Every and every day, there is no shortage of people who visit their doctors for their lower back pain. Medication has historically been the first line of ‘attack’ but certainly not working because the darn lower back pain keeps coming back.

The question I always have in the back of mind as I examine patients with lower back complaints involves their life style. Who does not have a sedentary life style anymore?!!! What is the result of that and how can we at least minimize the amount of damage imposed by this life style?

Cause of Pain

When sitting for an extended length of time, the part of the brain that sends the command to sit up straight does not get to practice. With the lack of use comes the shrinkage of THAT part of the brain in charge of the upright posture.

The same part of the brain called PMRF (PontoMedullary Reticular Formation) houses the nuclei of the very nerve (Vagas nerve) which is in charge of movement of the diaphragm and therefore crucial in breathing; with the sedentary life style comes the lack of deep breathing as well!!!

End result: stooped posture and lack of strength in the lower back muscles. This translates into a shift in the center of gravity to accommodate the tired and weak lower back musculature. The shifting back and forth around the true center of gravity means stooping the mid back to shift the center of gravity to the back or extending the pelvis backward to shift the center to the front.

The reason for this shift is to allow different groups of muscles to pick up the ‘load’ of the muscles that are tired and not doing their primary job. This is how poor posture develops, gluts get weak and the bulging tummy appears.

What Muscles are Involved?

Every muscle!!!! The immediate muscles, however are the lower back, abdominals, gluts, hamstring and quads. You see, the abdominals have to balance out the lower back muscles to keep you in place, centered and true to your ideal center of gravity.


This is a multi-level approach so let’s begin by first reviewing the life style. Take mini breaks throughout the day to assure you moving around. Sit on an air cushion (click here) to do mini-activation of the PMRF to avoid the ‘deactivation’ process imposed by the sedentary life style, stretch the tight muscles of gluts, hamstring, lower back, TFL (the outside part of your thighs), and mid back.

Now strengthen the lower back and abdominal muscles by doing the exercise shown in the video below where you will see what to watch out for and what to look for.

What if I don’t do this?

There are always plenty of things to do by the time we go home from a full day of work. The last thing many want to think about is exercise even if it means not leaving the home to go to a gym. What I am about to tell you can so easily creep up on you that you won’t even see it coming so brace yourself!!!

The level of energy goes down, you feel irritated, restless at the beginning leading up to developing anxiety!! Yes you are reading it correctly: remember Vagas nerve? Remember how it causes the diaphragm to move which is necessary to breath? What happens if you can’t breath?

Is it safe to say that you start having anxiety and panic? Well, that is what actually happens but it is so slow that you won’t even associate the two!! Then of course, there are plenty of drugs for the anxiety and panic and there is a laundry list of diagnosis to label people with.

It is easy to not have a restful sleep and the meds to take for that issue < where is the shocker emoji when I need one?!!> With the lack of proper sleep comes tiredness the next day. Of course, there is that one cup of coffee that will help but then you notice the one cup of coffee becomes 4 or 5 and you still feel tired!!!

There goes the social down spiral and the feeling of not wanting to deal with people including your own partner and children. As you are reading this blog, let’s try to see how many of them you are actually experiencing!!! I think you get the picture and I am not going to continue but fair to say that the list is not done.

By the way, I have not even gotten to the pain part yet!!! The number of times I hear patients telling me how they did not do anything and don’t understand why they have the back pain is countless. “It is not what you did the last few days that caused this necessarily”, I say. This has been going on for quite a while now.

Lower back pain, bulging tummy, pain down the leg, continuous injuries of knees, hip and ankles, propensity to fall and lack of motivation are a few things that happen when the posture is not at its best. Just to clarify the reason I focus on the posture has nothing to do with esthetics and everything to do with the fact that your posture is a reflection of your health.

Remember, you are the Designer and the Director of your own life so design and direct it the way you wish to live it.

Dr. Shakib