Lower back pain is one of the most commonly treated conditions in today’s society. With the sedentary lifestyle, either behind our computers, driving in traffic, or attending meetings/ school, the lumbar spine or lower back is one of the most deteriorated parts of the spine. These sedentary lifestyle factors are starting to be seen in people younger and younger which is why we now have teenagers with lower back pain. This is a serious issue! Chances are that you looked up one of the following and have ended up with this blog: will lower back pain go away, what lower back pain means, which doctor for lower back pain, lower back pain near spine, lower back pain can I exercise, lower back pain without injury, lower back pain for years, lower back pain causes, lower back pain from sitting, lower back pain exercises, lower back pain lifting, lower back pain office chair, lower back pain relief, lower back pain posture, lower back pain when running, lower back is killing me, lower back rehab, and lower back strengthening exercises.

How Lower Back Muscles Work

To truly fix your lower back pain it’s important to understand how the lower back is designed to function and how we deviate from this design. I promise you not to make it difficult to understand but look at it this way, the smart phone you are using, you had to understand some basic functions of it so you could not only use it but when you encounter any problems, the basic understanding of its operation, allows you to problem solve as well. The basic understanding about the lower back enables you to identify the things done on a daily basis that contribute to this pain and go on to effectively correcting it.

The spine, which consists of many small bones called vertebrae, is divided into 4 sections:

Cervical (neck)
Thoracic (midback)
Lumbar (lower back)
Sacrum (butt bone, consisting of fused vertebra)

The thoracic spine and sacrum have what is called a kyphotic curvature (the extreme version of it is hunch back) while the cervical and lumbar spine curve the opposite way known as a lordotic curvature (the extreme is arching the back excessively). These are natural curves that we have but these curves can become accentuated with the progression of bad posture which is the end result of super tight and super weak collection of muscles every where and not just at the location of the pain; this results in issues like lower back pain, but we’ll get into the specifics of this in the next section.

Between each vertebra, in the spine, there are discs that provide a cushion between the bones, as well as ligaments connecting each to the one above and below. Let’s not forget about the fact that there are nerves exiting through this area that allow the brain, the master coordinator, to communicate with all muscles and internal organs.

The sacrum, although considered to be part of the spine, works with the pelvis to make up the pelvic girdle which then connects to your leg bones. On top of all these bones and ligaments, we finally have muscles! For the purposes of this blog, we will focus specifically on the abdominal and paraspinal or erector spinae muscle groups which are on both sides of your spine in the back. The abdominal muscles (located in the front of your body) are long muscles that run from the bottom of your rib cage all the way down to the top of your pubic bone. On the other side of the body, the paraspinal muscles run along the entire length of your spine, as you can see in the photo on the right.

In a healthy lower back that is functioning properly, these two muscle groups are working together to provide a balance or stabilization to the lower back and pelvic areas. They work opposite of each other which is referred to as agonist and antagonist. If the relationship is imbalanced where one side is having to constantly work more than the other, this sets the ground for pain and injury. The next section explains how this pathological functioning develops.

How Lower Back Pain Occurs

Lifestyle and bad posture are the 2 main contributors to lower back pain. If you experience lower back pain without injury then these are likely the culprits. These lifestyle habits include:

Prolonged sitting
Working behind a computer
Bad ergonomics
Sedentary lifestyle
Exercise using bad form
Using handheld technology
Using a laptop
One-Sided sports

The list can go on and on. Anything that creates an imbalance in your anatomy can lead to a decline in posture. You might be wondering what posture has to do with your lower back pain?

One of the most commonly seen postural deviations is hyperlordosis when the lower back curve becomes accentuated (you can have this issue in the neck too where there is a lordotic curve). This is displayed in the image on the far right, where the buttocks is sticking out. This posture compresses the lumbar spine where the spine is connected to the pelvis and results in spasm in the muscles of the lower back and weakness of the lower abdominal muscles. This imbalance can stem from sitting behind a desk for so many hours a day with bad or even good ergonomics. An increase in the lower back curve goes hand in hand with another postural deviation referred to as the military posture where the chest sticks out beyond normal.

The opposite postural deviation, shown in the middle of the diagram above, has an increase curve in the mid back which compromises the positioning of the center of gravity, pushing it forward. This leads to the inability of the lower abs to stabilize the pelvis in a neutral position, and leading to lower back pain.

As you can see having bad posture is directly related to pain and dysfunction of the lower back. Bad posture and lower back pain are not only seen in sedentary people but are very common in active people. Why is that? Let’s find out.

Lower Back Pain from Going to the Gym

It should be clear by now that lower back pain has everything to do with the function of the lower abdominals and paraspinal muscles shown above. You’d think people with a six-pack who go to the gym every day have perfect posture, right? I am going to take the chances of making some of you upset but the answer is no!! Going to the gym to work on your abs doing abdominal crunches and all those other ab exercises will not do anything for your posture and might actually make the problem worse! The issue has to do with how we do the abdominal strengthening. Let’s be real, chances are high that you have done abdominal exercises just to end up with neck pain the next day. That’s because it was not your abs that you worked out. You somehow managed to do the crunches but it was not your abs that did the work.

It is very common also to not be using the right progression of the abdominal muscles when activating the abdominals. WHAT?!! Let me explain. You have the lower, middle and upper abs. They all are designed to initiate certain movements or come into the movement progression at a specific point. When the upper and middle abs are activated instead of the lower ab, there is a problem. I see many patients with six pack and all ‘buffed’ but have very weak lower ab muscles or their lower abdominal muscle has no clue what its role in movement is. That is planting the seed of pain and dysfunction.

Being active is great and certainly what it takes to be healthy; however, without realizing it, we don’t go to the gym to get fit but to get injured. Glute workouts are a great example of this. Most of the time we do a glute workout with the intention of firming and building them but we are actually working out the lower back instead.

Life begins with a breathe, and that breath serves as the foundation of our ability to move and stabilize ourselves starting at around 3 months of age. Biological breathing has a specific pattern that we all are born knowing (thank goodness for that). Our ability to breathe biologically is impacted as we started doing ‘one sided sports’, signing up for dance classes like ballet, doing head stands the wrong way, etc. (you get the point). This is when the biological patterns of breathing and movement fade and we develop the pathological patterns instead.

One of the most common types of dysfunctional breathing which contributes to lower back issues is what I refer to as the neck breathing! In this pathological pattern of breathing, instead of the up and down movements of the abdominal diaphragm signaling the emptying and refilling of the lungs, the neck flexors, in front of the neck, signal the movement and the abdominal diaphragm follows that signal. When you breathe this way, instead of expanding the abdomen like you’re supposed to, you engage your neck muscles to facilitate breathing. It’s not just a handful of people who breathe this way, just about every person who walks into my office has this issue. If you are not breathing correctly, you cannot move correctly. That is why breathing is the very first thing addressed in every one of my patients regardless of the area of complaint. The video below tells you how this is done and I so hope you will start working on it daily. We go to the gym with the best intentions of getting healthy and this is a great example of the most important exercise that you don’t have to leave home for.

You can use all the machines you want and do all those Instagram exercises and still end up with little to no lower ab function, a messed up back, a restricted breathing pattern, and overall leaving the gym with more issues than you started with. This is why I say people don’t go to the gym to get fit, they go to get injured. You don’t see a 5-month-old baby abdominal crunches to build their abs yet they get up and do planks like a pro.

Will Lower Back Pain Go Way On Its Own

If your lower back pain comes and goes, that doesn’t mean you fixed the problem. Maybe getting a massage feels good and the pain goes away for the day or you found some stretches online that seem to relieve the tension and that’s great. All these things may make you feel better for a short period of time but the pain returns because you have not actually addressed the cause of the problem.

Developmental Kinesiology and Postural Neurology work together to create the correct patterns of muscle signaling, progression of movement systematically and so the answer to any issues related to the movement goes back to them. There is a map of your body parts in your brain when it comes to movement and sensation; it is referred to as homunculus and this map is directly impacted and modified by your lifestyle and injuries. This map becomes the blueprint of movement, it is like the notes in front of the musical conductor. Through postural neurology we see what parts of the brain with regards to movement and sensation have become modified and through the related postural exercises, those areas become up to par. Through developmental kinesiology, we work on the movement patters we all did innately as babies until the ‘borders’ of the map in our brain get darker and darker until it becomes us. The video below tells you about it.

The videos below are examples of what the developmental kinesiology exercises, specifically the Dynamic Neuromuscular Stabilization or DNS which is what I find to be the true answer to all acquired musculoskeletal issues.

Lower Back Pain Exercises

The foundational exercises for lower back pain are the poses between 3 and 6 months of age. In the video below you can see how a 3-5-month-old baby begins to develop the lower ab. I often find in the majority of my patients that their lower ab is extremely underused, so much so that the patient has a hard time locating the muscle (in the brain) to activate it.

Note that in this pose we only want activation of the lower portion of the abdominal muscle, not the upper which is overly active in many people. Once a strong lower ab is developed, or the map of that area in the brain is made more clear, we can move to a pose that really challenges the lower ab and lower back muscles to work together and maintain a neutral spine. This next video is a 6-month prone pose.

Although the main mover in this movement is the triceps, the requirement is a neutral spine that requires the lower ab and lower back to do their part. Give it a try and you’ll feel what I’m talking about. If your lower back is dipped when doing this pose, you’re doing it incorrectly.

Lower Back Pain Prevention

The simplest form of exercise for the lower back health is what I refer to as the ‘tuck under’ where you tuck your tailbone under you when standing up. I do this every time I face a counter, bathroom, kitchen, office or whatever counter. By doubling up the move with activities, I am bound to do it daily and frequently. The ability to do it effectively is important and walking correctly (most people walk with dysfunctional movements) is a great example of how it comes in handy.

When doing your tuck under, pay attention to not bend your knee’s. Practice your tuck under daily to relieve pain and prevent it! Another great way to prevent lower back pain is by working on the map in your brain in regards to your lower back! When your brain loses that strong connection with a body part, there is a lack of movement and activation in that area. Lack of movement in the lumbar-pelvic area, just like any other part of the body, will result in restriction and pain. The postural neurology exercise shown below will help maintain the full movement of your lumbar spine to keep that map nice and clear.

The one exercise that directly impacts the portion of the brain that is in charge of the upright against the gravity command is the one shown below. You should do it every time you get up from your desk and are about to sit back down.

There are many more exercises that you will find on my Youtube channel and I strongly suggest you hop over and check them outI Check out the ones under the playlist Lower Back and make sure to subscribe while visiting.

Dr. Shakib

Lower Back Pain Causes and Treatment