A team of researchers has identified a catch-22 of lower back pain.

Those with lower back injuries can worsen their pain by avoiding using hurt muscles.

Other muscles, including those in the abdomen or on the sides of the torso, contort to compensate, leading to greater pressure on the spine and damaging discs.

Researchers have long suspected that patients guard their trunk muscles but this study has shown for the first time how this results in increases in spine loading that can lead to secondary back injuries.

The investigators then measured the electrical activity of participants' muscles and compared pressure on the spine, known as spine loading, and the side-to-side force on the spine, know as lateral shear.

Adults with lower back injuries used more muscles in the back when lifting, creating greater pressure on the spine. Injured patients experienced about 26% greater spine compression, a 75% increase in lateral shear, and used significantly more muscle activity for 10 muscles than noninjured adults.

Additionally, people with lower back pain weighed more than their uninjured peers, a factor that significantly increased pressure on the spine.

Excessive body weight, or a protruding stomach, is like always holding a box in front of you. One must counterbalance the weight with more activity in the back muscles that aren't as far from the spine. It is like a seesaw where the back muscles are not as far from the fulcrum as the weight of the belly.

The results of the study underscore the need for people with lower back pain to trim down, and suggest that physical therapy for certain types of back injuries aim to teach patients how to use their back muscles appropriately, the authors note. Typically, physical therapy focuses on strengthening the trunk muscles.

Spine December 1, 2001;26:2566-2574

Dr. Mercola's Comments:

Although I am trained as an osteopathic physician, my passion was not treating pain. I was much more fascinated with biochemistry and nutrition. I thought it would be nice to have the skill to help people with the muscle pains, but it clearly was not a major focus for me and I gradually used it less and less in my practice. With time I learned manual maneuvers that were developed in Australia that seem to be far superior to any conventional osteopathic or chiropractic treatment that I am aware of. Traditional osteopathic manipulations or chiropractic adjustments are far superior to the traditional medical approach to low back pain. Most physical therapists also provide superior treatment for these problems. However, NST seems to be a generation beyond the manual adjustment model as it treats the body at a far deeper level and clearly seems to work through balancing the autonomic nervous system. After I learned NST, I felt like a super doctor, as there was very little pain that did not seem to respond to NST. However, with time I realized that there was a subgroup of individuals who failed to respond, and each one of these people seemed to have an emotional stress involved. That is what motivated me to pursue EFT, which seemed to work quite well for these individuals. I gradually learned that EFT also seemed to facilitate the treatment of nearly all the patients I was seeing. It seems with the combination of EFT and NST there are very few structural pain problems that fail to respond. Related Articles: Low Back Pain Linked to Stress in Young Adulthood DOs Equal MDs At Relieving Chronic Back Pain Do You Have Low Back Pain? Forget the X-rays