There's good news for sufferers of chronic lower-back pain

by Ruth Nichol / 16 April, 2018
RelatedArticlesModule - Chronic lower back pain

Photo/Getty Images

Chronic-pain sufferer Cathryn Ramin advocates exercise for sore backs rather than medical intervention.

Cathryn Ramin has good news and bad news for those who suffer from chronic lower-back pain. The good news is that it’s possible to get rid of the pain without heavy-duty pain relief, spinal injections or surgery.

The bad news is that it will take a lot of time and effort to recondition the muscles associated with chronic lower back pain – the glutes, the pelvic muscles, the thighs, the knees and the feet. It will also be painful – at least initially – and you’ll need to keep at it. If you don’t, your symptoms will probably return.

“As I say to people, it didn’t take you five minutes to get to where you are, and it’s going to be hard work and going to take you time to get out of it,” says Ramin, the US author of Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery.

Ramin, who suffered from chronic lower-back pain for years, credits her recovery to a series of “back whisperers”. They include personal trainers, Iyengar yoga teachers and, most recently, postural therapy classes known as Egoscue.

She also regularly does three spine-stabilising exercises developed by Canadian spine specialist Stuart McGill – even when, as she was recently, she’s staying in remote huts in the South Island. “I just need to find enough floor space to do them.”

Like many of the estimated 10% of people who suffer from chronic lower-back pain (pain that lasts for three months or longer), Ramin was seduced by the promises of what she calls the back pain industry. MRI scans revealed she had something called “degenerative disc disease” – an ominous-sounding condition that she later discovered is common in all older people.

Cathryn Ramin. Photo/Jonathan Manierre

She eventually had minor back surgery, but her pain didn’t go away.

That failure spurred the long-time journalist to start a six-year investigation into what works – and what doesn’t – when it comes to treating chronic back pain. She concluded that unless your pain is caused by something like cancer or by obvious trauma such as a car accident, you’re better off strengthening the relevant muscles than attempting a “quick fix” through surgery or other medical means.

That means getting rid of a few preconceptions. The first is that your pain is the result of one very specific event.

“People are constantly looking for the pain generator. People say, ‘I leant over to pick up the newspaper and I hurt my back’, or ‘I took the luggage out of the car and hurt my back’. But you’ve done those things hundreds of times before and you didn’t do any serious damage to your musculoskeletal system.”

In most cases, she says, pain is the final stage of a cumulative process of deconditioning, often caused by too much sitting. Ramin says chronic lower-back pain doesn’t exist in countries where people use stools instead of chairs and squatting is common. “It’s very much an industrialised-society problem.”

The second preconception to put aside is that you should avoid activities and exercises that cause pain. “You need to get over the idea that hurt means harm.”

As real as your pain feels, she says, it’s not caused by tissue damage but by something called central sensitisation. Essentially, your nervous system has gone into a state of high alert and started responding in a disproportionate way to minor stimuli.

Enter the back whisperer, someone who can help you persevere despite the pain. In most cases they’ll be a personal trainer, though lower-cost alternatives include taking Feldenkrais or Alexander Technique classes, signing up for Iyengar yoga (“it’s a purely orthopaedic style of yoga”) and doing tai chi or qigong.

Ramin has a few tips on how to find the right person. Good bets include those who have heard of the work of McGill and Australian pain expert Lorimer Moseley and are familiar with and experienced in strengthening the muscles associated with back pain.

You might want to reconsider if they chuck a medicine ball at you or suggest you do sit-ups – which are bad for your back – or forward-bend from the hips to “stretch” your back. “They’re never a good idea.”

Cathryn Ramin will talk about her research at Functional Physio in Auckland on April 16.

This article was first published in the April 7, 2018 issue of the New Zealand Listener.

Latest

A big science investment - but where’s the transparency?
99199 2018-11-17 00:00:00Z Tech

A big science investment - but where’s the transpa…

by Peter Griffin

An extra $420m is being pumped into the National Science Challenges - but the reasoning behind the increased investment won't be released.

Read more
NZ music legend Gray Bartlett has a new album – and a wild past
99182 2018-11-16 13:32:58Z Music

NZ music legend Gray Bartlett has a new album – an…

by Donna Chisholm

We revisit this profile on award-winning guitarist Gray Bartlett, who's just released a new album, Platinum!

Read more
Vint Cerf: The father of the Internet reflects on what his creation has become
99178 2018-11-16 13:13:08Z Tech

Vint Cerf: The father of the Internet reflects on …

by Peter Griffin

"We were just a bunch of engineers trying to make it work. It didn't even occur to us that anybody would want to wreck it," says Vint Cerf.

Read more
Win a double pass to the NZ premiere screening of Mary Queen of Scots
99165 2018-11-16 10:51:28Z Win

Win a double pass to the NZ premiere screening of …

by The Listener

Starring Academy Award nominees Saoirse Ronan and Margot Robbie, Mary Queen of Scots explores the turbulent life of the charismatic Mary Stuart.

Read more
Goodside: The North Shore’s new food precinct
99155 2018-11-16 09:33:23Z Auckland Eats

Goodside: The North Shore’s new food precinct

by Alex Blackwood

North Shore residents will have plenty to choose from at Goodside.

Read more
A tribute to the dexterous, powerful and vulnerable Douglas Wright
99153 2018-11-16 08:25:30Z Arts

A tribute to the dexterous, powerful and vulnerabl…

by Sarah Foster-Sproull

To choreographer Sarah Foster-Sproull, Douglas Wright was both mentor and friend.

Read more
The death of Radio Live
99147 2018-11-16 06:54:48Z Radio

The death of Radio Live

by Colin Peacock

14 years after launching “the new voice of talk radio”, MediaWorks will silence Radio Live. Mediawatch looks at what could replace it.

Read more
Should Lime scooters stay or should they go?
99103 2018-11-16 00:00:00Z Social issues

Should Lime scooters stay or should they go?

by The Listener

For every safety warning, there’ll be a righteous uproar about the public good regarding the environment. It's about finding the right balance.

Read more