Low Back Pain*

Part 1: Looking for a Common Cause
by Doug Keller

In recent years an intense search has been underway to find a single common denominator that might provide a key to the problem of low back pain. The results have been rather surprising, and the solutions they suggest point to one of the most fundamental actions taught by the original hatha yogis – called the Uḍḍīyāna Bandha – as central to a simple program for overcoming recurring low back pain.

Of course there are indeed quite a few things that can go wrong in the spine that we think of as causing back pain – such as a herniated or degenerated disk, nerve compression in the spine, or imbalances arising from scoliosis, a tilted pelvis, or one leg being shorter than the other. And indeed, one or more of these problems may present in your own spine… But the surprising thing is that although you may have these problems, they are not necessarily the cause of your back pain! In fact, you may have these conditions and not even suffer from back pain at all!

This was the finding of a range of studies chronicled by Jim Johnson in his book, The Multifidus Back Pain Solution. Studies using MRIs in the mid 80s and 90s took the novel approach of doing extensive imaging of people with no complaints of back pain – in addition to those who do suffer from it – and found that a surprising 24% of people with no back pain had spinal nerve compression, and a whopping 64% of people with no pain had abnormal disks. Additional studies show that things such as having one leg longer than the other or one hip higher than the other, a stiff and inflexible back, an increased curve in your lower back, scoliosis (except when the curve is 80° or more) or even a herniated disk is not necessarily the cause of back pain, simply because such conditions can be found in people with pain-free backs.

Perhaps there is something that all sore backs have in common despite their different stories – something that explains why or how one person with a ‘bad disk’ suffers from back pain, while another does not. Then we would be much closer to preventing recurrences of back pain by treating the true cause.

Researchers were actually quite successful in coming up with just such a common denominator: a particular set of muscles called the multifidus muscles (pronounced ‘məl-ˈtif-ə-dəs’). People who suffer acute back pain have been found to have noticeable abnormalities in these muscles, while people who are pain-free had no such abnormalities in their multifidus – even though they did have disk and other problems. This was the finding of a researcher named Haig, published in the journal Spine in 1995.

This led to experiments in which exercises aimed specifically at strengthening the multifidus muscles were given to one group, while (in keeping with good scientific method) a second ‘control’ group was given no such exercises or treatment. At the end of a year only 30% of the ‘exercise’ group had a recurrence of low back pain, while the ‘non-exercise’ group suffered an 84% recurrence rate. After three years, the numbers shifted only slightly: a 35% recurrence rate for the exercise group, and 75% recurrence rate for the control group. It seems the researchers were on to something.
*Yoga As Therapy, Volume Two: Applications

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