Back pain

Self-Help Movements for Low Back Pain

Low back pain is one of the most common and persistent pain problems, affecting millions of people. Besides working hands-on with clients, I try to help them understand how pain works and to find ways they can continue to help themselves at home.

Cory Blickenstaff is a physical therapist in Vancouver, WA. My clients have found his videos on "edgework" and "novel movements" to be helpful and enjoyable.

"Edgework" is finding the point in a movement where it begins to transition from easy and comfortable to slightly guarded or painful. Movements should be done slowly, watching carefully for the first sign of holding the breath, muscular tension, or pain. The movement presented in the video is one possible movement. Other movements can be used as "edgework" using the same approach.

"Novel movements" are movements that are a little different from the way we normally move. As Cory says, they are movements about which the brain has not yet formed an opinion. By practicing novel movements, we can try to find movements that are not painful and break the association between movement and pain.

Research on Therapeutic Massage and Low Back Pain

NPR (National Public Radio) recently ran a story, "Got Low Back Pain? Massage Therapy May Rub It Out." The story points out that after colds, low back pain is one of the most common complaints seen by doctors. It causes lost time at work and brings misery into many people's lives. A recent study published in the Annals of Internal Medicine showed that therapeutic massage may be more effective than conventional treatment for low back pain.

A more detailed analysis of the study written in laymen's terms is available at Of note is that both Swedish massage and structural massage were both effective, with very little difference between them.

A Reader Asks About Sitting At The Computer

A reader asks:

Will sitting at a computer all day and leaning to one side cause poor posture and ultimately pain?  Linda 

Absolutely! A large percentage of my clients have postural and pain problems caused or aggravated by sitting in front of the computer for long hours. This bane of modern life can lead to lower back pain, upper back pain, neck pain, shoulder pain, and pain in the arms, including carpal tunnel syndrome (CTS).

Sitting itself can cause poor posture when it is done repeatedly for long hours. When we sit, the curve in our lower back tends to flatten our and this forces the head forward. Head forward posture is a very common problem in our sedentary society. When the head is moved forward, it's tendency is to look down. However, we don't usually want to look at the floor so we tilt the head upward. This creates a state of chronic tension in the muscles at the base of the skull. One way to minimize this problem is to use a small pillow to support and maintain the curve of the low back.

A Reader Asks About Swelling After Massage

Update on 4/5/13: Oddly, this has been one of my most popular articles. Apparently a significant number of people are looking up swelling and inflammation after massage therapy on google. Maybe massage therapists need to ease up a bit.

I might need to revise the language of this just a little, but my answer is still essentially the same. My clients don't seem to complain of this and while the reader insists the pressure was not too hard, I suspect it was either more than the body tolerated well or it was treated for too long. I'm not sure what else to say.

A reader asks:

I received a great massage about a week ago but the next day my lower back was swollen. Why would this happen? The massage was perfect pressure and she never hurt me at all. Can you please help me understand this?

Back Pain: Part II Muscle Strain

Perhaps the easiest type of back pain to resolve is simple muscle strain from overuse. Most of us have experienced this at some point in our life. We may have spent too much time working in the yard on a nice day when we haven't been accustomed to the activity. Perhaps we've been sitting too long at the computer, in meetings, or on a long car ride. Fatigue and overuse take their toll and we find ourselves feeling stiff with a dull, nagging ache.

Such a simple strain can respond well to rest and perhaps modest use of non-prescription pain relievers. It often will resolve itself in a day or two, although the symptoms may linger for longer periods. If this common back ache will pass with time and rest, why use massage therapy?

Massage Therapy and Back Pain: Part I

Mark asks, "Can you explain how massage helps each of the different types of back injuries: spinal (disc), nerve, and muscle (or tendon)?

Are there injuries where rest or exercise is the better treatment?"

That's an excellent question and a complex one. I'll try to answer as concisely yet thoroughly as I can, but the short answer is this: back pain can be a complicated problem and there is no short and easy answer to the question. However, in most cases I've encountered, massage therapy can be a helpful addition to other treatments, such as rest or exercise, and promote faster and more thorough recovery.