Why are strong abdominal muscles important for managing low back pain?
Chronic low back pain (CLBP) is recognised as one of the most prevalent musculoskeletal conditions affecting adults globally, with studies indicating a prevalence rate that can reach as high as 84% among the adult population.
This staggering statistic highlights the significant impact that CLBP has on individuals' quality of life, daily functioning, and overall well-being.
Unfortunately, despite extensive research and clinical evaluations, no specific underlying cause can be identified in approximately 85% of cases involving low back pain. This lack of a definitive diagnosis can lead to frustration for both patients and healthcare providers, as it complicates treatment strategies and can prolong suffering.
Moreover, there is a notable association between long-term back pain and dysfunction in the activation patterns of deep trunk muscles. This dysfunction often manifests as an inability to properly engage the muscles that are crucial for stabilizing the spine and maintaining proper posture. The deep trunk muscles primarily involved in this process include the transverse abdominals and internal obliques, which play vital roles in spinal support and core stability.
Patients suffering from low back pain typically exhibit several dysfunctions that can exacerbate their condition. These may include:
dynamic balance impairment during standing, which can lead to an increased risk of falls and further injury;
increased trunk stiffness when forward perturbation is applied to the trunk, which limits the natural movement and flexibility of the lumbar spine;
and restricted motion of the lumbar spine itself, which can significantly hinder daily activities and overall mobility.
Additionally, these issues can severely limit postural control, making it difficult for individuals to maintain proper alignment and balance in various positions.
Given these complexities, what treatment options can we explore as Chiropractors to provide relief and support to those suffering from chronic low back pain?
Research has shown that patients with chronic, long-term back pain can benefit significantly from a multi-faceted approach to treatment. It is essential to address not only the physical aspects of back pain but also to consider the potential psychological components that may be contributing to the patient's experience of pain. By focusing on physical rehabilitation and therapeutic interventions, we can create a comprehensive treatment plan that aims to alleviate pain and improve overall function.
This treatment approach includes:
Strengthening the multifidus and quadratus lumborum (QL) muscles, which are critical for providing stability to the lumbar spine and supporting proper movement patterns.
Activating the deep abdominal muscles helps to enhance core stability and support spinal alignment.
Alleviating facet joint dysfunction in the spine can be a source of pain and discomfort for many patients.
Improving postural balance, thereby reducing the risk of falls and enhancing overall stability.
Enhancing standing and walking gait mechanics to prevent exacerbation of pain, ensuring that patients can move more freely and comfortably.
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Hedayati R, Bagheri R, Ehsani F, Pourahmadi MR, Moghaddasi H. Association of Pain-Related Anxiety and Abdominal Muscle Thickness during Standing Postural Tasks in Patients with Non-Specific Chronic Low Back Pain. J Chiropr Med. 2024 Mar-Jun;23(1-2):47-58. doi: 10.1016/j.jcm.2024.02.001. Epub 2024 Apr 4. PMID: 39791005; PMCID: PMC11707377.
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