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Low back pain. Chances are, you've experienced it or will in your lifetime. Up to 85% of Americans will. And of those, the vast majority will suffer from what is termed "chronic non-specific low back pain" (CNLBP.)

This means that there is no definitive diagnosis of the cause of the pain. In the other cases, lumbar disc degeneration and herniation are two common causes of CNLBP.

CNLBP is usually diagnosed when X-ray, MRI , and symptoms rule out spinal or nerve pathologies. CNLBP is  

defined as pain, muscle tension or stiffness below the costal margins (ribs) and above the gluteal fold, with or without sciatica.

Lumbar disc degeneration can be suspected if there is a low-level of constant pain followed by episodic spasms and severe pain. Symptoms tend to worsen with sitting, and walking and changing position are more comfortable than a static position.

Disc degeneration is frequently a result of damage to the annulus (outer ring) of the disc. Inflammation and micro motion causes some instability, pain, and muscle "guarding(spasm)."

Disc herniations and fractures may result in unilateral, dull pain, especially when standing on one leg or hyperextending the spine.

Prolapsed or extruded discs often occur in the L5-S1 vertebrae ( lumbrosacral area) and may cause sharp pain and spasms at the site of the herniation. Sciatica is often present as well.

Sacrum and coccyx fractures often result in dull, unilateral pain that may extend to the buttock and thigh. Standing and sitting may be quite painful.

Very serious red flags include: pain not related to time or activity, persistent pain at night or while supine, pain that radiates to the leg or foot, numbness, and unilateral leg pain.

If pathologies have been ruled out by a medical professional, people with CNLBP should follow these recommendations for activities of daily living(ADL):

1. While sitting, keep the feet flat on the floor, and ensure proper lumbar support.

2. Try to change positions frequently while seated, and get up every 20-30 minutes.

3. While standing, shift weight, keep knees bent, and keep one foot raised, then the other on a regular basis.

4. Sleep on your side or back with a pillow between or under your knees.

5. Use a firm mattress or put a piece of plywood underneath your mattress.

6. Stay well-hydrated.

7. Acute pain can be treated with NSAIDs and ice for inflammation.

People suffering from CNLBP are advised to follow the same general exercise recommendations set for apparently healthy people. These include: 5x/ week aerobic exercise for a minimum of 30 minutes each session; 2-3x/week resistance exercise, 8-10 exercises for major muscle groups; and range-of-motion(ROM) and neuromotor exercises.

Specific exercises should include core, glute, and hip strengthening and lumbar extension ( such as bird dogs and swimmer). The hamstrings, hip flexors, and glutes should be stretched as well. ( the McGill Back Series is an excellent preventive as well as rehabilitative program that can do wonders in minutes per day.) Repeated spinal flexion( "crunches" for example) is to be avoided. Plank variations and posterior pelvic tilts are recommended.

Adherence to a regular exercise program has been should to significantly reduce muscle guarding, increase spinal segmental motion, and improve mechanical faults.

The good news: Studies have shown that individuals with CNLBP who adhere to the listed guidelines achieve much better outcomes than those who do not.

Ludacris(2004) "GET BACK"

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Make one false move I'll take ya down!