Avoiding back pain
If you have back pain, you are not alone. Around 70% of people will experience it at some point in their lives. The causes are very varied and not always easy to find. Often the pain is non-specific, and it takes some research to find a solution.
Possible causes
Non-specific back pain is said to be caused by the active musculoskeletal system of the back. In other words, the pain is caused by the muscles. No damage to the bone structure can be detected.
Muscle length
We have known for some time that muscles can adapt not only their cross-section but also their length. If muscles that attach to the spine or pelvis change, this affects the body's static alignment. The hip flexor, for example, can exert a constant pull on the spine when standing if it becomes shortened from sitting too often. This is because it attaches to the fourth lumbar vertebra and therefore defines the range of motion when bending and stretching.
Pelvis and spine
The spine rests on the pelvis. If the pelvis is misaligned, this also affects the bone structure above it. For example, the position of the pelvis influences the position of the lumbar spine. Such changes are compensated for by individual muscle groups. If this does not happen, problems arise in the long term. Reduced tension in the abdominal muscles can cause the pelvis to tilt forward. The result is a "hollow back", as the lumbar spine also curves.
Optimal back training
To promote muscle length, training is done through the full range of motion. However, this is not possible for all muscle groups, which is why Fle.xx Training is a good option. These exercises target muscle length specifically and therefore influence the static alignment of the spine.
Neglected abdominal muscles
The abdominal muscles play a stabilising role, especially for the lumbar spine (LWS). They are used in all movements of the upper body. In doing so, they are trained and their stability is maintained. However, if you avoid every exertion because it is commonly considered harmful to the back, you weaken your muscles. In addition, the abdominal muscles are hardly used when sitting.
A noticeable reduction in pain can often be achieved by deliberately strengthening the abdominal muscles. This simply reduces the load on the spine.
Neural control
Back pain can also be due to what is known as feedforward control. This refers to neural control that takes place before the actual movement happens. Through it, the body already takes measures before the movement has even begun. It ensures that the movement runs smoothly and safely. When walking, the muscles around the spine are activated. If the muscles react too late, they cannot be ready for the movement. A disturbance of neural control can be present when non-specific back pain occurs. The main cause is too little movement, which means the neural mechanism has been unlearned.
Regular movement trains it again and improves it.
Comparison of therapy methods
Three active therapy methods for chronic lumbar back pain were studied in August 2001.* 148 patients were assigned to one of the following therapy groups, with two sessions per week for three months:
active physiotherapy
trunk muscle reconditioning on training equipment
general aerobic programme.
Using a questionnaire, self-assessment of pain and disability was recorded before and after the therapy period, as well as 6 and 12 months after the end of therapy. Complete data was provided by 127 patients.
Conclusion: Throughout the entire follow-up period, the three treatment methods showed the same effectiveness in reducing pain intensity and frequency.
However, the subjectively assessed disability was perceived differently by the therapy groups. In the physiotherapy group, the positive effect was gone after six months. The other two groups still felt the positive effect one year after therapy.
There were also massive differences in costs. The aerobic programme was by far the least expensive. Therefore, using strength training or aerobics as therapy methods could massively reduce the treatment costs for chronic, non-specific, lumbar back pain.
*Source: Mannion, A. F.; Taimela, S.; Muntener, M.; Dvorak, J. (2001): Active therapy for chronic low back pain part 1. Effects on back muscle activation, fatigability, and strength. In: Spine 26 (8), pp. 897–908.
