Low Back Pain (LBP)
By Crystal Evans, ATC
Low back pain (LBP) occurs in 10 to 15% of all athletic injuries and ranks second and fifth for physician visits and orthopedic referrals, respectively. 1 Though much of the research conflicts on the effectiveness of core training and exercise therapy for LBP nearly all athletes maintain a specific core strengthening regimen. 2 Most often the athlete is not aware of how the pain began however is very specific as to where the discomfort is located. Among episodes of back pain 90% cannot be isolated to a single incident of injury. 3 Low back pain can occur within the region below the ribs and above the lowest portion of the gluteal area, however may also radiate down the legs.
The spine is made up of four sections including: cervical, thoracic, lumbar, and sacral regions. The lower portion of the thoracic area and all of the lumbar and sacral regions make up the location defined for low back pain. Each section of the spine, except the sacrum, is made up of vertebrae and inter-vertebral discs that rest between every vertebrae. Though the shape of the vertebrae may be different depending on its location each has the same basic structure. All vertebrae have a thick vertebral body with supporting appendages like the transverse process, spinous process and facet joints. Ligaments connect each facet joint of vertebrae above and below and provide structure and stability to the spine. The vertebral body and the connecting appendages form a hole that the spinal cord passes through from the brain, through the cervical, thoracic, and lumbar vertebrae. Inter-vertebral discs are made up of water and fibrocartilage, rest between every vertebrae and provide shock absorption. The lumbar spine allows for flexion, extension, rotation and side bending of the trunk and functions to support the head, cervical and thoracic spine in addition to the weight to the body making the lower back highly susceptible to stress and strain. All of the above mentioned structures can be targets of injury.
The specific diagnosis for LBP can range in severity from muscle strain to intervertebral disc herniation, sprained ligament or fractured vertebrae. Many low back disorders mimic each other’s symptoms. Back pain can stay in one specific location, be spread over a large area or send shooting pain. Pain may also limit certain postures and movements and in more significant cases numbness and tingling is present.
While the standard exercise therapy and core strengthening treatment protocols are controversial in the relief of low back pain one can protect the back from injury on a regular basis. Paying attention to posture and body mechanics during various daily activities may not only alleviate LBP but prevent it all together.
Low Back Pain Help
To protect your back try the following:
- Lay on your side with knees and hips bent and a pillow between your knees
- Lay on your back with a pillow under your knees
- Sit minimally reclined with knees bent and feet flat on the floor; may use a foot rest if the chair does not adjust.
- Place your center of gravity (mid body region) as close to the object as possible by bending at the knees and hips and use your legs as opposed to your back to pick up the object
1. Graw BP, Wiesel SW. Low Back Pain in the Aging Athlete. Sports Med Arthrosc Rev. 2008; 16(1):39-46
3. Manek NJ, MacGregor AJ. Epidemiology of back disorders: prevalence, risk factors, and prognosis. Current Opinion in Rheumatology. 2005; 17:134-140
4. Fahey TD, Insel PM, Roth WT. Fit and Well: Core Concepts and Labs in Physical Fitness and Wellness. Boston: McGraw-Hill; 2009
Crystal Evans, ATC was a participant in the Hughston Athletic Training Fellowship Program, Columbus, Georgia, from 2008-2009. Crystal earned a Bachelor of Science Degree in Athletic Training, as well as a Bachelor of Arts Degree in Mass