“Life can only be understood backwards; but it must be lived forwards” – Kierkegaard
Back and neck pain is extremely common in our society, causing pain and costing billions of dollars in treatment and disability costs per year.
In fact, lower back pain is the number one cause of years lived with disability in the world. Neck pain is number four.
Patients search for answers. They get confused over what’s wrong with them and what treatments will help. They start to think they must need an x-ray, CT scan or MRI scan of their spine to “see what’s wrong”.
While scans are good for detecting serious causes of pain, serious conditions actually make up less than 1% of all spinal pain. And these serious conditions may also be revealed in a good physical examination and blood tests.
Here’s the problem with scans. Typical findings on scans of the spine in anyone over 25 years old are:
1) Disc degeneration
3) Bone spurs
4) Stenosis (narrowing)
5) Disc bulges
And guess what? These findings are present in people with spine pain and without spine pain. That’s right, these finding are frequently present in people without any back or neck pain!
In fact, a recent study found that having a CT or MRI scan of your spine may actually increase the chance of having a worse outcome as you wait months in pain for specialist appointments that are often disappointing to most patients. Surgery is rarely the answer.
In my 40 years of experience, it is infrequent that a scan has altered the treatment, improved patient symptoms and very infrequent that it diagnosed some unforeseen serious condition.
Scans show your anatomy, not your pain. And pain is a very complex process mainly involving your spine, nervous system and brain. You can’t take a picture of it, at least not yet.
What’s Often The Real Issue?
Studies repeatedly show that in up to 95% of scans, neck and back pain is accompanied by profound changes in some of the stabilizing muscles of the spine. MRI scans do show things like fatty infiltration of muscles and muscle degeneration, but unfortunately are not usually mentioned in your scan report. Yet it’s probably the most important finding and the one thing you can do something about.
There’s a concept we discuss in the clinic called “Load-Tolerance”. If your load exceeds your tolerance, pain may result. It may be micro-injury, or it may be your sensitized nervous system on the lookout for possible injury and giving you a warning sign. Pain does not always mean tissue injury or damage.
In daily life, you are placing a load on your spine that it sometimes can’t tolerate or scares your nervous system and brain. The brain creates a pain response to get your attention.
For many people, just sitting all day is putting more load on their back that it can tolerate, and that creates pain. Your brain is yelling at you to get up and get moving.
For others, it’s doing their 1-2 hour walk on the weekend after having only minimal exercise or activity during the week. For some, it’s standing or walking slowly that overloads their muscle capacity. Standing and slow walking place more load on the spine that brisk walking.
Here’s what you can do:
Increase your tolerance for load. Stress causes adaptation.
- You need a good functioning spine, that’s one of our jobs here at Edgemont Chiropractic Clinic.
- Then get strong.
You need at least 30 minutes a day of some exercise activity that you like to do.
Usually any exercise or activity will do, but tell us your exercise program to be sure there are not activities that may be stressful for your spine at this time.
You need at least one hour, twice a week of strength training. Not a day of back exercises, a day of chest, a day of arms and legs. It’s your whole body that needs the integrated strength training.
You need functional strength training. Farm boy / farm girl strength. Your exercise program should include these functional and fundamental movements:
3) Hip hinging
6) Loaded carries
8) A few specific spine exercises as required
9) And a fabulous exercise that puts it all together, the Turkish Get Up. You can learn about it here.
These are the movements you will use in your daily life. You don’t use a bench press or leg press motion too often in daily life. And quit spending all that time training your core. That might be part of your problem. Read about it here.
If you’re getting older, you’re losing muscle at an increasing rate year by year, and getting weaker year by year.
An additional benefit is that we now know that strength training is superior to aerobic exercise in providing some protection from cognitive decline associated with aging.
We also know that 20-30 years of muscle wasting can be reversed in 2-3 months of supervised weight training.
You need good sleep. Sleep helps the body heal and decreases our sensitivity to pain through repair processes in the muscle and the brain.
You should be sure to hydrate and eat well.
And finally, it’s now being suggested that degeneration of discs and arthritis in the spine is not just “wear and tear”, it’s due to the fact that you haven’t had enough “wear and repair” in your lifetime. Sedentary people get more disc degeneration than active people. Load, when appropriately applied, stimulates bone, disc, nerve and muscle cells to produce healthy strong tissue!
And it’s never too late to start.