Low back pain 2

When you view low back pain, you can think of it from 2 perspectives.

1.  Biomechanical causes

2.  Metabolic causes

Most research has focused on the biomechanical causes of low back pain.  Truthfully, you could spend your entire life studying clinical biomechanics as it is a complex topic.  For example, in the 1980's, we thought you just needed to get some bed rest.  In the 1990's we realized that abdominal muscles were important in the stability of the back.  In the late 90's, gluteal muscles and legs were understood as important.  In the 2000's, there was an explosion of research on muscles with fancy names like; multifidus & transverse abdominis. And only fairly recently did many practitioners start appreciating the respiratory diaphragm and muscles of the pelvic floor.

As there are many practitioners who are skilled in this approach, I won't regurgitate this body of knowledge in this blog.  For more information, check out this blog by biomechanics expert, Will Stewart.  Will does a great job highlighting the importance of assessing all components of the kinetic chain from a variety of "real life" positions.  He also emphasizes a "real life" approach to rehab and exercise.  Great stuff and hours of mind-boggling reading.

I will mention that as we've learned more about the biomechanics of the spine, we've really come to appreciate the role of the nervous system.  While the term "musculoskeletal" has been around for decades, the term "neuromusculoskeletal" has been in use for the past 10-15 years as we've come to appreciate the role of the brain.

However, for most of those past 10-15 years, the "neuro" part has not been well described.  In the next post, I'll start there with the overall goal of bringing us into the metabolic arena.  I want to show you that to have a good biomechanical system, you must have a good "neuro"  system.  And to have a good "neuro" system, you must have a good endocrine and immune system.  And to have a good endocrine and immune system, you must eat well, manage your stress, sleep well and exercise... all the things that make you healthy.