Back Pain Relief Wiki
Learn how to use specific stretching and relaxation exercises to address the underlying causes of your back pain, which will not only provide relief to your pain, but will help you feel younger, more agile and more in tune with your body than ever before.
An Introduction to Stretching for Back Pain Relief
Almost everyone has suffered from neck or back pain.
Neck or back pain affects between 60 and 85 per cent of people. Probably you are one of these people. In one study, researchers reported that 21 per cent of patients experienced back pain in the fourteen days preceding the study. Another study reported that at least 5 per cent of all patient visits to the doctor are due to back pain.
Tremendous costs are involved.
Neck and back pain account for half the worker’s compensation payments in the United States and Australia: they are the single greatest cause of lost work time in both countries; and lower back pain alone costs over $85 billion annually in the United States (year 2000 figures), about one-third of this amount being the direct costs of medical care. The 10 per cent or so of patients who suffer from chronic back pain account for 75 per cent of Australia’s rehabilitation and compensation payments.
The social cost cannot be calculated—back pain is the most frequent cause of inactivity among people under forty-five years of age. In the US, Great Britain and Australia, the number of people disabled by these problems has increased exponentially since the 1970s, during a period of only modest population increase (Schwarzer, 1996; Rainville, 1996).
However, patients are not the only ones to suffer.
Back pain has been described as ‘a wilderness across whose inhospitable terrain orthopedic surgeons, neurosurgeons, physiotherapists and, above all, general practitioners are doomed to travel’ (Littler, 1983). Most doctors believe ‘there is little doubt that most cases are due to derangement of the intervertebral joint in association with “degeneration” of the disc and arthrosis of the facet joints’ (Ganora, 1984), or, as put more simply, ‘more than 95% of patients with low back pain suffer from mechanical back pain’ (Schwarzer, 1996).
And yet an article in the New York Times about a study published in the New England Journal of Medicine raises serious doubts about these claims: nearly two-thirds of a group studied had ‘spinal abnormalities, including bulging or protruding discs, herniated discs, and degenerated discs’ and, the researchers said, what was identified in this study as ‘pathology’ would be judged to be the cause of any of these patients’ back problems.
The difficulty was that none of the subjects in the study had back pain, or ever had suffered from this problem (Kolata, 1994).
There have been at least eight studies since then with similar results.
What Causes Back Pain?
Most ordinary neck and back pain is caused by excessive tension experienced in the muscles associated with the spine.This tension results from a variety of causes, from structural imbalances to various aspects of lifestyle. These sorts of causes can be identified and treated. Except for a very small percentage of neck and back pain, which can be dealt with successfully by surgery or drug therapy, Stretch Therapy advocates a conservative, exercise-based approach.
If you search the internet, you’ll find that many experts report that tight hamstrings are the cause of low back pain, but in my experience, tight hamstrings are an effect of another cause. Let me explain.
The most common posture seen in the Western world today is an “APT” (as the clinicians like to say); this term is shorthand for “Anterior Pelvic Tilt”. In other words, this term describes a physical shape where the pelvis is tilted forward from “normal*” (we will reconsider this term below) and the main effect of this change in position is that the lumbar “lordosis” (the concave curve in the lower part of the back) is exaggerated, and this change in shape is always accompanied by increased tension in the lumbar muscles (quadratus lumborum and erector spinae, the large muscles on either side of the lumbar spine).
The main reason for an APT is that we spend most of our working and recreational lives sitting these days. It's a simple thing to demonstrate experimentally, but the seated position for most people is also close to the position of maximum shortness for the hip flexors themselves. When I say “hip flexors”, I'm using this as a shorthand for three muscles: psoas, iliacus, and rectus femoris. The last-mentioned muscle is the main culprit in someone who doesn't do any stretching routinely – that is to say, rectus femoris, which crosses both the hip joint and the knee joint, will be chronically tight, and it will be, functionally, the tightest of the three hip flexors. These three muscles, when shorter than desirable, always tilt the pelvis forward and increase the curve in the lumbar spine.
Another quick test: lie down on the floor, trying to relax as much as you can. Now slide a hand in under your lumbar spine from the side – can you fit your hand between your back and the floor? If you are loose enough in the hip flexors, your lumbar spine will rest on the floor. This is extremely rare (based on our experience of classes and workshops, where this test is always done, usually just before we work on hip flexors!), and this is the reason most people need something under the back of their knees to feel comfortable lying on the floor. Lifting the back of the knees away from the floor with a bolster, for example, slackens rectus femoris, and that allows the pelvis to roll back a little and then the lower back can rest on the floor).
If we turn this image on its side and look at the one on the left, we see the most common shape people’s bodies make these days:
In today's culture most people experience their life as stressful, and particularly in the last 12 months (Covid-19). The experience of stress, while quite well understood from a chemical perspective (the “fight or flight response”), also has the effect of increasing the tension of all the muscles in the body – and the ones which are already short or tight from other causes can signal pain once their capacity to absorb stress is reached. And because people spend so much time in the sitting position, with the consequence of shortened hip flexors, the brain experiences this pattern as the ‘normal*’ (in other words, this must be ’normal', because that is how we are spending the bulk of daily life!) – and the pattern is reinforced.
Pain in the hip flexors themselves is unusual, but back pain, partly the result of the anteriorly tilted pelvis, is extremely common. In almost all instances of low back pain, the hip flexors play a partial, or full, causal role. Clinically, we have noticed that increasing the length of the hip flexors immediately decreases the tension held in the lumbar spine muscles themselves in most of the people we have worked with. We have palpated back muscles on many workshops pre- and post-hip flexor stretching, and this effect is real and significant. In other words, the tension experienced in the lower back muscles is a necessary adaptation to the anterior pelvic tilt. When the spine is straighter, less effort is required to maintain posture in the upright, load-bearing position, and all involved muscles relax.
An APT is itself a sufficient** cause of tight hamstrings – but the main reasons for tight hamstrings are two. The first is that we spend our life sitting, and we sit on our bottom and our hamstrings, with the necessary reduction in blood flow that this entails. The second is that because most people don't take these long muscles through anything like a fraction of their potential range of movement, they simply adapt to the movement patterns they are subjected to. As well, through a phenomena known as reciprocal inhibition reflex, if your hip flexors are tight, then your glutes are going to be inhibited – this is just a fancy way of saying that the glutes will tend to be lazy, or inactive, or simply not very strong. Strong, active glutes are absolutely necessary for any kind of efficient movement patterns.
All this can be changed: if the hip flexors are loosened in the non-back pain suffering person, the experience immediately is a lightening of the experience of being in one’s body, and walking is immediately felt as being ‘easier’ or ‘freer’. We hear this on workshops literally every time we run them. And for the back-pain sufferer, loosening the hip flexors can feel like the weight of the world has been removed from your shoulders, and the pain you were feeling has reduced, or even gone completely. If back pain (or neck pain) is a problem for you, you must loosen your hip flexors and see what happens – if the hip flexors are involved in your problem, the change in the tension in your back and neck will be noticed immediately.
One tight hip flexor, or both hip flexors tight (and I will explain what I mean by ‘tight’ below) are sufficient** causes of low back pain directly, and middle back and neck pain, less directly. Sufficient, as used here, means that alone, tight hip flexors can cause back pain. There are many other muscular factors, too, of course, but if the hip flexors are tight, back pain may be in your future.
[Click here to view a video tutorial of the above solo hip flexor stretch.]
See how my thigh is in the same line as my spine, and with my lumbar spine completely straight? We regard this as the minimum hip flexor available length, simply to be able to move around freely in daily life. And the reason is, if your hip flexors do not have this length, as soon as you stand up and take your weight on your feet, your lumbar spine will be curved backwards (the ‘lumbar lordosis’, as it’s called). This is because these same muscles attach to both the front of the lumbar spine and the front of the pelvis, and if not long enough, pull the pelvis and the lumbar spine forwards of the flatter position shown above (the right-hand image). Postural accommodation always occurs in the ‘least effort’ direction (by this, I mean whichever direction requires the least amount of energy to achieve, and maintain), and it is much easier for the lumbar spine to extend than the hip flexors lengthen.
And having run workshops around the world for more than fifteen years, I can say with certainty that most attendees do not have this suppleness available. And how do we know that this kind of length is needed, or useful? Because literally hundreds of attendees have mentioned to us that as soon as they stretch their hip flexors properly (in other words, in a way that changes their free length–tension relationship), they notice that their feet rest more evenly on the floor; that any back tension (or pain) they had when they walked in with had gone, and the same for the middle back and neck pain I mentioned above. They all tell us they walk around ‘lighter’ or more freely.
So, if there’s any doubt, you need to stretch your hip flexors! If you search on “hip flexors” here on the site, you will find what you need.
* Normal is a statistical assessment – the term describes where the bulk of a standardly distributed population is found. Mathematically, this is about 68%. Assuming a symmetrical distribution, this part of the distribution is described as “one standard deviation from the mean”. 96% includes the second standard deviation as well as the first. Here’s an image taken from the net:
Any analysis of the movement capacities of the normal population will show you that very few people have much capacity to extend at the hip joint at all – and these movements are controlled completely by the hip flexors. In other words, with respect to both movement and freedom from back pain, we do not want to be normal in the statistical sense; we want to be exceptional (or ‘abnormal’!) in the range of movement sense. Many other human qualities benefit from this approach.
** sufficient: this usage is from the world of philosophy (and medicine); it denotes a cause that, by itself, can create the problem being considered. There may be a number of sufficient causes for any problem. Sufficient in these frameworks is contrasted with “necessary”, the latter cause always being present in the problem under consideration.
An aside: I did not have a ‘message’ that I was trying to push or sell when I started the classes that eventually became the ST system. Instead, I wanted to know what would happen if we loosened the restricted parts of the body, and together with the teachers over 30 years, we paid attention to what was happening in the classes; we talked about what we’d seen; and the insights gained in working with tens of thousands of people was collected – the Overcome Neck & Back Pain, and Stretching & Flexibility books, and the Stretch Therapy method came out of this process, and this continues today.
Back Pain Relief FAQs
In back pain diagnosis, doctors use a term, "neurological deficits"; this term refers to any of the following serious symptoms:
- unrelenting sciatic pain (pain in hip, thigh, outer calf muscle, or foot);
- numbness around the buttocks, or thigh, calf muscle, or foot (sometimes only toes); or weakness in the legs
- back pain that does not change, morning to night, and day to day.
These symptoms can be caused by a prolapsed disc, pressing on a segmental nerve. Alternatively, with respect to the symptoms related to sciatica, piriformis syndrome may be the cause. It is also possible that two causal mechanisms can be present at the same time, their effects 'aggregating' as the technical term has it—this means that some causes can add to one another, making the first one more active. The latest research suggests that these serious causes account only for a few per cent of the cases that present to doctors, chiropractors, and osteopaths; more below.
Does your back pain come and go; in other words, are there good days and bad days?
If so, other causes (than disc prolapse or piriformis syndrome) may be active. Such causes include tight hip flexors (one or both), an actual skeletal leg-length difference (about half the population have a cumulative leg-length difference of 5mm, or more; and one's lifestyle can make this a cause of recurring back pain) and uneven strength and flexibility patterns, again reinforced by (for example) prolonged driving, or even one's sport, like golf. If your back pain comes on after doing a day's work in the garden where this is not your usual occupation, and typically two or three days after the new activity, then your back pain is more likely of the muscular sort.
Bed rest was once the universal recommendation of the practitioners who work with these problems, but that is now out of favour.
Instead, 'active rest' is recommended; this means avoiding the activity thought to have been the cause and keeping on moving—daily walking is recommended. If this causes pain in the back, however, substitute swimming—in this activity, the body's weight is supported and, assuming you can already swim, the exercise can be made as gentle as you need. Use a float if you are not a good swimmer.
Movement hastens all the recovery mechanisms.
The long-term research shows that in half of any population surveyed, back pain is gone after a week in 50% of the sufferers; 65% after two weeks; 85% after a month; and a small (2–3% of the same population) left with on-going problems after two months. Keep moving and see what happens in your case. If you have on-going problems after a month or so, consider seeing a doctor.
The kidneys, uterus, and liver are located low in the abdomen, and close to the lumbar spine. It is possible for problems in these organs to manifest as back pain. Cancer can cause back pain, too.
Pain on urination or blood in the urine; these are more serious symptoms of possible kidney involvement.
"Unrelenting and unchanging" are the key words here—if these describe your back pain, whether the neurological deficits described above are present or not, consider seeing a doctor. If you can still move around though, keep the statistics mentioned above in mind, keep moving, and be patient. See the point below, too.
If your pain changes (either day to night or from day to day, or over time) then it is more likely that the softer tissues of the body are the cause (muscles, tendons, ligaments and fascia). Time and movement usually helps this kind of back pain.
If your back pain does not change, though, the harder structures of the body may be involved (the vertebrae themselves, the spinal canal, or the discs in between the vertebrae).
The neurological deficits mentioned in the first section above are important to consider here. If you find yourself lying on the floor, unable to move, following a fall or an accident, call for help. You may have been unconscious for a while, too. The body experiences shock following a fall, and you may find that waiting for five minutes or so, the symptoms diminish—if they do, move carefully into a comfortable position and see what happens. If the pain is severe, and does not seem to diminish, get help.
If you are an older person, consider getting a safety alarm; if you fall, and find you can't move, having one of these alarms will be a great comfort.
Before attempting to answer this apparently simple question, let us look at the larger perspective of low back pain. With respect to recovery from low back pain, the statistics that have been collected around the world in a great many studies are remarkably consistent. One of these studies followed 25,000 people over five years, over a number of episodes of recurring low back pain. Here are the figures derived from all the best studies.
If a thousand people come down with acute onset low back pain today, half will be well within a week independent of treatment type (like physiotherapy, chiropractic, or massage) or no treatment at all. When the figures are large enough there is literally no difference between these two groups. This has led to many commentators making the claim 'if you come down with low back pain today, save your money because the chances are you'll get better all by yourself.'
65% of the thousand people will be fine at the end of the second week; 85% at the end of the fourth week; and there will be a tiny, residual 2 to 3% of people continuing to suffer at the end of two months.
These figures are why, in my first paper (Low back pain: review and prescription, all citations in my book Overcome Neck & Back Pain), I suggested that the most efficient and least invasive approach for the treatment of rapid onset low back pain is to do nothing at all – all of the studies show that the vast majority of people who are affected today will get better within weeks or a month or so. There are exceptions, of course.
Anyone who is suffering neurological deficits (look this term up) needs to ask a doctor or someone similarly trained to examine and test them – neurological deficits are much harder evidence of impingement to a segmental nerve or other nerve for example, or one of the other more serious pathologies. Neurological deficits include numbness around the buttocks, unrelenting pain down one or both legs, inability to lift the toes towards the foot (loss of dorsiflexion), strong tingling in the feet or the toes or the outer part of the calf muscle, loss of strength in the legs, and so on. It is testing for these sorts of things that determines how an accident on a football field, for example, will be handled – do we let the person get up and rejoin the game, or do they get stretchered off the field?
But the research I mention above suggests that the group of people with the more serious pathology are the ones who will find themselves in that 2 to 3% at the end of two months group, and because the rest of the group has gotten better in the meantime, this has led to many commentators observing that the best thing to do in the case of rapid onset low back pain is to keep moving, and wait and see what happens. As well, I recommend in one paper that the deployment of the diagnostic technologies like MRIs or x-rays should best be left to the end of that two month period and I want to explain why.
“Pathology is normal.” This seems like a shocking thing to say, but let me explain. There is a very famous study published in the New England Journal of Medicine (July, 1994) that claimed that nearly two-thirds of a group studied had ‘spinal abnormalities, including bulging or protruding discs, herniated discs, and degenerated discs’ and, the researchers said, what was identified in this study as ‘pathology’ would be assumed to be the cause of any of these patients’ back problems. The difficulty was that none of the subjects in the study had back pain, or ever had suffered from this problem (Jensen 1994; many more references in my book, Overcome Neck & Back Pain, as more than a dozen studies since then have confirmed this position).
Back in 1989 I wrote that it is likely that pathology exists benignly until an additional cause renders it active (like pulling a muscle, or doing an unusual activity, or moving awkwardly), and when this second cause settles down, as it usually does, the pathology settles back down into the background and once again becomes benign. The research also shows that anyone over the age of 30 is likely to have some degree of disc damage. But you don't feel any pain from it, your back works perfectly normally, and it is not a problem – it is simply part of the ageing process and using this thing that you live in. The difficulty with the pathology model is that if you are suffering low back pain, and you get examined using MRI or x-ray technology, and pathology is found, your back pain will be attributed to it and this may not, in fact be accurate. Best to keep moving and wait and see what happens.
As for physical therapy, if you do know a good practitioner, then I suggest you go and see him or her. There is no doubt that getting some kind of treatment and comfort from a healthcare professional can only assist you in your recovery. Whether there is any technical or process utility to the treatment, from a scientific point of view, is beside the point I believe. The placebo effect is alive and well, and doing good work in the majority of interactions between healthcare professionals and patients. Where the research has gone wrong, I believe, is that in all the attempts to separate out the placebo effects to try to find what the ‘active ingredient’ of any treatment or drug is, the baby has been thrown out with the bathwater. The fact is that discussing a problem with a trusted healthcare professional and getting treatment that helps you to feel good in that moment can only be of benefit.
All of the nerves that emerge left and right from the lowest lumbar and sacral vertebrae come together behind the hip to form the sciatic nerve – there are two main trunks. In most people, this large (2cm) nerve passes out of the pelvis below a muscle called piriformis before passing down the back of the leg.
“Sciatica” describes pain in the nerve itself, or in one of the structures this nerve innervates. Usually, when sciatica is experienced, it is assumed that some kind of disc event or compression of a segmental nerve somewhere in the lower back is the cause. Sciatica can be intermittent or unrelenting, and can affect one or both legs.
This perspective – that sciatica is caused by some problem in the lower back itself – is itself a problem. This is because in a significant fraction of the population, the sciatic nerve does not pass below piriformis as I described above at all – in fact the nerve pierces piriformis before travelling down the back of the leg as described above. A simple spasm in this muscle, often caused by long periods of sitting, can compress the nerve at this point and cause excruciating pain in the hip and all of the pains down the legs which may be interpreted as neurological deficits. If you find yourself suffering from sciatica, my strong recommendation is to try one or more of the gentle piriformis exercises (find a number of these in the Back Pain Relief Video section of this page – they each have the word piriformis in their title) to see whether it targets the location of the greatest amount of pain (usually the hip itself), or whether in fact the exercise reduces symptoms in the legs. The situation where piriformis is compressing part or all of the sciatic nerve is called piriformis syndrome.
The first study that looked at the course of the sciatic nerve through the pelvis found that up to 20% of the population had one or both trunks of the sciatic nerve physically emerging through the pelvis via piriformis. The latest study found that there is at least one more potential situation – where one or more nerves comprising the sciatic nerve separated from the sciatic nerve inside the pelvis and that one or more of these branches pierced piriformis while the rest of the sciatic nerve emerged from the pelvis below piriformis as all the anatomy books describe. In all, these researchers found, having examined over 250 half-pelvises, that nearly 40% of the population has one or more nerves piercing piriformis. Any of the 40% of the population we are discussing here is a candidate for piriformis syndrome. And this is precisely the reason why we recommend a simple piriformis exercise to be done as part of our "daily 5” exercises – as almost everybody spends most of their working life sitting down these days, either at a desk or driving, anyone in whom piriformis is pierced by one or more of these nerves is a candidate for this problem. And I can tell you from personal experience, it is utterly excruciating if it hits you! Fortunately, treatment is simple and you can do it by yourself.
You can think of the disc like a doughnut – think of an ordinary doughnut, but with the centre filled with jelly, and vertebrae above and below. The outer part of the pastry represents the annulus in this model – a tough fibrous material which joins a pair of vertebrae, top and bottom. The centre jelly represents the nucleus, held in by the annulus around it and the vertebrae above and below – it is this ball of proteins that facilitates the movement of individual vertebrae with respect to each other. If the outer part of the disc becomes weak, too dry, or diseased, some of this internal material can escape sideways – and the nucleus itself is a chemical irritant to the surrounding tissues. Another potential effect of this herniation (the term describes the movement of the nucleus sideways) is that the exiting material can find its way to where a nerve is (there’s no empty space in this part of the body) and the disc material can physically press on the nerve, causing pain at the site, and areas ‘downstream’ (in a neural sense) of it. The good news though is that if you can keep moving, in time the body will resorb this material.
Chronic pain is defined as pain which does not get better, or change, to any great degree over time. In other words, whatever is causing the pain is, to an extent, fixed in the body. What most people don't realise is that, in the absence of movement, the body is inclined to not change. The technical term for this is homeostasis – it takes an input of energy of some kind to move the system from its normal, or ordinary state, to a new state.
This is why in our work we always say getting going, or getting started, will take some effort on your part – there is absolutely no way around this. Fortunately in our Starter Course and Healing Series we have made the initial steps as small and as easy as possible. Just make a resolution to get going and start.
Degenerative disc disease is a serious sounding descriptor that is remarkably imprecise, in fact. Degenerative disc disease, or DDD, describes what an ordinary person would call wear and tear. And in fact if you search for this term on the Internet, wear and tear will be what you will find – as I kind of explanation of what DDD is. But, of course, wear and tear does not describe anything precisely. Well, the term wear and tear implies that the process is inevitable. My mechanic will describe any new noise in our old car as "normal wear and tear”.
Part of the process of DDD is a gradual drying out of the disc material. The outer part of the disc, called the annulus, is tough and fibrous and joins to the vertebra immediately above and below. In the centre of this material is a jelly like substance, the nucleus, and this substance is full of proteins which, if they escape from the centre of the disc, will chemically irritate the structures around it. As well, the annulus is rich in nerves, and if the annulus becomes sufficiently weak, the internal material, the jelly-like material I mentioned before, can make its way through to the outside – and that will be extremely painful. A further complication is that the jellylike material can physically press on one of the segmental nerves that emerges left and right from between every pair of vertebrae, as we look at the spine from in front or behind. This is what the term disc impingement refers to – the exiting jelly material is physically pressing on a nerve.
The research is clear on the next point: if you can survive the first six months following even a major disc extrusion event, the body will resorb the disc material, and the problem will go away by itself.
Crucial to this story is the role of movement – the research also clearly shows that one's hydration regime has zero effect on the state of the dryness of your intervertebral discs. The only thing that keeps the intervertebral discs moist and full of water is movement. There is a process called disc imbibition, where overnight water makes its way into the disc and plumps it up slightly. The only thing that we know that keeps the discs moist and plumped up is movement. This is what the old term 'use it or lose it' really refers to – movement keeps you young.
Muscle sprain or strain is, in fact, the most common cause of low back pain. Do not concern yourself with the technical, definitional, differences between sprain and strain – if either occurs the process I am going to discuss will occur. If a muscle is traumatised in such a way as to produce a sprain, or strain (or even a tear), it will undergo a process called splinting – which means that it becomes fixed and tight in order to inhibit any potential further damage to the area. As well, if the splinting goes on for long enough (and this may only take hours), then the muscles around the site of the injury will also undergo the splinting process.
The inflammation process is generally reckoned to occur within 1–3 days, too, and this is why I recommend against the long-term use of anti-inflammatories – these drugs really affect the digestive system negatively, and their long-term use can rarely be justified. Our recommendation is to avoid the movement that caused the problem in the first place, but definitely to keep moving inside the limit of experiencing too much pain or discomfort. Movement, in fact, enhances all of the healing processes – providing the movement doesn't cause further injury.
If muscle strain or sprain is the cause of your low back pain, often the first clue is that when you look at yourself you will see that you are bent or twisted in a way that is not normal for you. This is caused by key muscles shortening and splinting as I mentioned above, and most often affects a low back muscle called quadratus lamborum and also the hip flexor, the deep one called psoas, on the same side. Once the acute phase is over, we have very gentle exercises that can help these muscles regain their ordinary length–tension relationship.
It is worth mentioning at this juncture that far and away the most common cause of low back pain is simple isometric muscular tension. Pursuing a course of exercise that stretches (in the initial phase) and strengthens the muscles involved (later in the process) will provide long-term relief.
In the choice between ice and heat therapy, heat is my preference for relieving low back pain. Nothing is more shocking to the body when it's in pain than to put ice or similar cold substances on it. There are some good reasons for the use of ice on occasions, but low back pain is not one of these. And the reason is that the muscles that are normally the source of the pain in lower back pain are the deepest of the back muscles, called quadratus lumborum – and ice on the surface of the back will not affect these muscles at all.
Infrared treatment is particularly good for low back pain, and infrared lamps are inexpensive to buy, and will fit into standard domestic fittings. And some massage therapists also use heat technology, so if you know one who does you could test whether or not heat is likely to be helpful for you this way.
The definition of spinal stenosis is a narrowing of the bony spaces in the spine through which the spinal cord and its emerging segmental nerves travel. Stenosis most commonly occurs in the cervical or the lumbar spine. If the narrowing proceeds far enough, the spinal cord itself can be impinged upon, and this can cause all manner of downstream effects. It is worth noting that many people have a degree of spinal stenosis with no symptoms at all. If you are in any doubt about this, seek advice from a qualified health professional.
The statistics for spinal stenosis are roughly one person in 1000, if we are talking about a population that is over 65. Any gentle exercise like walking will help offset this condition. Even better is to make use of the range of movements available to the spine and the rest of the body—everything is kept loose and free if you do.
Radiating numbness is the experience of numbness (loss of feeling in a part of the body) which radiates out from a starting point. Numbness can be caused by nerve impingement (some part of the body pressing on a nerve, as in piriformis syndrome) or by some part of the body squeezing on an artery—like when you find your arm numb because you slept on it. By itself, as a one-off experience, this is nothing to worry about. But if it happens regularly, and the numbness proceeds outwards from where it is first experienced, I recommend seeing your doctor and discussing this with him or her.
Please search the Stretch Therapy site for piriformis syndrome, and also on sciatica, and the sciatic nerve. Hip muscles most definitely can be involved in low back pain.
The most common muscle relaxant is a drug called diazepam. The liquid form is used in operations in western hospitals every day. If you look up one of the diazepams (Valium, for example), you will see that it is described as an anti-anxiolytic – this means that the drug can relieve anxiety. But what is rarely described is how this effect is achieved. The diazepam family of drugs are, in fact, muscle relaxants – 20 minutes or so after taking one of them, all the muscles in your body relax to some extent (and sometimes to a great extent), and the experience is, “Ah: I have relaxed completely and I feel better”.
The Rolling Stones 1966 song, “Mother's Little Helper” is talking about this drug; it’s been around a long time! It used to be the Western world's most commonly prescribed drug.
As always, when legislators identify a drug that helps people to feel good, they want to limit its use. Thus, Valium has become harder to obtain currently. For the sufferer of low back pain, the occasional use of this drug can be extremely effective if tension in the affected muscles is the cause of your pain. If you have an understanding doctor, request a one-off prescription of the smallest of the diazepam tablets you can find in your area – in our area these are the 5 mg ones.
If you have recurring low back pain, you will know what the precursor feelings that precede a back-pain attack feel like. Try using the smallest amount of the drug that will have a beneficial effect. In my case 1/4 of a 5 mg tablet immediately stops the movement from tightness to a full on back pain attack; my experience is that it interupts the learned behaviour. I should also mention as an aside that I have had many discussions with doctors who have said that 1/4 of a 5 mg tablet is too small to have any effect. I assure readers that such a small amount can – it all depends on your own body's sensitivity to this drug. And taking such a small amount on an extremely infrequent basis (usually less than once every couple of months in my case), it is impossible to build up any kind of dependency on it.
Most definitely. In fact sporting activities are one of the major causes of low back pain. The easiest way to protect yourself from these kinds of injuries is to be sufficiently fit for the activity being pursued and to keep yourself agile and limber – and stretching exercises following the activity are the best way to do this. I have written extensively on this, and the Stretch Therapy Forums have a number of threads devoted to sports-related injuries.
The operations for treating any kind of back pain are invasive, and have a significant failure rate. Before undergoing an invasive surgical procedure, the prudent human explores all possible conservative measures. Apart from the massive benefit of learning how to help yourself if you do find a conservative measure that is effective is that by staying out of hospital one avoids the possibility of iatrogenesis —look up this term; it describes drug and surgical failures. And don’t forget the threat of sepsis, 'golden staph' (Staphylococcus aureus) and negligence.
“Radiculopathy” is simply a technical term for “pinched nerve”, itself a shorthand for impingement of a nerve by the body’s own structures, whether pathological or not. In discussions like these, what is not generally known is that only a very small force, in the order of grams, is needed to produce a downstream affect in a part of the body when a nerve is pressed upon.
This is one of the reasons we are deep believers in exploring the full range of movement of all of the parts of the body, to reduce the risk of impingement. The short story is that the challenge of movement gently pressures the body to adapt in whatever way it needs to, be it neural, facial, muscular, or postural, so that the same stress in the future does not create a negative effect. This phenomenon underlies all the adaptation mechanisms we call training effects.
The body wants to be better – we simply have to stress it in the right way so that adaptations occur in a way that we regard as useful. Many of the adaptations of the body are unconscious, unplanned, and negative.
Back Pain Relief Articles
Stretch Therapy began with a tight, occasionally competitive, athlete trying to find a way out of constant pain and tension, and over many years has become an efficient method for achieving grace, ease, and relaxation in the body. This section contains many articles that explore the context of where back pain is experienced, and a number of thought pieces that explore the very meaning of ‘rehabilitation’ in the current era, as well as the original conference paper “Low Back Pain: Review and Prescription” (below) which led to the book Overcome Neck & Back Pain. Please forward these to family and friends.
From the Fit Executive in the Financial Times
by Charles Wallace
Remedies for back pain that help avoid the surgeon's knife
Our unsymmetrical bodies are the issue, not disc deformity
Yet, having gone ahead with the procedure, it has so far done little to relieve the pain. I was reminded of this when I spoke to Kit Laughlin, an Australian expert in physiology and the causes of back ache. He noted that a 1994 study in the New England Journal of Medicine found that MRIs of 97 people with no back pain showed that a majority nonetheless had visible disc problems, such as a protrusion or a bulge, and 38 per cent had these problems in more than one disc.
The study concluded that “the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental”. In other words, it is often not the discs that are causing the pain, even though they may look terrible. To which Mr Laughlin adds: “Diagnostic technology can’t see soft structures like muscles, nerves or fascia and that’s why so many back operations are so spectacularly unsuccessful.”
To counter this, he has produced a new version of his book Overcome Neck and Back Pain, to which I have referred before in a column about joint flexibility. The book outlines a conservative approach to back pain management that sufferers could consider before trying a surgical solution, such as the fusion of vertebrae.
Mr Laughlin’s view is that only about 1 per cent of back pain sufferers have spinal deformities that require surgical intervention. One way to tell is if you have good days when back pain diminishes, alongside bad days when pain is relatively intense. Such situational pain often means the cause is something other than discs.
One of the things I admire about Mr Laughlin is that at 63 he is not afraid to admit that he too suffers from aches and pains, including bouts of backache, such as when he recently threw his back into spasm stepping off an 8cm kerb in a car park. The trick is knowing how to fix the problem.
June 27, 2016
A member of my family came to me recently with the distressing news that they were about to undergo a surgical procedure to relieve back pain. The doctor, he assured me, had showed him the images of an MRI scan that clearly indicated degeneration of spinal discs and said that this was the cause of his discomfort.
His big insight is that people think their bodies are symmetrical, but frequently they are not. One side is usually tighter or more flexible than the other. This applies not just to the upper body, which might be expected from using one hand more than the other, but also to the lower body. In fact, he notes that almost 50 per cent of the population has one leg physically longer than the other, which can easily be fixed with a heel insert.
Mr Laughlin says golfers often suffer from back pains related to the fact that their sport requires them to swing their bodies around the axis of rotation in only one direction many times a year and they become unbalanced. Similarly, boat crews move one shoulder in a wider arc than the other when rowing.
The answer to many of these muscle problems, which he demonstrates in his book and videos, is to gently stretch muscles until they relax on the overly tight side and to build up with exercise muscles that are too loose on the correspondingly weak side.
He adds that you should only stretch when your body is warm, preferably before the evening meal, and only twice a week, to allow the body to heal.
Stretch Therapy Overcome Back Pain
Course – now available online!
Despite being a competitive athlete, I suffered from chronic back pain.
For months I had to crawl to the bathroom every morning because I just couldn't get on my feet. This personal experience and the desire to help others led to the creation of the Stretch Therapy Method.
It teaches you how to use specific stretching and relaxation exercises to address the underlying causes of your back pain, which will not only provide relief to your pain, but will help you feel younger, more agile and more in tune with your body than ever before.
How Stretch Therapy Addresses Chronic Back Pain
At Stretch Therapy we know that you want to live an agile, pain-free life. In order to do that, you need a reliable way to relieve your back pain with as few side effects as possible. The problem is that frequent, debilitating back pain affects every aspect of your life. You are fed up with trying out so many "solutions" that just haven't worked.
The thought of risky, perhaps unnecessary, surgery produces anxiety but so does the possibility of having to live with never-ending pain. We believe that no one should have to suffer from unnecessary back pain, which is why we've spent over 35 years developing the Stretch Therapy Method that has alleviated the pain of tens of thousands of people just like you.
Here’s how we do it:
1. Sign up for the Stretch Therapy Overcome Back Pain course
2. Follow the instructions and do the online video lessons
3. You will gain a new understanding of your own body, be able to move much better and without pain.
Kit Laughlin literally wrote the best-selling book Overcome Neck & Back Pain, which is widely considered to be the definitive book on using stretching to alleviate back pain. Overcome Neck & Back Pain was the first exercise-based, self-help approach to neck and back pain, now considered orthodox treatment – it is hard to understand the impact that this book had when it was first released. It has been rewritten three times since then, too. ONBP (as we call it) is the result of years of investigation and experimentation with tens of thousands of students at the Australian National University, as well as describing the process that helped him overcome his own chronic back pain.
So, click here to sign up for our Overcome Back Pain Course. And in the meantime, download a free copy of Kit's ebook The Hidden Causes of Back Pain.
This way you can stop being captive to your back pain and instead feel younger, more agile and pain free than you have in years.
Discover the Book That Started a Back Pain Revolution
Overcome Neck & Back Pain
Considered by many to be the world's definitive resource on how to best utilise stretching and relaxation exercises to relieve chronic back pain.
The book Overcome Neck & Back Pain, now in its 4th edition, presents a comprehensive self-help exercise-based approach to treating these problems.
This is the book that started a revolution in treating neck, middle and lower back problems—and a method that explicitly recognises the necessity of the patient being actively involved in the treatment.
The book has been glowingly reviewed in all the peak medical journals as well as massage, shiatsu, chiropractic and complementary medical journals.
Back Pain Relief Videos
The Stretch Therapy Method teaches you how to use specific stretching and relaxation exercises to address the underlying causes of your back pain.
For over 35 years Kit Laughlin and Olivia Allnutt have been researching, investigating, teaching and perfecting the world's most complete stretching method.