Every Wednesday I spend 10+ hours in a Physical Rehabilitation Clinic. Talking to people who you usually wouldn't see in an ordinary day. People who are debilitated in one aspect or another. So, my job is to sort through the barrage of complaints, discuss options, educate and fix them. This is no easy task, my friend. My favorite complaint is "low back pain". We all have it or will. The lumbar spine is the work-horse of the human skeleton. It bears the weight of the trunk and noggin. The L-spine is a loner, relying on no one but its stocky self. The thoracic spine hangs out with the ribs and sternum while the delicate cervical spine only has to balance an eight pound noodle. So, why would the great omnipotent designer create a flaw in it's finest creation (i think the platypus is a close second)? Well, what we have are abdominal muscles to lend a hand to the lower back by adding support. So, during my initial assessment with a patient I always have them perform or attempt a sit up, not a crunch, a full fledged sit up. I have yet had a patient on their preliminary workup complete a full sit up in the past 6 months. Surprising I know.
Treatment for this pathology usually begins with pain management. If the person feels better they will be more active. Examples are narcotics, anti-inflamatories, depression meds with a co-indication for pain (pain and depression share neuro-receptors), steroids and etc. I like the combo of low dose narcotics and physical therapy with a focus on core strengthening. This works for a considerable portion (statistics will be publish once the research is complete) of my patients.
Love your lumbar spine and do some sit ups.
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