The Low-Down on Lower Back Pain

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When the term “lower body injury” is tossed around casually on an NHL team’s report, it could mean a variety of things wrong with a player. However, when reports start surfacing that it’s a back issue – that’s when it can get scary. Remember what happened to Nathan Horton in the last few years? He’s been experiencing debilitating back pain that’s kept him off the ice since April of 2014 from severe degenerative disk disease in several of his lower vertebrae that has effectively ended his pro career.

So lower back pain is nothing to be taken lightly. In fact, it’s the second most common cause of disability and is the second most common pain-related reason for lost work time.

What is low back pain?

For most people, lower back pain is a normal occurrence that goes away on it’s own, but if it’s recurring you need to take action.

There are two types of lower back pain: back dominant pain and leg dominant pain.

Back dominant pain radiates down the back and can sometimes also be felt in the hips or the legs. It’s an intermittent pain that can come in spasms and is reactive to certain back positions. This kind of pain is “good” because it isn’t from damage to nerves or the spinal cord.

Leg dominant pain is continuous or gradually worsens and comes from a problem in the spine. One cause is sciatica, where your discs put pressure on the spinal nerve and it usually feels better when you lie down. Another cause is neurogenic claudication caused by a narrowing of the spinal nerve tunnel and is felt when you stand, walk or run.

You asked the doc – he answered

You guys have been asking questions about lower back pain and our doctors are here to answer them.

Here is one from Dave in Philadelphia:

 I always have significant pain in my lower back and it gets to the point where I can’t play. I’ve had a couple of previous disc injuries but those don’t explain the muscular pain located at the top of my pelvic girdle. I don’t have a huge belly hanging out either. What are the most effective stretches and/or exercises to do to alleviate this pain? Is it all because of a lack of strength in my core? 

“Hi Dave. Back pain is one of the most common problems I see in my practice. You are definitely not alone. It sounds like your body is not able to recover from what’s causing the back pain, as it has in the past. And your pain feels different than before, which may mean it is a new injury, or a result of compensating for other injuries.

Stretching and core exercises may be part of the solution, but if you can’t play the sport you love because the pain is too much, I think it’s time you made an appointment with a health care specialist (family physician, sport medicine physician, physiotherapist, for example). Suggesting exercises sounds like a good idea, but without knowing more about the pain, some exercises may worsen, rather than help your current situation.

You have reached out via email in hopes of finding some answers, but I would suggest you reach a bit further and have a formal evaluation. That is likely the quickest way to get back on the ice to help your team win another Stanley Cup – or at least to enjoy a post game beer with your teammates.”

What works for low back pain?  

Here’s the good news. Low back pain is often treatable on it’s own. Of those who do seek medical attention 90% of patients with acute low back pain recover eventually.

But unfortunately you can’t fix your low back pain by lying in bed watching The Hanson Brothers. While rest is good for some people who have severe sciatica, those with lower back pain who don’t move at all get worse.

Moving is the best medicine for your lower back pain. Exercise combined with other therapies like massage, spinal manipulation or acupuncture can be great active therapies to improve your pain. Other solutions for low back pain in more chronic conditions are: having a multidisciplinary team, to bring different solutions to the table, and cognitive behavioral therapies, to change the way you think about your low back pain. A lot of your treatment is in your hands. Your attitude towards your back pain has a large correlation to outcomes from low back pain.



Once the pain has subsided exercises like yoga or Pilates can be good to strengthen the core.

Signs your back needs more attention

While most back pain is benign, and goes away on it’s own, in come cases it can be a sign of something more serious. If you have red flags along with your back pain it’s important to bring it to the attention of a medical professional.



“Back pain is like a lot of things in life. Your mindset and daily habits are critical—and so is self knowledge,” says Dr. Mike Evans.

If you’re suffering from low back pain make sure you know the red and yellow flags and take charge of your care.

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