Lower back pain and disc degeneration
Updated: Sep 29, 2018
Our lovely little studio has only been open a couple of months but already we're noticing that many of our clients are coming to us with something in common. It is not their gender, or their profession, or their age. It is not their body shape, their body size or even their shoe size (although it would be funny if it was). It is not their experience, or lack of experience, of doing Pilates. It is - you've guessed it (or you've just read the title of this blog) - the fact that many of them are coming to us with a history of lower back pain.
But that's no real surprise. Studies undertaken by the NHS have concluded that back pain accounts for the largest single cause of disability in the UK, with lower back pain alone accounting for 11% of the total disability of the UK population.* Whilst we would always advise going to your GP to check the underlying cause of any acute or chronic discomfort, some causes of back pain are preventable and treatable without the need for medical intervention.
One of the leading causes of lower back pain is due to 'disc degeneration.' As we age, the collective force that has been put through our spine over the years starts to impact our nice little cushiony discs that lay between the bones in the back. Initially, this might compress those discs, making them less spongy and pliable, much like a seat cushion that starts to flatten out after many hours of use. This, in itself, can be a cause of significant discomfort as we lose the shock-absorbing quality of the discs. Left unchecked, however, it may result in micro-tears in the disc themselves, creating more pain and making us more succeptible to disc herniation (where the fluid inside the disc starts to ooze out of the fissures and put pressure on the nerves in the spine).
So now we know what might be causing our pain, is there much that can be done about it? Well - in a word, yes. While disc degeneration is a natural and normal part of ageing, there are certainly things we can do to slow down the wear and tear process....
'Core strength' is a much bandied about term in fitness circles, but its importance goes way beyond looking good with not much on. In fact, the main stabilising muscles in our trunk (our transverse abdominus, obliques and our erector spinae muscles) wrap from the back of the body to the front - and, shock horror, they aren't even the ones that give us a six-pack! Slightly deeper set in the body, the muscles just mentioned act very much like a second spine, enabling us to stand upright and to move our limbs in a supported manner. When we lack strength in these muscles, our poor old spine is left to support the weight of the body alone and when it gets tired doing a two-man job, our posture is the first thing to suffer.
So how do we strengthen 'the core'? We hate to break it to you, but the traditional 'sit ups' are just not going to cut it - they may even make the problem worse. Nope, the main little guys we need to strengthen are those muscles mentioned before; our transverse abdominus, obliques and our erector spinae muscles. These muscles are so (SO) important for spine health and strengthening them requires controlled movements in all planes of motion (flexion, extension, rotation and side bending). If the bigger, more superficial muscles are dominant, we need to encourage the deeper musculature to come back from retirement and take over their rightful job as stabilisers! If you are experiencing the beginning of back ache now could be a very good time to enrol in a gentle but effective core-strengthing class; please, please stay away from big gym classes and opt instead for smaller, gentler more targeted classes - think Pilates rather than HIIT - at least until you've retrained those muscles and improved the all important 'core strength.'
Another very important factor affecting disc health is posture and habit and it's worth bearing in mind that sitting down puts the most amount of load on your lumbar spine (lower back) than any other position. Sitting for long periods of the day will also change the balance of muscles, creating tight hamstrings and tight hip flexor muscles which pull the pelvis out of alignment and create even more stress on the lower back. If you do have to sit for long periods of the day, factor in as many little breaks as you can just to take a walk and take some of that pressure off of those discs. And if you take the train into work, do you really, REALLY need to sit down? Breaking these little habits can really do wonders for your back - not to mention your stress levels when you become the only one not fighting to grab a seat. Bonus. If you want to step your back care up even more, do some gentle mobilising movements - pelvic tilts (alternately sticking your bottom out behind you and then tucking your tail bone forwards and under) can be done while seated and while standing and will prevent the lower back from stiffening up over time.
Perhaps the simplest way of improving disc health requires no money, no effort and no strange looks on the train. There is NO excuse not to do this. What is it?
How easy is that?!
At birth, approximately 80 percent of our discs are composed of water. In order to maintain their strength and pliability, we need to keep them well hydrated. We all know we need to drink water