Family Health Magazine - ACTIVE LIVING
Understanding the spine
The spine consists of 24 small bones, called vertebrae, stacked on top of each other. This stack of vertebrae, the spinal column, contains a canal or opening which protects the spinal cord connecting the brain to your body.
Spinal nerves extend from the spinal cord to all parts of the body to provide the connection driving your body's mmovement and co-ordination.
Between each vertebra is a disc or cushion that helps to absorb compression and provide some movement in the spinal column. The lumbar spine (lower back) and pelvis support much of your body weight.
Each vertebra in the spine has boney processes (parts that stick out) to which many ligaments and muscles attach. Some muscles attached to the vertebrae move your body, allowing you to bend or twist. Other muscles provide support, much like a corset or muscular weight belt around the spine.
The muscles of the spine are designed to either move or support you. Supportive muscles of the shoulder, buttocks and torso form a corset around the centre of the body and are often called the core muscles. The shoulder, buttocks and torso (abdominal and spinal) muscles form the core muscles.
Core muscles respond to small changes in the body's position and contract as you move your arms and legs. Ideally, the core muscles automatically support your body. When you experience back pain, these core muscles often take a vacation and do not work well. You must re-train them to work properly even after back pain subsides. To retrain the muscles, you must do core exercises.
The core muscles may not function because pain interrupts the complex system between your core muscles and your brain, changing how and when you use core muscles. Even if your back pain settles, the use of your core torso muscles does not automatically return. If you do not retrain your core torso muscles, low back pain will continue to flare. Preventing a recurrence involves retraining the core muscles.
Reasons for low back pain
Many factors contribute to the start, recurrence or continuation of low back pain.
Bony fractures, muscle strains, ligament sprains, disc irritation or herniation (rupture), spinal stenosis (narrowing of the spinal canal) or sciatica can all result in low back pain. Sciatica, a term referring to low back and often leg pain, ranges from a mild tingling sensation to numbness and severe pain in the lower back, buttock, and all or part of the leg. It is caused by irritation of the sciatic nerve, and varies depending on the source of irritation.
It is always smart to see your doctor to determine the likely cause of your low back pain. You will want to rule out any potentially serious causes of pain. Often the exact cause of low back pain is unknown. Your doctor can provide guidance in medications to manage pain, particularly night pain. A good night's sleep is an essential part of recovery from back pain.
Movement is nature's best remedy for low back pain. You need to move without pain, as little or as much as your body can handle! Moving every 20 minutes is the recommended time frame. You may need help to be able to move without pain. Some benefit from treatments including soft tissue techniques, acupuncture treatments, Gunn intramuscular stimulation treatments (a treatment using acupuncture needles to release muscle tightness and improve the health of the nerves) or spinal manipulation. Typically, these treatments help relieve low back pain. Therapeutic exercises that focus on correct breathing, restoring the movement of your spine, pelvis and hips, and improving your posture (spinal alignment) are essential.
Retraining core torso muscles (your abdominal and spinal muscles, specifically the transverse abdominis and the deep multifidi) with the buttocks and shoulder muscles is effective in treating low back pain. A physical therapist can teach specific core torso exercises and guide you through the exercises. Retraining your core torso muscles is different than other abdominal exercises. These exercises require mental concentration and focus!
Sometimes physical therapists use ultrasound imaging as a visual feedback to help you learn how to use your core torso muscles. Using a back brace or sacro-iliac (SIJ or pelvic) belt may give temporary support and help settle some muscle spasm while you retrain your core torso muscles.
There are four layers of abdominal muscles. The deepest abdominal layer is called the transverse abdominis. The transverse abdominis, along with the deep spinal muscles, form a muscular corset around your torso. This deep muscle corset contracts automatically to support your spine before you move.
If you are inactive or experience back pain, the core torso muscular corset does not always work effectively or automatically. You need to consciously retrain and use the core torso muscular corset to protect your spine and provide a foundation for movement.
The amount of effort required to turn on your core torso corset is similar to the force required to hold a pencil. The mental effort may be 110 per cent!
The sidebar below shows how to retrain your core torso corset muscles, specifically your deep abdominal muscles. Core conditioning classes, some yoga classes, Pilates, tai chi, and Acquacize are often safe types of exercise that can help you avoid back pain. Training and maintaining core torso fitness is a continuous commitment and daily habit which allows you to enjoy moving through life.
Visit www.corekinetics.com to get an easy-to-follow book on getting your core in shape.
Turn on your lower abdominals frequently throughout the day. Activate these muscles, while sitting, standing, walking, lifting or doing sports. You cannot activate your deep abdominal muscles too much! Eventually, these muscles will turn on automatically, without your mental involvement.