Back Pain

Low Back pain

Upwards of 80% of people will have back pain at some time in their lives. Some quickly heal, or respond to treatment - others do not. Understanding how the body works is vital to understanding low back pain and how to heal it. The spine is a finely tuned engine - as with any piece of machinery, smooth running depends on each piece being in the right place and moving the right way at the right time.

There are several sources of low back pain

  • Muscular
  • Disc prolapse/rupture/herniation commonly called a slipped disc
  • SIJ (sacro-iliac joint) dysfunction
  • Spinal stenosis - narrowing of the nerve canals
  • Spondylosis/degenrative disease/changes/accelerated degeneration
  • Spondylolysis - spinal instability that may progress to spondylolisthesis
  • Spondylolisthesis - forwards or backwards slippage of a vertebra through significant instability
  • Arthritis and osteo-arthritis
  • Osteoporosis

Symptoms can very from mild localized ache to widespread pain, shooting pain - down one or both legs, radiating pain, pins and needles, numbness, muscle weakness, loss of bladder, bowel or sexual function, muscular atrophy (muscles wasting).

Other than traumatic injury, there are two common problems that I see in people with low back pain

  • Altered spinal curves and lack of normal spinal mobility
  • Lack of stabilizer function

The spine is designed to function with three basic curves - cervical, thoracic and lumbar. These curves should each measure between 30 and 35° and all be equal. Although this is significant in any case of low back pain in my experience with clients, assessing and correcting the spinal curves is fairly rare outside of CHEK Practitioners. Treatment through drugs that mask symptoms and short-term 'fixes' through osteopathy or physiotherapy are common, but often fail in the long-term.

Many people are trying to help themselves with poor information and with inadequately qualified therapists or personal trainers. If you are working with someone it is vital that you ascertain that the person is suitably qualified in low back pain and not just in general exercise and fitness. Unless their training and knowledge is adequate they may be able to help you to a small degree, but at they could make you significantly worse! For example, a sit up is not an exercise that helps stabilizer function, and will make a slipped disc worse - specific back extension exercises will improve the problem. However, give the same back extension exercises to someone with spondylolisthesis and they could get worse.

Often I see exercises that are prescribed to strengthen the core that are inappropriate, they may be too demanding and exceed the person's threshold of stability or have not be taught correctly. The nervous system is the 'messenger' in any muscle activity so it is important to re-educate the messages to the muscles.

What you do the most has the greatest influence. Therefore if you spend most of the time standing or sitting in poor posture, or moving around with poor mechanics and movement patterns your body is more likely to hurt and fail to get better even with treatment or exercises.

Plan of Action

If you have low back pain it should not be ignored other than for a day or so if it is mild and thought to be muscular. Your Plan of Action should be to find a reputable Practitioner - preferably a CHEK Practitioner Level I and above, who can correctly

  • Assess you thoroughly including measuring your spinal curves and assessing your stabilizer (core) function. Without assessing to establish where you are at it is just down to guesswork!
  • Assess you for organ dysfunction and digestive tract health as an inflamed digestive tract or organ can cause referred pain elsewhere in the body, as well as shut down the stabilizer muscles. What you eat and drink will affect your healing, so advice on optimising your diet is important to successful rehabilitation.
  • Re-educate you to use your body correctly and give you ergonomic advice.
  • Design you an exercise program that is exactly right for you to stretch, mobilize and strengthen where necessary, including the core.
  • Provide you with contacts to any other reputable therapist that you may need to see to fully rehabilitate your condition. Some conditions such as spondylolisthesis cannot be fully rehabilitated but need careful management to prevent the condition worsening.

Arthritis, osteo-arthritis and osteoporosis can be helped through correct diet, exercise and lifestyle changes too.


Low back pain should not be ignored, and painkillers and anti-inflammatory drugs should be used sparingly. Taking action quickly may prevent the condition worsening and shorten your rehabilitation time. Although many therapists are recommending Pilates, the choice of exercise and skill of the teacher makes all the difference. Remember that there is not usually an assessment before a class or course is taken (although this is beginning to change) and therefore exercise prescription is still somewhat random.

Think of your body like your car - it needs servicing, and when it goes wrong it needs the specialist attention. Unlike a car, your body is yours for life - take care of it and it will give you long, pain-free service!