• On Your Mark

Back Pain Treatment and Relief - Facts You Should Know. NY Therapist shares remedy.

Updated: Jul 12, 2019

Lower back pain is one of the most common complaints we hear from clients seeking medical massage therapy, especially here in New York City. Chances are you or someone you know has experienced back pain to the point of needing to see a chiropractor, or back pain specialist, have physical therapy and receive medical treatments for pain relief.

In fact, the National Institute of Health estimates that 80% of people have experienced some sort of low back pain or condition at some point in their lives and that at any given point in time the prevalence rate for low back pain is 50%. Chronic lower or upper back pain is part of life for a lot of New Yorkers because many of us sit long hours at desks, walk and run on hard surfaces consistently and are generally active people. Thankfully, it doesn't have to be if you know how to counter the problem.

Why is back pain so common?

Our lower back, anatomically known as the lumbar spine or lumbar spine region, supports most of our upper body weight and is used in so many of our daily movements, including sitting, standing, walking and running as well as in pretty much any sport or movement. Not only that, but we often rely on the weight-bearing capability of our lower backs when we perform heavy lifting so wear and tear of this region of our bodies is all too frequent.

“I had chronic lower back problems and Mark helped me manage and reduce my pain over the past two years with Active Release Techniques and massage therapy. His expertise in both personal traioning and massage therapy are what make him great at what he does.” - Marc

Want to know which of these conditions apply to you? Get a free health consultation HERE

4 Causes of Back Pain:

Unless there is direct trauma to the lumbar spine from, for example, a car accident, collision during a sporting event or a bad fall, the chances are that there can be many contributing factors to low back pain. A sedentary lifestyle as well as an active one both create wear and tear on joints, ligaments and muscles throughout the entire body, including the low back. It is to a large extent unavoidable.

One of the challenges to getting rid of low back pain for New Yorkers and non-New Yorkers alike is to have a firm understanding of what is uniquely causing your low back pain. Do you have a structural leg-length discrepancy? Does low back pain run in your family? Are you struggling to maintain a healthy weight? Do you sit for countless hours at your desk, on the train and slouching the couch? Do you do squats and deadlights with heavy weight? Are you an avid kick-boxer? Some or all of the above.

There may not be just one cause to your low back pain? Often times there are several. And some factors may be more important for you than others. The key is understanding how your posture, your unique anatomy, your weight, your lifestyle and other factors are affecting the health of your musculoskeletal system and in this case your lumbar spine with all of its intricate joints, crisscrossing muscles and dense connective tissue.

Below are four factors that are often at the heart of low back trouble. But it's important to note that they may exist for different reasons. For example, you may have short and overactive hip flexors because you sit a desk for 8 hours a day or because you do aggressive kickboxing classes 3 days a week which jack up your hip flexor muscles. Perhaps you may have weak abdominal muscles because of a c-section or because you aren't doing the best exercises to support your low back, as you'll see below.

Every person is unique, so while these 4 causes apply to many people, it's not always so easy to understand which ones are most pressing and why as well as what other issues they've led to and thus compounded the problem..

1.) Short and Tight Hip Flexors: When you sit at a desk, in cars and on the couch as much as modern humans do, the muscles in the front of our hip and spine shorten, weaken and create a comprehensive force on your lower back (lumbar spine) and in the hip joint.

This problem is made worse by the fact that so many people reinforce this pattern by doing the wrong abdominal, back and lower body exercises.

For example, if you have low back pain and do lots of crunches, sit-ups and leg lifts thinking this will help, in all likelihood all you are really doing is exercising and thus shortening your hip flexors, most notably the Illiopsoas, which are already short and overworked. The Hip Flexors often times (not always) need to be stretched (a lot), not tightened.

2.) De-activated and weak glutes and hip muscles: The Gluteal muscles (Maximus, Medius and Minimus) and Hip Rotators (There are 6: Piriformis, Obterator Externus and Internus, Quadratus Femoris and the Superior and Inferior Gemelae) are very important muscles that are weak and under-activated in so many people.


The reason is the amount of time we spend sitting, which shuts these muscles off. In addition, many people do lots of squats, cycling and running without focusing enough on activating and strengthening the smaller (and in the case of the Gluteus Maximus which is the largest in the body) muscles in the back and side of your pelvis and hip. To activate these muscles requires doing very specific and not glamorous or impressive exercises.

Want to activate your glutes to help with low back pain? Click here for 5 great exercises!

Too many of us overlook the importance of these muscles for lack of knowledge and/or in favor of more fun and exciting exercise choices. To avoid knee, hip and back pain, spending some time and effort on targeted exercises for these muscles is essential.

3.) Weak Abdominal Muscles: A lot of people have weak abdominal muscles that fail to stabilize the trunk and move the abdomen in an optimal way, and for so many people it is not for a lack of trying.

The problem is that people fail to do the correct exercises (or they do the correct ones improperly).

First of all, as one of my mentors, Brent from the Brookbush Institute, always says, “there is no such thing as the lower abs”. What he means is that when you do leg lifts on the ground or while hanging from a pull-up bar, you are only working the abdominals partly. What you are really doing is working the hip flexors which can makes things worse.

And second, in doing countless sit-ups on the floor or yoga ball, and crunch after crunch, what you are doing is working only the top (superficial) abdominal muscles. This causes two problems, one being that it fails to target the deepest muscle known as the Transversus Abdominus (TA), one of the most important muscles in the entire body because of its primary role of stabilizing the lumbar spine. Not only that, but doing these crunches and sit-ups actually de-activates the TA which makes it much less effective and harder to activate.

"A client came to me with chronic shin- splints, a painful injury experienced by many runners. By targeting the 3 most common muscles indicated in this condition, the Tibilais Posterior, Flexor Digitorum Longus and Flexor Hallucis Longus, she was running pain-free within 4 sessions." - Mark

4.) “Weekend Warriors” – have you heard this term before? It refers to the people who have the 3 problems above created by sitting all day and either not exercising or exercising incorrectly. Then on the weekends, these same people go play aggressive sports, lift heavy machinery while re-organizing the garage or moving the entertainment stand or go to the gym to do intense strength training.

So in essence they go from a sedentary week at work and on the train to a very active and demanding lifestyle for which their bodies are not properly trained. It’s like trying to run your best 5K race without doing any training or trying to write a 20 page academic paper when you haven’t been in school for 15 years. Your body and mind just aren’t ready. That is a recipe for injury and your lower back is almost always the most common and serious victim.

Some of the most common back pain and spine conditions are:

  • Bulging/Slipped Disc - intervertebral discs wear down and “bulge,” or protrude, into the small spaces in the spinal column where the nerve roots that exit the spinal cord are located. The pain and discomfort can be confined to the site of the nerve root or it can radiate to other parts of the body, including the hips, legs, buttocks or even the feet.

  • Herniated Disc - more severe than a bulging disc because the inner fluid material that makes up the disc center ‘spills’ out of the nucleus causing pain, inflammation and further disc degeneration. It can lead to other conditions such as Sciatica which affects the buttocks and legs as well.

  • Osteoarthritis - degeneration (often from age or injury) of the vertebral disc and/or the facet joints. As the degenerative process continues, the spine is more vulnerable to many types of back injuries.

  • Spinal Stenosis – narrowing of the spinal canal. The spinal chord travels through the spinal canal and can get impinged causing severe pain and dysfunction.

  • Spndylolisthesis – when one vertebrae moves forward in relation to the adjacent vertebrae, putting pressure and strain on the discs, facet joints, the surrounding muscles, the spinal nerves and potentially the spinal chord.