Rather, it could be the extra 50 pounds your midsection is carrying around or the fact that you sit 10-12 hours a day. Identifying the true cause of your pain will help you carve out the proper plan of treatment that will result in lifelong success.  Which leads me to…


2. Understand that what your MRI report says and what is actually causing the pain are very frequently two different things:

Here’s a great excerpt from a prominent New York radiologist: “Medical imaging is simply one piece of the clinical puzzle. An analogy can be made with astronomy. You can image the universe at visible light, x-ray, ultraviolet, infrared, etc. Each modality provides a vital, but incomplete picture of the universe. You have to put it all together to get the big picture.”


3. Appreciate that where you are feeling pain and the cause of that pain is usually found in two different places.

This point is probably most simply illustrated by the patient who comes in with complaints of pain in the bottom of the foot. Many patients with low back dysfunction will never actually report pain in their low back. Pain at the bottom of the foot can also be related to the lower lumbar nerve root coming from the spine. Even though there may not be any pain in the spine that is the very location where the treatment should be focused. And this is one of the many reasons to seek out treatment from a qualified and knowledgeable practitioner.


4. Acknowledge that even though you may be asymptomatic at this moment, you may still be a structural mess.
So your physician prescribed some medications and an injection or two and your pain has disappeared. Please understand that while those treatments will help reduce inflammation, they do nothing at all to change the physical anatomy of your spine. Your pain will surely return. Most people do not wake up one morning with debilitating back pain (although I do get reports of that all the time), so you will not wake up tomorrow with a sudden cessation of all your pain either. We should focus our time on things that will actually change our physical anatomy, such as stability training, stretching, balance, posture and body awareness.

Which brings me to…


5. Consider starting a Pilates regimen.

See those things I mentioned in the point above. Well, Pilates can help with all of that. Pilates teaches us how to improve the mobility of our spine to decrease stresses placed on damaged discs. It also improved strength and flexibility, which is crucial in the recovery of back pain. A 2006 study reported in the Journal of Sports Rehabilitation found “Pilates can improve general health, pain level, sports functioning, flexibility in people with chronic low back pain”.


Back pain can be a normal aspect of aging, secondary to poor habits or a result of injury. Regardless, it is a condition that should be met with acknowledgment, patience and, even more importantly, a change in lifestyle, particularly exercising and stretching properly.



In Health,


Christa Gurka, MSPT, PMA®-CPT


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