If you’ve ever had back pain in Toronto, you know how absolutely crippling this can be, or at least how it makes even the simplest things in life so frustrating. From bending over to tie up your shoes, to picking up the kids, or to just getting out of a chair…it can be frustrating when you don’t know why it happens, or how to fix it.
Before we start talking about back pain treatment and back pain relief in Toronto, the first step is to try to determine WHAT the problem is. You can’t successfully treat your back pain without an accurate understanding of it, and proper diagnosis.
Unfortunately, this is where it gets a bit complicated. The low back is not a simple structure. If only it was as easy as you have pain there, therefore it’s this. Not the case with most pain in general, and especially not for low back pain.
There are a number of areas that can be potentially involved in any low back problem. Based on which activities you find aggravating, and which might relieve some of the pain, will help you to start pinpointing what your exact low back problem may be.
The low back is comprised of 5 bones, called vertebra. These are connected by discs, which are gel-filled structures surrounded by a fibrous outer ring. You’ve likely heard of discs, as the most severe low back problems typically involve disc damage.
There are joints in the back portion of each vertebra, called facet joints (or zygapophyseal joints), and these guide the motion of the vertebra through daily activities. There are also a number of ligaments, tendons, and muscles, which further stabilize the low back, and allow for active movement.
Another critical part of the low back anatomy is the curve in the spine, which in the case of the low back, is called a lordosis, or more specifically, the lumbar lordosis.
The purpose of this curve, which curves forward in the front of the low back, similar to the curve in your neck, is to absorb some of the gravitational stress, which is compressing you 24-7.
This lordosis, and the other curves in your spine, function like a giant spring, to flex and bend, helping to absorb some of the compressive gravitational loading.
This curve also functions to allow the tendons and ligaments to properly stabilize your spine, and to allow the muscles to function optimally for strength and movement.
In short, your lumbar curve is crucial to keep your low back healthy, and for successful back pain treatment and back pain relief in Toronto.
Ever sleep twisted at night, part on your stomach, and part on your side?
This is one of the most common causes of back pain in Toronto. Being twisted like this all night twists, or rotates your back, which your low back was never deigned for.
Doing this for a minute or two during the day is fine, but doing this for 6 or 7 hours while you sleep is not ok.
This irritates the joints in the back of your spine, stretching and irritating muscles, and can also irritate joints in your pelvis called your sacroiliac joints.
What should you do?
First step, stop sleeping like this!
Ideally, sleep on your back, so that gravitational compression is balanced on your spine.
If you have very tight hamstrings and calves (from sitting all day…a very common problem), put a small pillow under your knees to release some of the tension. Doing this alone can often provide some back pain relief.
If you sleep on your side, put a small pillow between your knees, to keep yourself from flopping over onto your stomach, twisting your back, and irritating your joints and muscles.
Avoid sleeping on your stomach, as this will irritate your back, but also potentially cause neck pain (link) over time.
This is most commonly caused by any type of twisting activity, or landing harshly (without preparation) on your leg, so that you don’t have time to absorb the stress properly. This irritation to the facet joints (in the back of your low back) and/or sacroiliac joints (in your pelvis) will lead to inflammation, irritating nerves, leading to muscle tension and spasm, and often back pain.
What can you do for SI joint pain treatment?
The first step is to ensure that you’re not further irritating the tissues. Whatever activity you were doing prior to the injury, stop it. Seems simple enough, but a lot of people don’t want to change their activity, and continue to do what injured them in the first place, only making it worse. So, as best you can, try to identify the activity, and stop it, or at the least, modify it so it’s not continuing to aggravate the condition and cause you more low back pain.
Some gentle SI stretches can also help, and I emphasize gentle. No pain, no gain is NOT true in this instance, and never applies to injuries.
The piriformis muscle crosses over the sacroiliac (SI) joint, and is one of the most common muscles involved in SI joint pain.
For a simple way to stretch it, lie on your back, with both legs outstretched. Bend your right knee, and slowly bring your right leg up towards your left chest, on the opposite side. Use your hands to pull gently on your leg, for a slightly greater stretch. You should feel the stretch in your gluts area. Hold the stretch for 20-30 seconds. Then repeat on the opposite side. Try to do each side 2-3 times. DO this consistently for SI joint pain relief.
The bridge is one of our favorite exercises for low back pain relief. It is simple, builds strength in the gluts and low back (critical for creating stability in the joints), but also will not aggravate low back pain if not done perfectly.
To perform a bridge, lie on your back, with your knees bent, and your arms at your side, with your palms down towards the ground. Slowly engage your gluts by squeezing them, and slowly raise your hips off the ground, to form a straight diagonal line from your knees into your torso. Hold this position, and the glut contraction, for 5 seconds. Then slowly lower your hips back to the ground. Repeat 10 times.
The plank is another exercise we love for low back pain relief, as it’s simple, requires no equipment, and even if not done perfectly, will not cause further damage.
To do a plank, start out in the pushup position, then bend your arms to 90 degrees, and rest your weight on your forearms. Your body should be a straight line from your head to your feet, with your weight on your toes and on your forearms. Your elbows should be directly under your shoulders. Hold this position for 30-60 seconds, or whatever you’re able to while maintaining proper form.
If this is too difficult to start, instead of balancing on your toes, do the same exercise on your knees, so that your body forms a straight line from head to knees. Again try to hold for 30-60 seconds.
Perform 2-3 sets.
As with any exercises, if you feel any pain, please discontinue the exercises. Without knowing the exact details of your injury, or specific pain patterns, it’s impossible to fine tune the exercises to your exact needs. Start out slow with any exercises, and try to maintain proper form. Better to do the exercises for a shorter duration, with proper form, than to do them for longer but “cheat” with improper form, and potentially aggravate your back pain.
The most common source of chronic low back pain in Toronto, and the most debilitating, is disc pain from disc degeneration or disc herniation.
This is the back pain that typically happens when you bend over to pick up your shoe off the floor, something you’ve literally done thousands of time before, but this time, there is a lightning bolt of pain that shoots into your low back, and maybe into your butt or down your leg. One of the worst pains you’ve ever felt!
To understand why this happened, let’s look at the anatomy of the low back, and specifically the disc, in more detail.
The discs functions as both a cushion, and spacer, in your low back. There is a central area, called the nucleus pulposus, which is a gel-like inner disc, which is surrounded by an outer fibrous ring layer, called the annulus fibrosus.
The primary function of the disc is not to absorb shock, although this is one of its functions. The main structure designed to absorb gravitational compression is the curve in your low back, called the lumbar lordosis.
The disc helps to absorb some of this compression, but its main job is to guide the movement in your low back, along with the joints in the back of the vertebra (facet joints), along with the active engagement of your muscles.
If you maintain the proper curvature in your low back, the lordosis, over your entire lifetime, barring any major catastrophic traumas, it’s very likely the discs in your spine will stay relatively healthy, with minimal disc bulges or disc herniations.
The issue comes when there is chronic flexion stress on the low back, such as from chronically slouched posture. The most common cause of this is from sitting in a chair staring at a computer or screen for hours and hours per day.
This flexed posture, causing a posterior pelvic tilt, causes the normal curvature in the low back to disappear, leading to either a flattening of the normal lumbar lordosis, or worse yet, a reversal of it.
As this happens, this places more and more stress on the front of the disc, where it shouldn’t be, slowly forcing the central nucleus pulposus gel backwards. If this stress becomes chronic, over months and years, this gel-like material gradually forces its way through the outer annulus fibres, eventually causing a lumbar disc bulge, or even worse, a lumbar disc herniation.
This is when you experience that lightning bolt of back pain, worse than any other back pain you’ve had before. This can bring you to your knees, where you can barely stand up, and it’s all you can do to hobble over to your bed.
It wasn’t the bending down in that moment to pick up your shoes that caused it. That was simply the straw that broke the camels back. It was the months and years of loss of the normal lumbar curve, with increased pressure on the front of the discs, slowly forcing them backwards, until they were at a critical point, ready to bulge or herniate through the disc itself.
That last effort to bend down, and pick up the shoe, was all that was needed to finish that process, causing the disc bulge or disc herniation, compressing the nerve, and causing debilitating back pain like you’ve never had before.
If bending down caused the back pain, then try to avoid this type of activity. In fact, try to avoid anything that compresses your spine. This means bending down, especially early in the morning, when your spine is more pressurized after sleeping, and more likely to have a further disc bulge or disc herniation.
First thing in the morning, wait as long as possible before your sit down, or bend over excessively.
After a disc injury myself years ago, I changed my morning routine. After I shower and get dressed (all done standing), I then make my breakfast and eat it standing. It’s at least an hour into my day before I ever sit, which makes a huge difference for back pain relief. I also avoid any forward bending (such as to put on socks or shoes for as long as possible). Simple, but it can make a huge difference.
If you sit a lot during your day, try to interrupt it as much as possible for back pain relief.
Set a timer so that every 30 minutes you are standing up, marching on the spot, reaching up to touch the sky, and doing a couple air squats to engage your gluts and hips, before you sit down again.
Doing this for even a minute every 30 minutes can make a huge difference in providing back pain relief in Toronto.
Try to start using a standing desk, or possibly alternate between a seated and a standing posture.
The key is to move, and to alternate the stresses on your low back, so it doesn’t continue to build and build for hours at a time. Click (here) for a more detailed article on the best way to sit for back pain relief in Toronto.
Our favorite back pain exercises are the bridge and plank, which were outlined previously in this article under the SI joint.
An additional exercise which is great for stabilizing the low back, and for back pain relief, is the side plank.
Lie on your right side with your legs out straight. Prop yourself up on your right forearm, so that your body makes a straight diagonal line from your head to your toes. Contract your abs, and hold this position for 20-30 seconds, or whatever you are capable of. Switch sides. Repeat 2-3 times per side.
As stated previously, if you experience any pain, please discontinue the exercise, and consult with a spinal correction chiropractor.
Although the types of back pain exercises that involve bringing your knees to your chest, or reaching down to touch your toes, can provide some temporary back pain relief in Toronto, if there is a disc problem in your back, these exercises over time can make it worse.
If you want to stretch your hamstrings and calves (which is a good idea), focus on hinging at your hips and not your low back. You won’t get as low, but you’ll definitely feel the stretch in your leg muscles, and will go a long way to sparing the discs in your low back at the same time.
Long term bed rest, while recommended years ago, has now been shown to be one of the WORST things you can do for low back pain. In most cases, it is best to try to be upright and moving around, walking slowly, if for only short periods of time, for back pain relief. Otherwise, lying down on a firm bed, in whatever position is comfortable, is best, but only temporarily, and not for days and weeks on end.
Because forward bending or flexion is the culprit 90% of the time with disc degeneration and disc herniations, leading to back pain, avoiding any forward bending or slouching while you’re experiencing back pain would be highly recommended.
Minimize how much sitting you are doing, but specifically avoiding sitting in a flexed posture, on a soft couch or chair.
So, in general, trying to be upright and moving, however gingerly it is, is going to be best for you, and minimizing any forward bending or slouched sitting, for the quickest Toronto back pain relief.
We’ve been helping patients get back pain relief in Toronto for over 15 years, and have helped thousands of people suffering with back pain.
While the recommendations we’ve given in this article are well researched and based on over 15 years of clinical experience with back pain, everyone is different, including you!
It is beyond the scope of this article to give specific back pain treatment recommendations for each person, as this will vary depending on your history, specific symptoms, and objective examination and structural x-ray findings.
Please consult with a qualified and experienced back pain specialist in Toronto before starting any new back pain stretches or exercise, or any Toronto back pain treatment program.
If you are having significant back pain, or numbness or tingling or weakness, please consult with a qualified corrective chiropractor. They will have specialized back pain treatments to help you to feel better as quickly as possible, but also to correct the underlying cause of your back pain so that it does not continue to worsen over time.
If we can be of assistance, or if you have any specific questions, please don’t hesitate to contact our Toronto back pain clinic today.
Dr. Byron Mackay