By Nancy Alexander, PT, CSCS
It is estimated that 70% to 85% of the population will experience an episode of low back pain at some point, according to studies published by the National Institutes of Health (NIH). Ninety percent of these individuals will have more than one episode. Moreover, functional disability follows right along causing people to move less and limit participation in activities they want to do. It is probably the most common reason my patients had for seeing me over the last 26 years.
When we look at the aging population, some of these studies show that individuals aged between 60 and 102 years had a prevalence of low back pain ranging from 21% to 75%. The levels of functional disability, as well as functional difficulties, activities of daily living, and physical capacity, were identified in 60% of the studies. This is significant. These studies indicate that there is a high prevalence of low back pain in elderly individuals and, as a result, functional disability is affecting their independence.
Could this be you? Do you need help with basic home maintenance? Do you experience frequent back pain that limits your ability to participate in activities you enjoy? If so, you are not alone as the statistics show. Movement can help and that is why I have created a new class called BackStrong.
Movement is a Miracle Drug
In Chapter 7 from my latest book, “Get UP! Defy Aging with Movement,” I discuss common chronic conditions that affect us as we age. Titled, “The Miracle Drug for Chronic Conditions,” I explain how movement and exercise can help reverse the effects of these degenerative changes. Here is an excerpt:
What is it?
Did you know there are over 100 types of arthritis conditions out there? The one we’re discussing here is the most common and called osteoarthritis (OA). In general, it is an inflammation (any time you see a work ending with itis, it means inflammation) or swelling of one or more joints and most commonly occurs in the hands, hips, and knees. It is caused by damage or breakdown of joint cartilage between bones and is, therefore, considered degenerative.
According to the Centers for Disease Control and Prevention, osteoarthritis is defined as a wearing down of cartilage within a joint and the underlying bone begins to change. (CDC, Arthritis.) I liken it to a road. Pretend the road you’re driving on is the bone surface at a joint. A new road is smooth and flat and the ride is not bumpy. When you have OA, the road is full of cracks and maybe even some pot holes. The ride (or movement of the joint) is no longer smooth but is bumpy and often painful. Inflammation occurs as a result and over time, the road continues to worsen. This is consistent with OA as symptoms usually develop slowly and get worse over time.
OA causes pain, stiffness, decreased flexibility, and swelling in affected joints. Over time, mobility suffers and the joint cannot move as fully as it once did. Soft tissue around the joint such as muscles and tendons then shorten because they are not used to their full advantage any more. Deformity of the joint often occurs in later stages and can be visible to the naked eye. Have you ever seen someone who is bowlegged? That is one example of a deformity at the knees. Imaging such as x-rays are useful in confirming this diagnosis.
Most joints are synovial joints, and this includes joints of the hand, hips, and knees. You may recall we discussed this in Chapter 5. Joints with OA benefit from movement because as the joints move, synovial fluid coats all the bony surfaces. This fluid lubricates the joint and results in less friction, so the ride is smoother if we again use the analogy of a road surface. Synovial fluid provides oxygen and nutrients to the boney surfaces, which helps reduce pain and swelling.
Other purposeful movement including strengthening and stretching can help improve the function of that joint and help normalize the forces within that joint. This allows it to better perform and, therefore, reduces pain and swelling.
There is something to keep in mind here. When you hurt, often the last thing you want to do is move. I get that. But, especially in the early stages of OA, movement is exactly what you need. That’s where your physician and movement specialist can help. As I said in Chapter 6, they can assess where you are now and develop a plan to gradually improve your flexibility, strength, and function to reach your goals for the future.
Here’s another bonus. Movement can help you lose weight as you begin to burn more calories than you did when you were sitting in pain. Weight loss is a tremendous strategy to help offload those joints where you bear weight like your knees, hips, and even your spine. You will feel better with less down force (or compression) through those joints.
What is it?
Certain spine conditions can be considered degenerative, and one of the most common is spinal stenosis. Spinal stenosis is a narrowing of the openings at the side of your spine where the nerves exit from the spinal cord and feed the rest of your body.
Spinal stenosis often occurs at your low back (lumbar spine) and can cause pain down your legs and even numbness and weakness. You can also experience stenosis at the cervical spine (neck). However, this affects your arms and not your legs. The nerves from the spinal cord at the neck feed your arms, and with stenosis, you would experience the same symptoms noted above, just at your arms.
There is a directional preference for movement with stenosis to help relieve symptoms. And it is typically to flex your spine, that is, to bend forward. At your neck, you would bring your chin down to your chest. For your low back, just sitting can be enough to relieve your symptoms. Occasionally, you can benefit from sitting at the edge of a chair and bending forward trying to touch your toes. Forward bending enlarges the openings where the nerves go and, therefore, relieves the pressure on those nerves. Standing and arching backward make the openings smaller. This would typically make your symptoms worse.
Be sure that arthritis at your spine is very common, though not mentioned in the excerpt above. It may also be called spondylosis which describes general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.
Please consult with your physician first before trying the maneuvers above. You may have certain conditions where bending forward is a risk to you (called a contraindication). Team up with your health professionals to devise a plan that is safe for you. I also welcome your questions as well and will guide you in the best way possible.
Arthritis and spinal stenosis are just two causes of chronic pain at your low back. And many times, there are multiple issues going on at the same time. These conditions do not have a cure. There is no magic pill either. In some severe cases, surgical intervention can help. An example of this might be a laminectomy which helps relieve pressure on the nerves exiting your spinal cord. In my years of practice, though, I have learned that this rarely comes on suddenly. Surgery is often not the answer especially in the early stages of degenerative changes. This is when you manage it. And the one common tool that helps manage them all is movement.
What is BackStrong?
I created BackStrong to help you ease pain and stiffness at your low back and legs so that you can do more and do it more comfortably. This one-hour class will include specially designed exercises for core and lower body strengthening and stretching. You will learn proper form for these conditions and although this is not a Buff Bones® class, modifications will be offered to those with osteoporosis. This class is ideal for those with degenerative changes at your low back including arthritis, spinal stenosis, spondylolisthesis and degenerative disc disease. Anyone who is active with recent participation in an exercise class is appropriate to attend.
For your safety, you must be able to stand on both feet and get up from the floor without assistance. Please allow enough space for your mat and space around it to move (approximately 5 feet total on either side). Please have a mat, small towel, and a bottle of water ready for use. A small ball or pillow, small hand weights, a resistance band, and a long belt/strap are highly recommended but not mandatory.
BackStrong will be presented virtually via Zoom in partnership with Oasis Rochester and anyone in the US may attend. This 10-week session begins Thursday, September 15th, with each one-hour class starting at 9:00am (ET). Each class ends with a short Q&A session. Visit https://www.prosolutions55.com/events/ for more information. Registration opens August 8th. Have questions? Please contact me at email@example.com at any time.
Keep moving friends.