Low Back Pain Self Care
According to the National Institute of Neurological Disorder and Stroke, Americans spent over 50 billion dollars on low back pain per year. Additionally "about 80 percent of adults experience low back pain at some point in their lifetimes. It is the most common cause of job-related disability and a leading contributor to missed work days."(1). So what can be done for low back pain short of surgery?
First of all I want to recommend those with low back pain find an acupuncturist. Studies such as https://www.ncbi.nlm.nih.gov/pubmed/27505963 show that acupuncture may have a favorable impact on low back pain. In my experience acupuncture can have extremely positive effects on low back pain. Tui na, cupping, bleeding and moxas along with herbs and liniments may also be used by a practitioner to foster a client's self healing abilities. In this article I want to focus more on self care. Clients that follow my self care suggestions usually see me very few times as their pain usually quickly subsides.
As mentioned in a prior post, Dr. John Sarno popularized a mind body approach to pain. He suggested that pain, especially low back pain is a defensive mechanism of the unconscious mind to keep painful emotions repressed. When one becomes conscious of the painful emotional content there is no longer a need for the pain. One must therefore work to become conscious of this "unconscious rage." A simple way to begin with this is to write down all the things that come to mind that may have cause one pain. One may also write down current things that may be causing emotional pain. These items should be considered daily in a contemplative manner. Looking at what has been written and considering it can bring up emotional content. This is perfect and one should just feel exactly how they feel about it without reacting or distracting. Just feel it. This is a basic form of biofeedback. One writes down these things and then looks at what has been written allowing painful emotions to surface and integrate. I also recommend reading any of Sarno's work as the simple reading of his books has stopped some people's back pain.
The Ma Roller. This device was created by an acupuncturist with the name of...you guessed it, Ma. Alongside the spine there exist some very important acupuncture points that related to all the organs of the body. This makes perfect sense because the nerves that innervate the organs come off the various levels of the spine. Impingement at a vertebral level may effect an organ or a muscle group. The ma roller is a tool that stimulates these acupuncture points and helps to release muscular tightness of the para spinal muscles. I am a big fan of this tool and recommend it to many people. I worked as a foreman for a moving crew here in NYC where we did grueling days of 3-5 moves per day often with 5th floor walkups. I maintained the ability to work for months straight with only a day or two off partially as a result of using a ma roller daily. One of my guys hurt his back and constantly had shoulder problems. I kept telling him to get a ma roller and use it. When he finally heeded this advice his back was rejuvenated and his shoulder pain stopped.
Commonly when people have acute back pain they say "oh, I need to stretch my back out." They then proceed to forcefully stretch the legs and back out. In general this is a recipe for more problems. When muscles have seized it is counterproductive to try to force them back to the way one thinks they should be. It is better to allow them to release on their own. Yoga as currently taught in America does not take into account that Patanjali stated in the Yoga Sutras that the requirement of an asana are "The posture (asana) for Yoga meditation should be steady, stable, and motionless, as well as comfortable." Comfortable. Stretching a muscle to the max is not comfortable. It is more productive to "stay behind the stretch." By this I mean that a person should perform position in a way that they stay right behind the point where the stretch fully engages. In general one will feel very little. This is the idea behind Positional Release Strain/Counterstrain. One can use asanas for positional release. To do so just take a posture and relax into it without trying to stretch. Often when done correctly one will feel muscles fasiculate and release which allows one to go a little deeper in the position with ease.
The body and its movements can be explored from different positions (standing, sitting, supine, prone and transitions between any of these). If one has a problem bending over, that movement can be explored slowly with curiosity. This allows one to become aware of what is happening in the body through a movement. Are their compensations happening? What is the painless range of motion. As one experiments with their body pain often vanishes. This work should be fun and playful. It is the antithesis of doing reps and acting tyrannically toward the body with another exercise regimen. Play around the pain like a child and see what happens.
Walking is one of the best exercises for back pain. It is best to walk 30 minutes a day. Humans are designed to move slowly over long distances. Walking will decrease the chance of heart attack and appetite and weight are often regulated as a result of regular walking. The legs act as a second heart. As the muscles contract in the legs the blood is pushed throughout the entire body. The moving of the blood mass around the body can help heal the body (low back pain) and benefits the immune system.
Taking time to relax everyday is an essential. By relax I do not mean sit with friends and drink beer. I mean to provide the body and mind the time and method to come to a place of stillness. Herbert Benson's Relaxation Response is a practical place to start in this area. Yoga Nidra is another good place to start. I recommend these recordings of Swami Satyanada Saraswati's version of Yoga Nidra. https://www.youtube.com/user/spandakarika/videos The pacing is pretty good. Many versions of Yoga Nidra drone on so slowly the mind stops following the instruction and the benefit is nullified. Yoga Nidra or other forms of relaxation ala Herbert Benson's method seem to help the conscious and unconscious mind communicate which allows the psyche to unwind. This in turn leads to a much more relaxed and enjoyable life.
This list of self care is a starting point. There are many other alternatives that are helpful, these are a good basic place to start. I hope the reader can find value in this information.