Saturday, January 17, 2009

Lower Back Pain and Strength

"I must be getting old: my back hurts."

It's often said in a joking manner, but all jokes aside, back pain is NOT a side effect of aging. Examples of true aging side effects include a decrease in speed of digestion, loss of vision, and playing BINGO. Lower back pain is often a side effect of having weak lower back muscles.

The picture above is a profile view from the right side of the spine. The thick, marshmallow-shaped bones on the right side are the vertebral bodies. Vertebrae have wing-like structures on both sides called transverse processes (the right side is pointing at the viewer). The vertical yellow tube is the spinal cord, which travels through a hole in the middle of all of the vertebrae (only seen from a view above). The spinal cord has roots that branch out between the vetrebrae's body and "wings". Lower back pain results as a compression of the spinal cord or its roots. In most cases, it is the vertebrae that collapse on each other, narrowing the space between where the nerve passes through.

As you see in the picture above, the red line indicates the compressed nerve. Notice that the space between the top two vertebrae is a little greater than the space where the compression is. Strong lower back muscles (especially a muscle called the multifidus) maintain a healthy length of the spine where there is enough space for the nerve to pass through without any impingement.

Unfortunately, the most popular treatments used today don't offer long term solutions. Examples of these are pain medication, weight lifting belts, and inversion tables.

However, strength training does offer a chronic solution by increasing the space for nerves roots to lie in. It  strengthens the multifidus and other lower back muscles, making them more capable of handling those tough tasks. Finally, training the lower back brings a greater blood flow into the area. With increased blood flow comes more nutrients and greater removal of undesired substances/tissue.

If you have back pain, consider a lower back strengthening routine. Even once set per week has relieved pain for many of my clients.


Unknown said...

Your arrow illustrates the IVF or intervertebral foramen not the spinal canal.
It is thought that up to 30% of the population have disc bulges but no back pain nor leg symptoms.
Exercises strengthen muscles, and in the spine, improve circulation, especially to the disc. In adults the disc has no blood supply of its own, thus exercises help to slow degenerative changes in addition to all the other benefits

Dr. Sean Preuss said...
This comment has been removed by the author.
Dr. Sean Preuss said...


Thanks for reading. No matter how many times I proofread, I always seem to miss something. Thanks for catching the mistake on alluding to the VF.

Taru Fisher said...

Yes, having a MedX Low Back machine in our Redwood City, CA fitness studio has really proven to help strengthen our clients backs and alleviate their back pain - mine included. We love hearing them comment on how they no longer have back pain and can now do some of the activities they had previously given up because of it.

Unknown said...

hey sean, great blog...stubmled over it from Jimmy Moore's, was reading it for awhile before I realized, hey, that's the guy that used to train me sometimes in New York...

anyway, regarding back pain. A good machine, like Fred's MedX can be good at not only preventing back pain, but fixing it as well.

For some foolish reason, I decided to see if I could run 5 miles. I'm 52, and hadnt done any running in about 2 years. I was able to do the run without problems, but a day or so later massive back pain ensued. It was so bad I had to take a couple days off work.

3 or 4 days into this, Eugene (at the serious strength studio) put me thru a light workout on the lower back machine, and I felt better almost immediately. Over the next few days, the back pain vanished, and has never returned.

Needless to say, I haven't run since. Except maybe an occasional short sprint to catch the ferry to work.

Apparently this works when the problem is muscular, the workout saps all the energy the muscles are using to stay tight, they give up, you feel better. Or something like that.

Dr. Sean Preuss said...

Taru-nothing beats a MedX Low Back machine. Be thankful you have it...I hear MedX is going out of business. Keep up the good work with your clients, and thanks for reading.

Fritz-great to hear from you! Thanks for the kind words. I'm glad you learned from your running experience, although I understand the need for an occasional mass transit sprint. Hang in there and keep up the strength training!