Dr. Mitch Broser
The Stats
Chronic low back pain in American adults has consistently accounted for the largest number of years lived with disability in 1990 and 2010. Health expenditures for adults with spinal problems has been progressively increasing from the 1990s to 2000s and were estimated at roughly $6,000 per person with chronic low back pain in 2005, with a total cost of $102 billion (Shmagel, et al 2016).
In 2015, over ½ a billion people worldwide had low back pain and more than a third of a billion had neck pain of more than 3 months duration. Low back and neck pain prevalence and disability have increased significantly over the past 25 years and will likely increase further with the aging population. Globally, the prevalence of low back and neck pain has increased by 18.7%. (Hurwitz, et al.2018)
The spine is a long column of bones, called vertebra, that are stacked on top of each other to make a long, mobile yet stable cylinder. Typically, the cervical spine (neck) is made of up 7 vertebrae, the thoracic spine 12, and the lumbar spine 5. These regions all function slightly differently due to the change in the structure of the joints, but they all must contribute to healthy spine movement.
Poorly managed injury, repetitive movement, and sedentary lifestyle all contribute to the steady rise in back and neck pain globally. In order for the spine to function optimally, all of its joints must be able to move freely and with control. This allows for force to be distributed evenly across the whole spine. When some areas of your spine do not move well, then other areas or joints have to pick-up the slack and move more. The areas picking up the slack will end up taking on more load, predisposing those joints to injury.
When I was younger, I would go ice-fishing and play hockey on the pond with my friends and family. I was taught that if the ice is thin, you need to lay flat on your stomach to distribute your weight across more surface area to prevent yourself from falling through. If you were to stand on your feet, your entire body would be stacked on top of the small surface area of your feet, increasing your risk of falling through the ice.
Think of this for the spine – A healthy spine `can distribute force evenly across its entire length to minimize overloading at one joint. However, if one joint or area moves well while the rest of the spine doesn’t, then all of the force will be funneled into that one area, increasing the risk of an overload injury at the well-moving segment. The area of the spine that moves more to compensate for the lack of spine function elsewhere is referred to as a hinge point.
When someone blows out their back, it does not actually “blow out”. Stu McGill (world-renowned spine biomechanics expert hailing out of Waterloo, Ontario) refers to this as a “spinal buckle.” This occurs at spine segments that are more prone to movement and loading, such as at these hinge-points. The misconception is that training stability is the key to managing low back pain. Developing strength, stability, and control of the spinal buckle (or hinge point) is only part of the equation. Establishing movement and control throughout the other areas of the spine is vital in rehabilitation and training to create a strong, robust spine.
In the SPINE Flexion/Extension Kinstretch Express Class, we focus on developing fundamental mobility, capacity, and control throughout the entire thoracic and lumbar spinal level to promote optimal spine function and reduce the risk of acute injury and chronic back pain.
References:
Hurwitz EL., Randhawa K., Hainan Y., Cote & Haldeman S. The global spine care initiative: a summary of the global burden of low back and neck pain studies. European spine journal. 2017
Shmagel A., Foley R & Ibrahim H. Epidemiology of chronic low back pain in US adults: data from thee 2009-2010 national health and nutrition examination survey. Arthritis care and research. Vol 68, No 11, pp 1688-169. 2016.