Back Clinic Lower Back Pain Chiropractic Team. More than 80% of the population suffers from back pain at some point in their lives. Most cases can be linked to the most common causes: muscle strain, injury, or overuse. But it can also be attributed to a specific condition of the spine: Herniated Disc, Degenerative Disc Disease, Spondylolisthesis, Spinal Stenosis, and Osteoarthritis. Less common conditions are sacroiliac joint dysfunction, spinal tumors, fibromyalgia, and piriformis syndrome.
Pain is caused by damage or injury to the muscles and ligaments of the back. Dr. Alex Jimenez compiled articles outline the importance of understanding the causes and effects of this uncomfortable symptom. Chiropractic focuses on restoring a person’s strength and flexibility to help improve symptoms of lower back pain.
Can individuals relieve back pain by incorporating core strength training to reduce pain and discomfort in their lower backs?
Introduction
Many individuals worldwide have dealt with back issues that make it difficult to complete any task that they are doing. Many often feel pain and discomfort radiating from the three sections of the back and can radiate from the neck, shoulders, and hips. When these areas of the musculoskeletal system are being affected, it can lead to a life of pain and chronic conditions that cause overlapping risk profiles. At the same time, some causes of back pain often correlate with environmental factors and weak core muscles. When a person is dealing with weak core muscles, they will experience instability and pain when they are mobile, leading to back pain. In today’s article, we look at what the core muscles are, how they are connected to back pain, and how strengthening them can reduce the effects of back pain. We discuss with certified medical providers who inform our patients how strengthening the core muscles can reduce back pain. While asking informed questions to our associated medical providers, we advise patients to incorporate various core strengthening exercises to prevent overlapping risk profiles correlated with back pain. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer.
What Are The Core Muscles?
Do you feel a constant ache or pain in your back after lifting or carrying objects in a hunched position? Do you experience muscle weakness in your torso that you can’t stay in a plank position for a few seconds? Or do you experience radiating pain from your lower back to your leg? The core muscles are a group of muscles wrapped around the torso like a support belt that helps with stability, balance, and protecting the lumbar from injuries. The core muscles are found in the lower body’s front, back, and sides. At the same time, the core muscles can help generate intrabdominal pressure while moving the vertebral column. (Flynn & Vickerton, 2024) In the core muscles, the transverse abdominis muscle or the seatbelt muscle. This muscle works with the inspiratory muscles through elastic loading to evoke transversus expiratory activity when breathing and functioning in motion. (De Troyer et al., 1990)
Core Muscles & Back Pain
The core muscles, especially the transverse abdominis muscles, are often overlooked as many individuals frequently deal with numerous factors that cause low back pain. Common core muscles are associated with back pain because environmental factors can neglect the transverse abdominis muscles. Fatigue in the core muscles can cause repetitive asymmetric loading on the spine, which enhances susceptibility to back pain and other injuries. (Zemkova & Zapletalova, 2021) Since back pain is a multifactorial condition that is one of the leading causes of hospital visits and socio-economic issues, many individuals start to neglect the core muscles over time, causing them to be weak. Some symptoms correlated with weak core muscles include:
When this happens, many people start looking for treatment to reduce their back pain and help strengthen their core muscles.
Discover The Benefits Of Chiropractic Care- Video
Strengthening Core Muscles
Before people reduce their back pain and return to their daily routine, they would have to be assessed by a pain specialist like a chiropractor to assess fully what environmental factors are causing the back pain. After the assessment, a chiropractor can work with a physical therapist to reduce back pain and strengthen the core muscles to prevent back pain from returning. When it comes to core strengthening exercises, they focus on either the deep or superficial muscles of the torso, which might produce different effects on lumbar motion. (Puntumetakul et al., 2021) Additionally, core stability exercises can reduce pain in the back and disability reduction and improve a person’s quality of life. (Kanwal et al., 2021) Engaging the muscles through core strengthening exercises can help achieve optimal strength with twisting and side-bending movements to reduce back pain.
Pay Attention To Engaged Core Muscles
However, individuals need to pay attention to engaging their core muscles while maintaining a neutral spine position for stability and preventing back pain. (Cigdem Karacay et al., 2022) This allows individuals to be consistent with strengthening their core and to commit to short workouts incorporated as part of not only their routine but also as part of their customized treatment plan. When it comes to reducing back pain, it is important to ensure that the core muscles are engaged to help build strength and stability, decrease back pain, and improve functionality. When people start strengthening their core muscles, they will be able to be more mindful about how to present themselves and live healthier lives.
References
Cigdem Karacay, B., Sahbaz, T., Gurtekin, B., Yildiz, S., & Ozcan, E. (2022). Effectiveness of whole-body vibration exercise and core stabilization exercise in chronic non-specific low back pain: A randomized-controlled study. Turk J Phys Med Rehabil, 68(2), 184-194. doi.org/10.5606/tftrd.2022.7060
De Troyer, A., Estenne, M., Ninane, V., Van Gansbeke, D., & Gorini, M. (1990). Transversus abdominis muscle function in humans. J Appl Physiol (1985), 68(3), 1010-1016. doi.org/10.1152/jappl.1990.68.3.1010
Kanwal, S., Yaqoob, I., Shakil-Ur-Rehman, S., Ghous, M., Ghazal, J., & Namroz, N. (2021). Effects of core muscle stability on low back pain and quality of life in post-menopausal women: A comparative study. J Pak Med Assoc, 71(1(A)), 37-40. doi.org/10.47391/JPMA.151
Puntumetakul, R., Saiklang, P., Tapanya, W., Chatprem, T., Kanpittaya, J., Arayawichanon, P., & Boucaut, R. (2021). The Effects of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique versus General Strengthening Exercise on Lumbar Segmental Motion in Patients with Clinical Lumbar Instability: A Randomized Controlled Trial with 12-Month Follow-Up. Int J Environ Res Public Health, 18(15). doi.org/10.3390/ijerph18157811
Wattananon, P., Sinsurin, K., & Somprasong, S. (2020). Association between lumbopelvic motion and muscle activation in patients with non-specific low back pain during forward bending task: A cross-sectional study. Hong Kong Physiother J, 40(1), 29-37. doi.org/10.1142/S1013702520500043
Zemkova, E., & Zapletalova, L. (2021). Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training. Int J Environ Res Public Health, 18(10). doi.org/10.3390/ijerph18105400
Can individuals utilize chiropractic care to reduce sciatica pain and help restore mobility to their lower back and legs?
Introduction
Many individuals are always on the move and utilize the lower half of the body to go from one location to another. From the lower back to the feet, many individuals do repetitive movement that causes the lower back muscles to be constantly stretched. This, in turn, can lead to overlapping risk profiles that can affect the lower back and a long nerve connected to the lower back, known as the sciatic nerve. When numerous issues affect the sciatic nerve, many individuals experience pain and discomfort over time, which can develop into something chronic without treatment. Luckily, when individuals begin to think about their health and wellness, it reduces the chances of pain and discomfort from returning. Today’s article looks at the causes of sciatica and how non-surgical treatments like chiropractic care can help relieve sciatica pain and restore mobility to the lower back and legs. We discuss with certified medical providers who inform our patients how sciatica pain correlates with the lower back. While asking informed questions to our associated medical providers, we advise patients to incorporate non-surgical treatments like chiropractic care to reduce sciatica pain and help realign the body. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer.
What Causes Sciatica?
Do you feel numbness or tingling sensations in your legs, making walking unbearable? Do you experience pain or discomfort in your lower back after lifting a heavy object? Or how long have you stretched your body after sitting down or standing excessively at work? Many of these scenarios are often correlated with low back pain. However, low back pain is always connected with sciatica and can impact the body. While the sciatic nerve plays a huge role in direct motor function to the hamstrings and lower extremities, sciatica is when environmental factors impact or compress the sciatic nerve, causing pain-like symptoms to the lower extremities. (Davis et al., 2024) Since the sciatic nerve is large and travels down to the feet, it allows mobility to the lower extremities. When many individuals experience low back pain, they will also experience sciatica.
Sciatica also means that pain will always be transmitted along the sciatic nerve root, leading to various impairments and socioeconomic consequences and affecting a person’s quality of life. (Siddiq et al., 2020) Many of the causes of sciatica pain can vary as they are all correlated with low back pain. Some of the various environmental factors that can cause sciatica include:
Physical inactivity
Excessive sitting or standing
Poor posture
Musculoskeletal conditions
Another environmental factor that leads to the development of sciatica is disc degeneration. This can cause the nerves to be irritated due to herniation and cause asymptomatic overlapping risk profiles (Zhou et al., 2021). When people are dealing with the overlapping risk profiles of sciatica, many often seek treatment to reduce the pain and restore mobility to the lower extremities.
Sciatica: Causes, Symptoms, & Tips- Video
How Chiropractic Care Reduces Sciatica
Since sciatica is commonly experienced as a frequent symptom cause of low back and leg pain, the symptoms can range from a mild tingling sensation to a burning sensation, and treatment is needed. Many individuals will seek out non-surgical treatments to reduce the pain caused by sciatica. Non-surgical treatments are non-invasive, affordable, and customizable to the individual. One of the non-surgical treatments is chiropractic care, which can help many individuals dealing with sciatica. A chiropractor can diagnose a person’s sciatica and assess the root cause of the symptoms to provide the most appropriate form of treatment. The main goal for chiropractic care is to restore the natural mobility of the spine and provide progressive relief from pain and stiffness in the lower extremities while improving a person’s daily living. (Kruse et al., 2019)
Chiropractic Care Restores Lower Back & Leg Mobility
Chiropractors utilize manual and mechanical spinal manipulation to increase lumbar spinal mobility and flexibility and improve the legs biomechanically. (Siciliano et al., 2024) Chiropractic treatments can also use various methods like neural mobilization intervention to decrease the pain and restore nerve function in the lower extremities and lower back. (Peacock et al., 2023) This allows individuals to have a reduced disability from sciatica associated with low back pain, and it is possible to prevent sciatica from occurring in the future. As many people begin to become more mindful of what is causing their sciatica, they can find effective ways to improve their spine’s well-being and prevent sciatica symptoms from affecting the lower extremities.
Kruse, R. A., White, B. A., & Gudavalli, S. (2019). Management of Lumbar Radiculopathy Associated With an Extruded L4-L5 Spondylolytic Spondylolisthesis Using Flexion-Distraction Manipulation: A Case Study. J Chiropr Med, 18(4), 311-316. doi.org/10.1016/j.jcm.2019.02.001
Peacock, M., Douglas, S., & Nair, P. (2023). Neural mobilization in low back and radicular pain: a systematic review. J Man Manip Ther, 31(1), 4-12. doi.org/10.1080/10669817.2022.2065599
Siciliano, T. B., Gudavalli, M. R., & Kruse, R. (2024). Spinal manipulation and mobilization forces delivered treating sciatica: a case report. Front Integr Neurosci, 18, 1356564. doi.org/10.3389/fnint.2024.1356564
Siddiq, M. A. B., Clegg, D., Hasan, S. A., & Rasker, J. J. (2020). Extra-spinal sciatica and sciatica mimics: a scoping review. Korean J Pain, 33(4), 305-317. doi.org/10.3344/kjp.2020.33.4.305
Zhou, J., Mi, J., Peng, Y., Han, H., & Liu, Z. (2021). Causal Associations of Obesity With the Intervertebral Degeneration, Low Back Pain, and Sciatica: A Two-Sample Mendelian Randomization Study. Front Endocrinol (Lausanne), 12, 740200. doi.org/10.3389/fendo.2021.740200
Can individuals with body pain incorporate Pilates to reduce general aches and pains while strengthening muscles in the body?
Introduction
Environmental factors like poor posture, improper steps, mechanical overload, physical inactivity, and poor dieting can affect a person’s health and wellness, leading to body pains in the neck, shoulders, and back. When this happens, the surrounding muscles become weak and overstretched over time, causing pain and discomfort in different body areas. However, many individuals thinking about their health and wellness can seek various treatment options to reduce the pain and discomfort in their bodies and help improve their muscle strength. Today’s article looks at how body pain can affect posture, what Pilates is, how this exercise regime can be incorporated for body pain, and its benefits. We talk with certified associated medical providers who inform our patients about how incorporating Pilates can reduce body pain. While asking associated medical providers intricate questions, we advise patients to incorporate Pilates as part of their routine and how it can improve their muscle strength. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
How Body Pain Can Affect Posture
Do you experience stiffness or general aches and pains in different muscle areas? Do you often feel constantly tired throughout the entire day? Or do you notice your posture worsening after looking at a computer or phone screen? Many of these environmental factors can lead to pain and discomfort in the body, which then can cause issues that many individuals will tend to ignore until it becomes too much. For instance, environmental factors like obesity are commonly associated with musculoskeletal problems and incorrect body posture, which can be represented as a causal factor for impairment to the body. (Calcaterra et al., 2022) This is because many individuals don’t realize that improper posture can be associated with body pain and, if not corrected, can lead to overlapping risk factors in the musculoskeletal system. Hence, many individuals start seeking treatments to improve postural alignment, but it can also be used to prevent and treat musculoskeletal pain. (Matsutani et al., 2023)
The Non-Surgical Approach To Wellness- Video
What Is Pilates?
While many people seek treatment for their body pain and improve muscle strength, many have started exercising to reduce the stress and discomfort caused by body pains associated with the musculoskeletal system. Since everyone knows that exercising is excellent for health and wellness, it can also help make the body healthier. Many individuals looking for an exercise routine have various options, including Pilates.
Developed in the early 20th century, Joseph Pilates created a system of exercises primarily focused on controlled muscle movement, stretching, and breathing known as Pilates. It has become popular later in the years not only as a physical fitness routine but also as a rehabilitation program. (Byrnes et al., 2018) Pilates uses a combination of repetitive exercises to create muscular exertion and is designed to increase muscle strength and endurance, enhance flexibility, and improve posture and balance. (Kloubec, 2011)
How Is It Incorporated For Body Pain?
While many people are dealing with body pain, some may wonder how Pilates is incorporated into a health and wellness treatment plan. Well, when environmental factors like poor posture and body pain associated with the musculoskeletal system start to cause pain and discomfort to the body. At the same time, that pain and discomfort, if not treated, will also affect the spine’s alignment, causing more musculoskeletal problems. (Shadi et al., 2024) Additionally, Pilates can be combined with non-surgical treatments like chiropractic care to help improve musculoskeletal pain and restore a person’s strength, flexibility, and mobility. This, in turn, promotes mindfulness and a faster recovery. Many individuals will begin to notice that combining a therapeutic exercise method like Pilates and non-surgical treatments can allow the individual to be pain-free and experience additional benefits. This will enable people to understand the impact of stretching exercises caused by Pilates on the components of musculoskeletal fitness aimed at rehabilitation or physical conditioning. (Dos Reis et al., 2024)
The Benefits Of Pilates
Many people will notice how Pilates can help their bodies through these benefits. This includes:
Adapting Pilates to your fitness level and needs: Anyone can start Pilates at any fitness level and go at their own pace.
Core strength increases: Pilates can help strengthen the core muscles, which correlates to improved posture and a strong body.
Strengthening muscles: Pilates can help strengthen and elongate muscles to help individuals look toned.
Natural energy booster: Like many exercise routines, Pilates can give people an energy boost through focus breathing. This increases circulation, stimulating the muscles and spine.
Utilizing Pilates for rehabilitation combined with non-surgical treatment can allow individuals to be more mindful of their bodies and to make tiny changes in their routines. This allows the chances of pain and discomfort from returning, allowing individuals to have a healthier lifestyle.
References
Byrnes, K., Wu, P. J., & Whillier, S. (2018). Is Pilates an effective rehabilitation tool? A systematic review. J Bodyw Mov Ther, 22(1), 192-202. doi.org/10.1016/j.jbmt.2017.04.008
Calcaterra, V., Marin, L., Vandoni, M., Rossi, V., Pirazzi, A., Grazi, R., Patane, P., Silvestro, G. S., Carnevale Pellino, V., Albanese, I., Fabiano, V., Febbi, M., Silvestri, D., & Zuccotti, G. (2022). Childhood Obesity and Incorrect Body Posture: Impact on Physical Activity and the Therapeutic Role of Exercise. Int J Environ Res Public Health, 19(24). doi.org/10.3390/ijerph192416728
Dos Reis, A. L., de Oliveira, L. C., & de Oliveira, R. G. (2024). Effects of stretching in a pilates program on musculoskeletal fitness: a randomized clinical trial. BMC Sports Sci Med Rehabil, 16(1), 11. doi.org/10.1186/s13102-024-00808-6
Matsutani, L. A., Sousa do Espirito Santo, A., Ciscato, M., Yuan, S. L. K., & Marques, A. P. (2023). Global posture reeducation compared with segmental muscle stretching exercises in the treatment of fibromyalgia: a randomized controlled trial. Trials, 24(1), 384. doi.org/10.1186/s13063-023-07422-w
Shadi, N., Khalaghi, K., & Seyedahmadi, M. (2024). Comparing the effects of Pilates, corrective exercises, and Alexander’s technique on upper cross syndrome among adolescent girls student (ages 13-16): a six-week study. BMC Sports Sci Med Rehabil, 16(1), 143. doi.org/10.1186/s13102-024-00933-2
For individuals dealing with newly formed or chronic lower back pain, can making daily walks a part of a weekly routine help relieve pain and discomfort symptoms and prevent strains and injuries?
Walking For Low Back Pain Relief
Walking is recommended to treat and prevent chronic or recurrent lower back pain. A study found that a personalized and progressive weekly walking program that builds up to 130 minutes of moderate intensity can significantly relieve severe lower back pain and prevent future flare-ups. (Pocovi N. C. et al., 2024) Walking is a cost-effective and easily accessible way to relieve lower back pain and prevent recurring or future injuries. It strengthens the back muscles, improves posture, and stabilizes the spine. (Suh JH, et al., 2019) Other benefits include improved overall physical health, posture, and circulation.
How Walking Helps
Walking for low back pain relief and general movement is better than not engaging in physical activities for individuals with recurrent lower back pain. Being sedentary can worsen back pain symptoms. (National Library of Medicine. 2019) Walking is second nature and is easy to incorporate into a weekly routine to help relieve back pain and improve overall health (Macquarie University, 2024)
Increases Spinal Flexibility
Walking and gentle movements increase the lower back’s functional range of motion, improve spinal flexibility, and reduce stiffness. (Smith J. A. et al., 2022)
Stabilizes Lumbar/Low Back Muscles
Walking builds muscle endurance and strength in the paraspinal muscles, increasing lumbar spinal stabilization. (Suh JH, et al., 2019)
Strengthens Core Muscles
Walking increases the body load and strengthens core muscles like the transversus abdominis, which lowers the risk of chronic lower back pain. (Lee J. S. and Kang S. J. 2016)
Improves Posture
Movement of the legs during walking enhances bodily awareness and helps correct posture.(Henry M. and Baudry S. 2019)
Increases Blood Circulation
Walking increases blood circulation to the muscles, supplying essential nutrients to spinal discs. It also reduces the frequency and severity of lower back muscle spasms. (Sitthipornvorakul E. et al., 2018)
Lubricates Spinal joints
Low-impact walking improves synovial fluid production and circulation, lubricating the lumbar spine’s facet joints and other joints that tend to get achy, such as the knees. (Zhang S. L. et al., 2013)
Relieves Inflammation
Walking helps reduce the presence of pro-inflammatory cytokines, like (IL-8 and TNF-alpha) associated with chronic lower back pain. (Slouma M. et al., 2023)
Promotes Weight Loss
Walking and a healthy diet can help individuals lose excess fat, which puts added strain on the lower back and correlates with lumbar intervertebral disc degeneration. (Wang M. et al., 2024)
Stress Relief
Regular walking can reduce mental stress associated with chronic lower back pain. (Choi S. et al., 2021)
Releases Endorphins
Moderate to vigorous physical activity, like walking at about 3 miles per hour for a half-hour daily, stimulates the release of endorphins, the body’s natural pain relievers. (Bruehl S. et al., 2020)
Walking Correctly
To get all the benefits of walking for low back pain relief, it is recommended to practice the following (Macquarie University, 2024)
Start slowly.
Gradually build intensity.
Stay consistent with the walking program.
Track progress to maintain motivation.
Healthcare Provider Consultation
Walking is a low-risk, low-impact activity well-tolerated by most individuals with nonspecific low back pain. (Pocovi N. C. et al., 2022) Because it doesn’t involve twisting or vigorous movements, it is considered a safe exercise for individuals with back pain symptoms (Gordon R. and Bloxham S. 2016). However, individuals experiencing severe lower back pain due to a traumatic injury or medical condition should consult a healthcare provider before starting a regular walking program.
Limit High Impact Activities
High-impact activities like running on hard surfaces or playing sports can exacerbate chronic lower back pain. If there is chronic lower back pain, it is recommended to limit activities that involve: (Al-Otaibi S. T. 2015)
Heavy lifting
Repetitive bending
Twisting motions
Injury Medical Chiropractic and Functional Medicine Clinic
Walking for low back pain relief. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Movement as Medicine
References
Pocovi, N. C., Lin, C. C., French, S. D., Graham, P. L., van Dongen, J. M., Latimer, J., Merom, D., Tiedemann, A., Maher, C. G., Clavisi, O., Tong, S. Y. K., & Hancock, M. J. (2024). Effectiveness and cost-effectiveness of an individualised, progressive walking and education intervention for the prevention of low back pain recurrence in Australia (WalkBack): a randomised controlled trial. Lancet (London, England), 404(10448), 134–144. doi.org/10.1016/S0140-6736(24)00755-4
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. doi.org/10.1097/MD.0000000000016173
National Library of Medicine., & InformedHealth.org [Internet]. Cologne, G. I. f. Q. a. E. i. H. C. I. (2022). Low back pain: Learn More – Why movement is so important for back pain. www.ncbi.nlm.nih.gov/books/NBK284944/
Smith, J. A., Stabbert, H., Bagwell, J. J., Teng, H. L., Wade, V., & Lee, S. P. (2022). Do people with low back pain walk differently? A systematic review and meta-analysis. Journal of sport and health science, 11(4), 450–465. doi.org/10.1016/j.jshs.2022.02.001
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. doi.org/10.1097/MD.0000000000016173
Lee, J. S., & Kang, S. J. (2016). The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. Journal of exercise rehabilitation, 12(5), 463–470. doi.org/10.12965/jer.1632650.325
Henry, M., & Baudry, S. (2019). Age-related changes in leg proprioception: implications for postural control. Journal of neurophysiology, 122(2), 525–538. doi.org/10.1152/jn.00067.2019
Sitthipornvorakul, E., Klinsophon, T., Sihawong, R., & Janwantanakul, P. (2018). The effects of walking intervention in patients with chronic low back pain: A meta-analysis of randomized controlled trials. Musculoskeletal science & practice, 34, 38–46. doi.org/10.1016/j.msksp.2017.12.003
Zhang, S. L., Liu, H. Q., Xu, X. Z., Zhi, J., Geng, J. J., & Chen, J. (2013). Effects of exercise therapy on knee joint function and synovial fluid cytokine levels in patients with knee osteoarthritis. Molecular medicine reports, 7(1), 183–186. doi.org/10.3892/mmr.2012.1168
Slouma, M., Kharrat, L., Tezegdenti, A., Metoui, L., Ghazouani, E., Dhahri, R., Gharsallah, I., & Louzir, B. (2023). Pro-inflammatory cytokines in patients with low back pain: A comparative study. Reumatologia clinica, 19(5), 244–248. doi.org/10.1016/j.reumae.2022.07.002
Wang, M., Yuan, H., Lei, F., Zhang, S., Jiang, L., Yan, J., & Feng, D. (2024). Abdominal Fat is a Reliable Indicator of Lumbar Intervertebral Disc Degeneration than Body Mass Index. World neurosurgery, 182, e171–e177. doi.org/10.1016/j.wneu.2023.11.066
Choi, S., Nah, S., Jang, H. D., Moon, J. E., & Han, S. (2021). Association between chronic low back pain and degree of stress: a nationwide cross-sectional study. Scientific reports, 11(1), 14549. doi.org/10.1038/s41598-021-94001-1
Bruehl, S., Burns, J. W., Koltyn, K., Gupta, R., Buvanendran, A., Edwards, D., Chont, M., Wu, Y. H., Qu’d, D., & Stone, A. (2020). Are endogenous opioid mechanisms involved in the effects of aerobic exercise training on chronic low back pain? A randomized controlled trial. Pain, 161(12), 2887–2897. doi.org/10.1097/j.pain.0000000000001969
Pocovi, N. C., de Campos, T. F., Christine Lin, C. W., Merom, D., Tiedemann, A., & Hancock, M. J. (2022). Walking, Cycling, and Swimming for Nonspecific Low Back Pain: A Systematic Review With Meta-analysis. The Journal of orthopaedic and sports physical therapy, 52(2), 85–99. doi.org/10.2519/jospt.2022.10612
Gordon, R., & Bloxham, S. (2016). A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel, Switzerland), 4(2), 22. doi.org/10.3390/healthcare4020022
Al-Otaibi S. T. (2015). Prevention of occupational Back Pain. Journal of family & community medicine, 22(2), 73–77. doi.org/10.4103/2230-8229.155370
Incorrect manual handling and lifting is a leading cause of workplace injuries. Can health and safety training help reduce injuries and lost workdays?
Correct Manual Lifting Technique
Manually lifting objects using incorrect techniques can lead to acute back injuries, herniated discs, sciatica, and long-term issues like increased risk of reinjury, body misalignment, and chronic back pain. Individuals can prevent spinal disc compression and/or lower back muscle strain by learning to use correct manual lifting techniques. (CDC. The National Institute for Occupational Safety and Health (NIOSH). 2007)
Lifting Guide
Individuals can protect their backs and prevent injury by following simple steps when lifting objects.
Support Base
Ensure there is a healthy support base from which to lift.
Keep feet shoulder-width apart with one foot slightly in front of the other.
Ask For Help
If coworkers or colleagues are available, ask for assistance.
If the load is too heavy, ask for help lifting and moving the object/s.
Use Mechanical Assistant Devices
Use hand trucks, dollies, or pushcarts whenever possible for uneven and heavy loads.
Squat To Lift Object
Bend at the hips and knees only, not the back.
Put one knee on the ground to ensure stability before lifting.
Check Posture
Looking straight ahead, maintain posture upright with the chest out, shoulders back, and lower back slightly arched.
Lift Slowly
Lift with the knees and hips only, gradually straightening the lower back.
Load Positioning
Once upright, hold the load close to the body around the stomach.
Move and Maintain Alertness
Always take small steps.
Maintain alertness as to where you are going.
Keep the shoulders square with the hips when changing directions to avoid twisting and losing or shifting balance.
Rest
If you are fatigued, set the load/object down and rest for a few minutes until you can fully engage in the task.
Squat To Set Object Down
Squat with the knees and hips and set the load down slowly.
Avoid quickly rising and jerking movements, and allow the legs, hips, and back muscles to reset.
Planning and Tips
Lifting anything heavy takes planning to prevent muscle spasms, back strain, and other musculoskeletal injuries. Considerations to keep in mind:
Make a Plan Before Lifting
Knowing what object/s are being lifted and where they are going will prevent individuals from making awkward movements while holding and carrying something heavy.
Set and clear a path.
If lifting something with another person, ensure both agree and understand the plan.
Lift Close to The Body
Individuals are stronger and more stable lifters if the object is held close to their body rather than at the end of their reach.
Make sure there is a firm hold on the object.
It is easier to maintain balance close to the body.
Maintain Feet Shoulder-Width Apart
Keep the feet about shoulder-width apart.
Having a solid base of support is important while lifting.
Placing the feet too close together will cause instability while placing them too far apart will hinder movement.
Take short steps.
Visualize The Motions Involved and Practice The Motions Before Lifting
Think about the motion before lifting.
Practice the lifting motion before lifting the object.
Focus on keeping the spine straight.
Raise and lower to the ground by bending the knees.
Avoid bending at the waist or hips.
Tighten the Stomach Muscles
Tightening the abdominal muscles will hold the back in a healthy lifting position and help prevent excessive force on the spine.
Lift With the Legs
The legs are stronger than the back muscles, so let the leg strength do the work.
Lower yourself to the ground by bending the knees, not the back.
Keep Eyes Up
Looking slightly upwards will help maintain a better spine position and help keep the back straight.
Avoid Twisting or Bending
Face in the direction you are walking.
Stop, take small steps, and continue walking if turning is required.
Back Belts
It has become common for many who work in jobs requiring manual lifting to wear back belts or support. However, research does not show that they decrease the risk of a lifting injury. (CDC and The National Institute for Occupational Safety and Health, 2023) Instead, it is recommended that the belt be thought of as a reminder of where the back muscles are positioned to keep the individual aligned, combined with the correct lifting techniques.
Injury Medical Chiropractic and Functional Medicine Clinic
Training the body and maintaining its optimal health for correct manual lifting techniques requires daily efforts through practice, conscious position corrections, and ergonomics. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Chiropractic Care For Injury Recovery
References
CDC. The National Institute for Occupational Safety and Health (NIOSH). (2007). Ergonomic Guidelines for Manual Material Handling. (No. 2007-131). Retrieved from www.cdc.gov/niosh/docs/2007-131/pdfs/2007-131.pdf
CDC. The National Institute for Occupational Safety and Health (NIOSH) (2023). Back Belts – Do They Prevent Injury? (No. 94-127). Retrieved from www.cdc.gov/niosh/docs/94-127/
Can the Oswestry Low Back Pain Disability Questionnaire help assess how low back pain impacts individuals’ ability to perform everyday tasks and activities and help physical therapists incorporate the outcome measure into an effective treatment plan?
Oswestry Disability Questionnaire
The Oswestry Disability Questionnaire, also known as the Oswestry Disability Index, provides objective data about an individual’s lower back pain. It determines the severity of the pain and how much it limits their daily activities. The questionnaire is a validated measure backed by research that can be used to justify the need for medical treatment. It includes questions regarding the symptoms and severity of low back pain and how these symptoms interfere with regular activities. Lower back pain can result from various causes (National Institute of Neurological Disorders and Stroke, 2020)
Arthritis, including inflammatory types of arthritis like psoriatic arthritis and ankylosing spondylitis.
Lumbar vertebrae compression fractures – usually from trauma or osteoporosis.
Low back surgery – including spinal fusions, discectomies, and laminectomies.
Spinal stenosis
Spondylolisthesis
Scoliosis
How The Questionnaire Works
The Oswestry Disability Questionnaire consists of 10 questions about the impact of lower back pain on daily life. The questions are divided into the following categories: (American Academy of Orthopedic Surgeons, N.D.)
Pain Intensity
How intense is the pain?
If painkillers are used, how much symptom relief do they provide?
Personal Care
Can the patient perform self-care activities like bathing and dressing when experiencing significant pain or limitations?
Whether physical assistance from another person is needed?
Lifting
Can the patient lift objects like weights with or without pain?
Can lifting be performed from the floor or a higher surface like a table if the objects are light, moderate, or heavy?
Walking
If and to what extent does the pain limit the patient’s walking distance and independence?
If an assistive device like a cane or crutches are needed?
Sitting
If so, how much pain limits the patient’s sitting tolerance?
Standing
If so, how much pain limits the patient’s standing tolerance?
Sleeping
If so, how much pain limits a patient’s sleeping duration?
Whether pain medication is needed to help the patient sleep comfortably?
Social Life
If and to what extent a patient’s social activities are limited because of pain symptoms?
Traveling
If so, to what extent does pain limit a patient’s ability to travel?
Employment and/or Homemaking Duties
Does pain limit a patient’s ability to perform job-related and/or household activities, including physically demanding and light duties?
Patients self-report the information and complete it on their own based on their understanding of the extent of their lower back pain and disability.
Each question can be scored between 0 and 5, with 0 indicating no limitations and 5 indicating complete disability.
The scores from all the questions are added together for a cumulative total score of 50 points.
Scores
The Oswestry Disability Questionnaire assesses how much a patient’s lower back pain limits daily activities. This information is used in clinical documentation for medical services. A higher score indicates a greater level of disability, according to the following scoring criteria:
0–4: No disability
5–14: Mild disability
15–24: Moderate disability
25–34: Severe disability
35–50: Completely disabled
Physical therapists must create individualized goals for each patient to develop a treatment plan and receive authorization from insurance companies. One of the most important aspects of a physical therapy goal is that it must be measurable. The Oswestry Disability Questionnaire provides a numerical score to track functional limitations and monitor the range of motion and strength testing. A baseline measurement is taken at the beginning of treatment, and progress is tracked in follow-up visits. A new score is used as a treatment goal. According to a study, the minimal clinically important difference (MCID) for the Oswestry Disability Questionnaire is 12.88. The MCID is the minimum score healthcare providers need to confirm a patient’s progress in function due to treatment. (Johnsen, L. G. et al., 2013)
By tracking changes in the total score before, during, and after treatment, healthcare providers can better assess whether treatment improves symptoms. A decrease in total score by 13 points or more would indicate that treatment is helping to improve a patient’s lower back pain and level of disability. Along with physical examination results, the patient’s score and the severity of symptoms can help healthcare providers determine an appropriate treatment plan.
No Disability
Treatment is unnecessary other than providing advice for lifting mechanics and general physical activity to maintain health.
Mild Disability
Conservative measures, such as physical therapy, exercise, hot or cold therapy, pain medication, and rest, are needed to help alleviate symptoms.
Moderate Disability
More aggressive intervention is needed, which can include extensive physical therapy services and pain management.
Severe Disability
Significant medical intervention is needed, including surgery, pain management, equipment like wheelchairs, and help from a caretaker.
Completely Disabled
Patients are either bedbound or have worsening symptoms, and a caretaker is needed to complete daily activities and self-care tasks.
Injury Medical Chiropractic and Functional Medicine Clinic
Improvements in range of motion, strength, and quality of movement and a decrease in total score can help show the treatment’s positive impact in managing lower back pain. A thorough medical exam and diagnostic tests, such as X-ray, MRI, or EMG, can help determine the underlying causes, discover the cause of the problem, and develop an effective treatment plan. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop personalized treatment programs. Using an integrated approach to treating injuries and chronic pain syndromes to improve flexibility, mobility, and agility and help individuals return to normal activities. Our providers use Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers.
Johnsen, L. G., Hellum, C., Nygaard, O. P., Storheim, K., Brox, J. I., Rossvoll, I., Leivseth, G., & Grotle, M. (2013). Comparison of the SF6D, the EQ5D, and the oswestry disability index in patients with chronic low back pain and degenerative disc disease. BMC musculoskeletal disorders, 14, 148. doi.org/10.1186/1471-2474-14-148
Individuals who sit in an office chair for a long period naturally tend to slouch over or slouch down into the chair. This posture can overstretch the spinal ligaments, strain the discs and surrounding structures in the spine, and contribute to or worsen back pain. Can the right office chair settings help relieve and prevent future injuries?
Work Office Chair
Sitting in an office chair for prolonged periods can cause lower back pain or worsen an existing back problem. The main reason behind this is that sitting is a static posture that increases stress in the back, shoulders, arms, and legs, putting pressure on the back muscles and spinal discs. Over time, incorrect sitting posture can damage the spinal structures. Most office chair customers base their decisions on availability, color, style, and price. However, it’s recommended that individuals learn about fitting seating equipment to their height, frame, or any condition, such as back or hip pain. The controls on or under the armrests and at the bottom of the chair seat, including the levers, paddles, and knobs, are there for a reason. Here are some recommendations for adjusting their work office chair to decrease back and hip pain.
Height Adjustment
The chair’s height affects the quadriceps, psoas, and hamstring muscles, which are important in posture-related back pain. Height adjustment is the primary way to change the angle of the hip joint while sitting. This angle affects the position of the pelvis and the degree of curve in the lower back, which can alter the spine’s normal alignment. (De Carvalho D. et al., 2017) Adjusting the chair’s height can provide a reference for other chair and workstation adjustments.
Back Angle
The hip angle is how close (increased hip flexion) or how far away (less hip flexion) the trunk is to the top of the thigh when sitting. Adjusting chair height can control the angle of the hip joint. When adjusting the height, adjust the degree of flexion at the hip joint to ensure ideal alignment for the individual body frame. A recent study measured the load that sitting has on simulated spinal discs. Researchers concluded that pressure on the spine can be relieved with a more open angle between the trunk and the thigh, that is, the hip joint angle. (Rohlmann A. et al., 2011) The backrest, seat tilt, and lumbar support features help maintain a pain-free back and relieve pressure and tension in the lower back and should be utilized.
Seat Depth
A kitchen chair, for example, may have no back supports or armrests to assist with posture and angle. (Holzgreve F. et al., 2022) When sitting, the individual’s back should be against the back of the work office chair for the best support and a healthy posture. Individuals will want to check and see how concave the seat surface is. If there is a prominent curve, this will cause the back to be rounded when sitting, which can become uncomfortable and lead to back pain. A chair with built-in support or a pillow can help adjust the depth. This means that chair size matters, as different people will need seats of varying depths to match their musculoskeletal structure.
Seat Height
Another way to understand the hip joint angle is to compare the height of the knees to the height of the hips. This is usually the easiest way to assess whether the chair height is right while adjusting. When the seat is right, the feet will be flat on the floor. The feet should reach the floor without causing pressure on the back of the thighs. Individuals with dangling feet, which may be because of their height, should place a footrest or thick book under them. The knees should be approximately level with or lower than the hips. In this case, the level is a 90-degree angle between the hip and trunk, which is stress-free on the hips and back.
Risks
Chair Too High
For individuals who can’t reach their feet to the floor, the chair is probably too high. The Occupational Safety and Health Administration (OSHA) says this is potentially hazardous because it can lead to scooting forward and forgoing the backrest’s support (United States Department of Labor, N.D.) Sitting like this is considered an awkward posture and a risk factor for work-related musculoskeletal disorders (MSD). Musculoskeletal disorders and symptoms caused by awkward sitting posture include muscle fatigue, swelling, pain, numbness, or decreased circulation. (Ng, P. K., Jee, K. S. and Lim, S. Y. 2016)
Chair Too Low
If the knees are higher than the hips, the chair is probably too low, causing extreme flexion in the hip joints. Most individuals’ backs can’t handle this well because their hip muscles are not flexible enough. If sitting with knees higher than hips, the position can cause lower back pain.
Taking Breaks
No matter how comfortable a work office chair is, prolonged static posture is unhealthy for the spine and is a common contributor to back problems and muscle strain. Remember to stand, stretch, and walk for at least a minute or two every half hour to prevent the back from staying in one position for a long period. A quick stretch or minimal movement, like a quick walk, will help. A longer walk will help even more, promoting blood circulation to supply nutrients to all the spinal structures.
Moving and stretching regularly throughout the day will help keep the joints, ligaments, muscles, and tendons loose and promote comfort, relaxation, and the ability to focus productively.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop personalized treatment programs. An integrated approach to treating injuries and chronic pain syndromes improves flexibility, mobility, and agility, relieving pain and helping individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers.
Low Back Pain: Impact and Chiropractic Solutions
References
De Carvalho, D., Grondin, D., & Callaghan, J. (2017). The impact of office chair features on lumbar lordosis, intervertebral joint and sacral tilt angles: a radiographic assessment. Ergonomics, 60(10), 1393–1404. doi.org/10.1080/00140139.2016.1265670
Rohlmann, A., Zander, T., Graichen, F., Dreischarf, M., & Bergmann, G. (2011). Measured loads on a vertebral body replacement during sitting. The spine journal : official journal of the North American Spine Society, 11(9), 870–875. doi.org/10.1016/j.spinee.2011.06.017
Holzgreve, F., Maurer-Grubinger, C., Fraeulin, L., Bausch, J., Groneberg, D. A., & Ohlendorf, D. (2022). Home office versus ergonomic workstation – is the ergonomic risk increased when working at the dining table? An inertial motion capture based pilot study. BMC musculoskeletal disorders, 23(1), 745. doi.org/10.1186/s12891-022-05704-z
Ng, P. K., Jee, K. S. & Lim, S. Y. (2016). Development of Ergonomics Guidelines for Improved Sitting Postures in the Classroom among Malaysian University Students. American Journal of Applied Sciences, 13(8), 907-912. doi.org/10.3844/ajassp.2016.907.912
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