This is Why You Have Chronic Lower Back Pain
And what you can do about it, Part 1
Lower back pain is one of the most common conditions in adults as we age. I once saw a statistic that said 80% of adults will have back pain at some point in their life. It’s not really surprising though, since so many of us spend hours each day, sitting at a desk with poor posture. One day is fine, but over years or decades, this can lead to significant pain. Plus we are one side dominant creatures (being left-handed or right-handed) who don’t lead symmetrical lives. This leads to multiple physical imbalances that can also cause pain.
While some people with lower back pain have bulging discs or spinal stenosis, these conditions don’t happen out of nowhere. Sometimes it’s comes about from a sudden trauma, like a fall, but many times it’s due to years and years of straining the body with poor posture. Plus falling alone won’t cause this type of problem; often it just pushes the body over the edge.
Understanding our basic anatomy and how our muscles are supposed to function, even on a very basic level, can help when it comes to getting out of pain.
The Spine
The spine has 5 parts: Cervical (7 vertebrae in the neck), Thoracic (12 vertebrae with ribs attached), Lumbar (5 vertebrae in the lower back), and the Sacrum (triangular bone at the back of the pelvis) and the Coccyx (tailbone). The Sacrum and Coccyx are made up of fused vertebral bones that we now consider single bones in and of themselves. The area of discussion in this post will be the Lumbar region that makes up the lower back.
As you can see from the photo above, there is a natural curvature of the spine in both directions depending on the part of the spine. The lumbar spine should be slightly lordotic, which means that the spine curves toward the front of the body. A diagnosis of "lordosis" is having too much curve in that direction, and often accompanies weak abdominal muscles. When the spine is "neutral," it should have a small lordotic curve.
Lumbar Muscles
While there are many related muscles that affect the lower back, and I will discuss some of them in next week's post, today's muscles are the Erector Spinae group and the Quadratus lumborum.
Erector Spinae
This group of muscles runs vertically up and down the back of the torso. As the name implies, they help us stand erect. These 3 muscles run alongside the spine and are extensors, which means they contract when we bend backward or hold us upright. They stretch when we bend forward, rounding the spine.
These muscles can feel tight both from being overly contracted and overly stretched. Neck and back pain from "sitting at a desk" for a living is usually fromt straining these muslces. They are not actually tight, though that’s how they feel. They are actually over-stretched.
When you sit for long periods of time, slouching tends to set in. You can only resist gravity for so long. Slouching causes the lower ack to round, and you fall to the back edge of your sit bones. These bones are at the base of the pelvis (ischial tuberosities).
There is nothing inherently wrong with rounding the lower back, it can be a great stretch (like in Cat pose), but if you are sitting rounded for long periods of time, you are over-stretching this muscle, which causes strain. Sitting with your pelvis in a vertical position gives a very gentle contraction to this muscle group and can relieve the “tightness” you feel.
Quadratus lumborum, aka the QL
This muscle sits on either side of the lumbar spine and runs from the 12 rib to the posterior aspect of the Iliac Crest, with attachments on the transverse processes of all 5 lumbar vertebrae. This deep muscle group is the source of a lot of lower back pain. It stabilizes our lumbar area as well as creates lateral flexion (side bending). Our one-side dominant lifestyle often causes one side to over work, and the other side to under work. Therefore, when we think we’re standing upright, we are often tilted to one side.
Check it out for yourself. Stand facing a full length mirror and close your eyes. Try to stand up straight. Open your eyes and see if what feels straight is actually straight. Chances are, you might be slightly tilted to one side. Notice if your shoulders are level, or if your ribs are uneven left to right. This is often due to tightness of one of your QL muscles, or one side of your erector spinae group.
Side bending stretches can help, but be sure to stretch to both sides. Even if only one side feels tight, the side that feels tight is not always the side that is tight. Remember, "tightness" can be a misleading sensation. Your back can feel tight when, in reality, it has been over-stretched. Notice to which side you have less lateral (side) movement when you bend. This is the side on which you want to spend a little more time.
Simple Yoga Stretches To Relieve Lower Back Pain
This simple Cat/Cow series, that I often lead when I teach, is wonderful to relieve all of this tension.
Start in Table pose with your shoulders over your wrists and your hips over your knees. As you exhale, round the spine from your tailbone to your head, trying to connect your movement to your breath. Initiate the movement with the start of your exhale, and finish your movement when you finish your exhale. This is Cat pose/Marjariasana.
As you inhale (also connecting the movement to your breath), lift the tailbone, drop your waist, press your chest forward through your arms and slide the shoulder blades toward your waist. This is Cow pose/Bitilasana. I have covered these two poses multiple times here, and in all of the Ask a Yoga Teacher posts.
Once you’ve gone back and forth between Cat and Cow 3 full rounds, you can move on to Variation 1.
Variation 1
Stay in Cat pose, and as you inhale, shift forward so that you round more in the upper back, and as you exhale, shift backward so that you round more in the lower back. Come back to center for Cow pose as you inhale. As you exhale, keep your pelvis stable, and move your right ribs toward your right hip, in a side bend. You should feel a delightful opening in your left waist and lower back. Inhale back to Cow pose, then side bend to the left. Try to move only the rib cage and not the pelvis.
Do this full sequence 2-3 times.
Variation 2
Repeat Variation 1, and when you are in the side bend to your right, stay there, and as you inhale, shift your hips to the left, leaning more on your left knee and shin. As you exhale, bring the hips back over your knees. Repeat this to the other side. Do this whole sequence 2-3 times.
Variation 3
Repeat Variation 2, and after you bring your hips back over your knees in your right side bend, cross your left knee directly behind your right knee. Keep your knees on the floor, and as you exhale, lean your hips backward toward your feet. It’s like Child’s pose, but with your knees crossed, reaching your hips on a slight diagonal. Lengthen your left hip away from your left palm and breathe into the hip stretch. You can stay here 3-5 breaths, then inhale to Cow pose and repeat on the other side.
This will conclude your Cat/Cow sequence. Rest in Child’s pose for a few breaths, and notice how your back feels.
To watch a short video on this sequence, click below.
If it’s tough for you to get onto the floor for Cat and Cow, here’s a video of Cat/Cow with variations in a chair, and standing:
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Love your work Janine. The simplest movements which can be done anywhere, anytime have profound effects.
Janine, I needed this post and all of these exercises today! Thank you!