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Raise your virtual hands if you are tired of hearing the words ‘strengthen your core’ by different providers you have spoken to about your back pain or sciatica problems. It is a huge number and trust me you’re not alone. Almost every patient with a diagnosis of “back pain and sciatica” or any other spinal issue gets the same advise & is tired or clueless about how many “sit-ups” they need to do in a day to really “build that core” enough so that their back would stop hurting.
But Is strengthening your core REALLY the answer to all your back related problems? What does Research say about it? Let’s stop and take a look. Most of the recent RESEARCH about low back pain & sciatica issues talks about MOVEMENT in a specific direction. The technical word is called directional preference and that is the basic premise of the Mckenzie Method.
Based on a Study done in 2004, People suffering from Back pain & Sciatica were divided into 2 groups: One that received Mckenzie method based specific Movements and others that did General exercises. And as you would guess correctly, people in the first group had much better outcomes even several months after the program had been completed in comparison to people who did the general exercises.
Now don’t get me wrong, I am all for building your core & I even frequently prescribe core exercises to my patients as well & very often work on those as a part of their program. But my point is that core exercises are a great supplement to build on your recovery once the underlying problem in your spine has been resolved by using the ‘right movements’ first. Core stability is a great supplement to add to your exercise routine once your back pain & sciatica problem has been resolved & it is not the Solution to your problem.
Building on your core strength is great for athletes who want to continue Running or Playing sports or Being active with a proper form, it is also great for Moms who have given birth recently as their core muscles have lost ‘tone’ & elasticity in the process of childbirth, it is great for someone who has no pain but wants to be more active overall. So sure it has its place but it is certainly not the million dollar solution to your back pain problem.
So why does everyone talk about core strengthening?
That is a great question. In the research done in the past years, people with symptoms of low back pain were found to have a weak Transversus abdominis (aka your core muscle). Hence, the obvious conclusion that building this muscle will help solve the problem of low back pain.
But as research techniques have improved, it was found that having a weak core did not have much association with your low back pain or sciatica symptoms just as positive findings in your MRI does not have much association with your pain or other symptoms. We will touch on the topic of the MRI in a separate blog post as it is a long story suitable for another time.
However, you get the point. Chances of Mr. A with a very strong core having back pain are almost the same as chances of Mr. B having a weak core. But Mr. A with a strong core will have a better Running & sport performance & will cope with back pain better than Mr. B who will have a poor running & sport performance.
Hence, we can stop inserting round pegs in square holes & start prescribing a Unique treatment to every back pain story because Every Back Pain is Different & hence needs to be managed differently. There is No One Size Fits All & No Movements/Exercises should be a prescribed to a person in pain without doing an assessment first.
What do you mean by Assessment. Who will perform this Assessment?
Your Mckenzie Method Specialist will perform an assessment of your Spine that usually involves looking at your Range of Motion & then moving your spine several times in certain directions to see which movement actually helps or hurts not just your pain but also your function or mobility like walking, ability to touch your toes etc.
Based on that, he/she can decide which movement/exercise is best suited to your needs & will prescribe you a treatment program accordingly.
Once you are fully symptom-free, you can then be cleared to start doing the core strengthening exercises if necessary.
Want to learn more?
If you or someone you know experiences this very familiar early morning stiffness and/or pain, call us or visit our website to talk to your Spine Specialist today or you can even schedule a Free Discovery Session to learn more specifically about your problem and ways in which we can probably help.
We also know not everyone is ready to commit to regular physical therapy appointments, and that’s why we offer our Free Information Guide! This Guide is for people in our community who want really valuable, expert information about their Back Pain or Sciatica problems. We know it’s confusing out there with all of the information floating around on Google and Facebook, and this is a valuable first step towards getting some real answers for your problem.
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