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‘Pain is not the only problem’: LBP Lifestyle Co-contributors

Since patient lifestyle choices are the commonest contributor to LBP, it is prudent for the clinician to discuss co-contributors as well as FMP within the Report of Findings.

1. Smoking is the #1 comorbid factor to low back pain.
2. Pot holes/rough roads, speed bumps, sudden stops, loose seatbelts, declined/deep auto seats.
3. Tight-fitting & high-waisted garments and belts: gym shorts/undergarments with thin elastic bands.
4. Plush seats/chairs, deep seated sofa/couch, soft beds, water beds, reclining chairs, “C” sitting shape,
sitting > 1 hour without correcting sitting position.
5. Long-term: standing/sitting greater than 30 minutes without a movement break; commuting, high
heels worn all day (standing or not), sacral motion absent.
6. Exercise in sagittal plane only, lateral and rotation planes absent, small/imbalanced aROM.
7. Exercises that require lying down or sitting (absent GFR, sequencing, core activation.)
8. Exercising by ‘body part’ (leg-day, etc.) or bilaterally reduces/eliminates sling-activation.
9. Walking, jogging, running: on a motorized treadmill (eliminates hamstring contribution) and toe-off.
10. Spin-cycling: reduced hip aROM, heel-strike + push-off absent, narrow/fixed foot base, balance absent.
11. Elliptical: reduced gait, narrow/fixed foot base (eliminates hip flexion & plantar flexion contribution)
12. One-sided “acceleration” sports: tennis, golf (especially without specialized form instruction.)
13. Dehydration, diuretics (caffeine), low mineral content water (distilled) shrinks disc height and suppleness.
14. Saunas, hot tubs, heat pads over-heat inflamed disks.
15. Shoulder bags or hand-held briefcase asymmetrically loads the spine, shoulder elevation.
16. Trunk flexion + twisting + lifting (lifting luggage), or trunk flexion + twisting (rising from bed.)
17. Inflammatory foods: energy drinks, caffeine, juice, alcohol, grain products, meat fat, high sodium.
18. Histamine-producing foods: condiments, sardines, ‘counter-top’ foods, alcohol, leftovers, deli-meats.
19. Low ORAC values diet, poor gut health, KETO/Atkins/high protein foods.
18. Delay in bladder and bowel emptying (‘holding’) due to lifestyle, over-scheduling.
19. Slouch/Upper-Cross Syndrome, looking down: at technologies, for no reason.
20. Wearing flip-flops/slip-ons/clogs as primary footwear, no lace-up shoes.
21. Pes planus (un-corrected), shoes worn too small, too big, lacing medially (can’t bend over.)
22. Fear or anger of perpetuated LBP symptoms.
23. Patient disinterest in resolving their problem, blaming their caregiver, non-ownership to participate.
24. Sympathetic lifestyle.

LBP Blog General information

Series Description

These articles intend to (1) re-evaluate the prevailing clinical practices thought to manage low back ‘pain’, (2) submit and debate novel low back ‘pain’ contributors and mechanisms, (3) meet patient expectations & satisfaction and clinically meaningful results, (4) recommend a conservative non-surgical course of care to over-ride ‘pain’ instantly, and (5) restore ADLs and patient confidence on the first visit at low cost. This article has a companion podcast.

Dr. Dean Bio

Forester Dean is a chiropractic and physiotherapy sports medicine doctor practicing in Los Angeles, California. Dr. Dean is a lifetime athlete, and currently teaches tennis, track, boxing, yoga. The Core X System™ Campus flagship location was opened by Dr. Dean in 2020.

© Copyright 2021 SpineSync, Forester Dean, DC
Duplication with permission only

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