If it is one thing we have established so far this month, it is that it takes multiple interventions to help with chronic pain, and that is because there are many factors at play. Depending on the origin and cause of each person's pain point, different treatments may be appropriate.

According to the National Institute of Neurological Disorders and Stroke (NINDS), low back pain is the most common cause of job-related disability. At least 80 percent of Americans will experience low back pain in their lifetime.

Most low back pain is the result of an injury, such as muscle sprains or strains due to sudden movements or poor body mechanics while lifting heavy objects. It can also come from other sources such as cancer of the spinal cord, a ruptured or herniated disc, sciatica, arthritis, kidney infections or infections of the spine.

Low back pain is more likely to occur in individuals between the ages of 30 and 50. This is partly due to the changes that occur in the body with aging. As you grow older, there’s a reduction in the fluid content between the vertebrae in the spine.

This means discs in the spine experience irritation more easily. You also lose some muscle tone, which makes the back more prone to injury. This is why strengthening your back and core muscles and using good body mechanics are helpful in preventing low back pain.

See our video on Lower Back Pain from our Pain & Inflammation Live Series.

What does the research say about Exercise and Low Back Pain?

Geneen et al. performed a systematic review of 264 research studies using exercise as an intervention for chronic pain. The review included almost 20k subjects and covered the following conditions:

💥 Rheumatoid arthritis

💥 Osteoarthritis

💥 Fibromyalgia

💥 Low back pain

💥 Intermittent claudication

💥 Dysmenorrhea

💥 Mechanical neck disorder

💥 Spinal cord injury

💥 Postpolio syndrome

💥 Patellofemoral pain

Workouts included: strength training, stretching, range of motion, core, balance, yoga, Pilates, Tai Chi and cardio. Results of the analyses support that exercise improves pain severity and physical function resulting in improved quality of life, with few adverse effects.

Similarly, Searle and colleagues performed a systematic review and meta-analysis of 39 randomized controlled trials. Exercises included coordination/stabilization, strength/resistance, cardiorespiratory and combined. The results showed that exercise interventions reduce low back pain, yet cardio had the lowest effect.

The bottom line, it is going to take both stretching and exercises to create the right mechanical changes to support a healthy back. Another key component is is mindfulness - awareness of your posture, how you're sitting, how you're driving, how you're sleeping, etc.

Here are some tips:

✨ Strengthen the glutes - you can clench while seated, squats over a chair, or bridges.

✨ Strengthen the core/transverse abs - hug the abdominal muscles in toward the spine as if you're zipping up tight clothes.

✨ Strengthen adductors (inner thigh) - Squeeze the legs together; use a block, ball, pillow, fist, etc.

✨ Stretch - cat/cow which can be done seated

✨ Seated spinal twist

✨ Tune into your gut health - they're related!

✨ Research suggests a regular routine that includes coordination/stabilization, strength/resistance has positive results with reduced pain and increased functioning for chronic low back pain.

Tune into our virtual classes for more exercises and stretches to help your body.

Acupressure & Low Back Pain

Acupressure is similar to acupuncture which releases energy along meridian energy channels, but instead of needles you use fingers to massage pressure points.

Results from a recent study showed positive improvement in pain in acupressure groups compared with usual care. Pain was reduced by 35–36% in the acupressure groups. Improvement in fatigue was also found in stimulating acupressure compared with usual care. Adverse events were minimal and related to application of too much pressure.

Watch our video below for a demonstration on how to perform self-acupressure for chronic low back pain.

We'll be taking a deep dive into finding the source of and treating chronic lower back pain in our Love Your Lower Back virtual workshop on 6/24/20. Presenters: Dr. Dana Gulati, DOM, Christine Camara, LMT, Holistic Health Coach, Alyssa Knapp, MS, Certified Exercise Physiologist.

The biggest differentiation between Western Medicine and Eastern (like Traditional Chinese Medicine) is that the latter looks at your body in a very concrete and logical way, while the former focuses on the energy of the whole person.

Much like a mechanic looks at a car, Western doctors go directly to the symptom and treat it. In contrast, a Traditional Chinese Medicine (TCM) doctor or practitioner doesn’t focus on science and medicine. Instead, they focus on balance, harmony, and energy and treat with remedies that enhance the body’s own ability to heal.

As we investigate one of the top health complaints, chronic pain and inflammation, it’s worth noting that one of the most popular forms of treatment in TCM is acupuncture, and for good reason. According to the National Institute of Health, results from a number of studies suggest acupuncture may help ease types of pain that are often chronic, such as low-back pain, neck pain, osteoarthritis/knee pain, and carpal tunnel syndrome.

I asked our acupuncturist, Dr. Dana Gulati, DAOM, to shed some light on how a TCM doctor addresses pain and inflammation.

In TCM, inflammation is mostly caused by stagnation. Stagnation is when blood, Qi (energy), and bodily fluids slow down and/or stop, causing obstruction in the meridians (the channels in which your body's energy flow). When stagnation occurs, the free flow of energy and blood become “stuck.”

Stagnation can be caused by a number of different factors. Mostly, trauma or injury takes place and proper flow is affected. Certain foods like excess consumption of simple carbohydrates and fried foods tend to cause stagnation as well. Sedentary lifestyle, stress, anxiety and some medications can cause obstruction and lead to stagnation, inflammation and pain.

Acupuncture, herbal medicine, proper nutrition and exercise can help with chronic inflammation and reverse the negative effects of obstruction while reducing pain in the body.

Throughout the entire month of June we will looking at healing pain and inflammation from a holistic perspective and introduce some of the evidence-based ways to manage it outside of Western medicine. Plus, if you suffer from Chronic Low Back pain, you do NOT want to miss our workshop, Love Your Low Back.

This article was written in partnership with Dr. Dana Gulati, DAOM. Join me with Dr. Gulati, Christine Camara, LMT, Holistic Health Practitioner, and Lisa Medley, MA, CMT and other experts in their field for the Pain & Inflammation Facebook Live Series, or sign up for our weekly newsletter to get the recap in your inbox.

Updated: Jun 7

We are all familiar with inflammation. You twist your ankle and it becomes red, hot and swollen. Or you have a virus and run a fever. That’s your body’s immune system at work. It is your defense against injurious forces and is a normal, healthy healing response.

However, when inflammation persists after the event has passed, it can become problematic and turn into chronic, invisible inflammation.

Chronic inflammation is when the immune system mistakenly attacks normal tissues. This type of inflammation is rarely visible, unlike when you sprain your ankle and you see the red, swollen area. With chronic inflammation, you feel rather than see the effect. Inflammation can affect the brain, skin, organs and muscles - literally every part of us. It can lead to a general feeling of malaise.

Some signs of invisible inflammation include:

  • Pain that moves from one area to another

  • Irritability

  • Joint pain and stiffness

  • Insomnia

  • Fatigue

  • Inability to lose/gain weight

  • Bloating and excessive gas

  • Cramping

  • Brain fog/memory loss

Inflammation does not show up on a CAT scan or other medical tests. You may visit your doctor because you know something is not right and be told nothing is wrong, that your tests are all negative. This can be VERY frustrating and you may start to think it’s all in your head. There is help, and no, it is not all in your head. What you are feeling is, in fact, very real.

Oxidative Stress

Microbial invasions, trauma (physical or emotional), injury, diet and stress can all “turn on” the inflammatory response. Stress, be it physical or emotional, creates an oxidation of our cells. Think of an apple. When you cut an apple open and leave it on the counter, it turns brown and begins to rot. This is an example of oxidative stress, a mutation of cells. This can be the start of disease. All diseases start with inflammation. For example, heart disease, chronic pain, insomnia, arthritis, autoimmune issues, etc all have an inflammatory start.

Emotional, physical or mental stress can cause inflammation. Stress increases the production of cortisol (a stress hormone) and the body reacts as if it is under attack. Mutations occur to fight the invader. If left unchecked, injuries and disease follow.

Cellular Inflammation

Cellular inflammation can stay in the body for years. It spreads through our central nervous system and affects our daily life. It can take up to 10-20 years before muscles start to break down and we feel symptoms. Lifestyle and diet can play a role in conditions brought about by chronic inflammation. Things such as Rheumatoid Arthritis, fibromyalgia, chronic fatigue, other autoimmune issue are all a result of chronic, invisible inflammation.

So, now that we know a little about chronic inflammation, what can we do?

There are many facets under our control. Often it is not a matter of one particular thing, but a combination of things. The more steps we take in the positive column, the better we feel. This can include our diet and managing our stressors. Stress is a part of life and we will never be stress free. It’s all about how we deal and manage our stress.

Throughout the entire month of June we will looking at healing pain and inflammation from a holistic perspective and introduce some of the evidence-based ways to manage it outside of Western medicine.

This article was written by Christine Camara, LMT, Holistic Health Practitioner. Join me with Christine, Dr. Dana Gulati, DAOM, Lisa Medley, MA, CMT and other experts in their field for the Pain and Inflammation Facebook Live Series, or sign up for our weekly newsletter to get the recap in your inbox.

Watch the replay of our first session below!

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