How to categorize lower back pain

I’ve never been satisfied with the usual categories that doctors (and the general public) use to describe back pain. The most typical schema is to try to identify the specific anatomical structure – the muscle, disc, ligament, nerve, whatever – that’s been damaged.

Low back pain is way more complicated than that. In my experience, identifying a particular offending tissue is at best only a tiny forward step in grappling with the overall issue.

That’s why I was heartened to read a recent article by Marc Heller, DC.  He tries to understand the functional basis of the low back pain patterns he sees clinically.

One of the common patterns Dr. Heller identified was “flexion-intolerant low back pain.”  That rang a bell for me. Every week – practically every day – I see patients who can be described as having flexion intolerant back pain.

Here are some of the features of “flexion-intolerant low back pain”:

• you’re over 50, maybe even over 60
• you get a general achy feeling in the low back when you get out of bed in the morning
• the pain is in the center of your back, or on both sides symmetrically
• you don’t have pain shooting down the sciatic nerve
• you could be a woman, but it’s more likely you’re a man
• when you get out of a car your back feels creaky
• forward bending bothers your low back
• from time to time your back pain might get really bad, but then it subsides

What’s going on with the anatomy?

Someone with flexion-intolerant back pain has accumulated damage in the intervertebral discs of the low back. Forward bending posture put extra strain on the disc fibers, causing pain. You may also have a low level of inflammation around the disc.

What can you do about it?

You may not be able to completely eliminate the pain of a flexion-intolerant low back. But you can do a lot to help your cause. Here are some steps you can implement:

• Follow an anti-inflammatory diet and add supplements if necessary
• Get a new mattress if yours doesn’t support your spine without sagging
• Develop postural awareness so you can stand and sit with your spine in a balanced alignment
• Strengthen your spine’s support muscles with exercises such as the plank pose
• Limber the low back in a non-weight-bearing position – the cat-cow exercise is good for this.
• NeuroTactile® Therapy – relieves stress in your connective tissues and changes the pain messages going to your brain
• Lumbar flexion-distraction therapy – opens up space between the vertebrae to allow your discs to regenerate

Get started on improving your situation. Call for an appointment – 212-400-9663 or 609-497-1944.

Dr. Lavine has been an innovator in the use of movement and touch to promote health since 1981. He practices in New York City and Princeton, NJ.