New Perspective on Low Back Pain

By Jordan Hui, Candidate of Doctor of Osteopathy 2017
Courtney Cheng, DO, MSHS 2017

In the US, mechanical low back pain is the second most common reason for seeing a doctor. Every 4 out of 5 people will have at some point in their life low back pain.  Most of the time, the back pain resolves on its own within 2-4 weeks.  The body has a great ability to self-correct.  However, when insult to the body remains or if the structure is unable to be restored, the ability to function will be hindered and pain will be a loud cry from the body for help.

The cause of low back pain can be anatomical, neurological, or psychological in nature.  A health care professional can help to differentiate the cause of this problem and provide management for the resolution of the pain.  If not properly managed by a physician, the pain can worsen resulting in decreased quality of life.  Most low back pain is not due to a serious medical problem and can be treated with conservative measures.  This article provides some understanding and tips for conservatively managing back pain.  The suggestions provided are not intended to replace the role of a qualified medical professional.  If you try one of the recommendations with worsening of your condition, you should cease immediately and consult a health care professional.


What are some causes of Low Back Pain?  The majority of people (>85%) have an unclear etiology or abnormality in the spine causing low back pain.  Many people will attribute their back pain to osteoarthritis, spinal stenosis, herniated discs, strain to the ligaments in the back, poor posture, and multifactorial.


What can you do to improve and prevent LBP? Treatment modalities for low back pain are dependent on the underlying cause.  If there is a structural component, releasing any structural restrictions anomalies through proper stretching and strengthening can improve functional limitations.  Any muscle weakness in the supporting structures of the back including the gluteal muscles, back muscles and abdominal muscles as well pelvic floor muscles should be strengthened. Tightness in hamstring muscles, hip flexors should be released and stretched.  Although high-impact activities may worsen pain, light exercises such as walking, stretching and swimming can be therapeutic.

Awareness of proper posture and body balance can also help improve low back pain.   Studies have shown that tai chi class not only benefits postural awareness and balance but improves low back pain for many.  

Chronic low pain can result in changes in mood and ability to cope with daily activities.  Addressing the psychological component of low back pain can also help the healing process.  In a recent JAMA article, mindfulness-based stress reduction or cognitive behavioral therapy, compared with usual care, resulted in greater improvement in back pain and functional limitations.  


Osteopathic Manipulative Medicine (OMM) is a treatment modality that allows the body to heal itself. Subtle movements that osteopathic physicians perform can release tension or strain on a muscle and allow the muscle to become relaxed.  In a recent study, OMM was found to be more effective when combining it with conventional therapy for chronic low back pain. If you are unable to find relief from corrective exercises and postural retraining, consider osteopathy or mindful meditation.

Further Resources

Licciardone, J. C., Gatchel, R. J., & Aryal, S. (2016). Recovery From Chronic Low Back Pain After Osteopathic Manipulative Treatment: A Randomized Controlled Trial. The Journal of the American Osteopathic Association J Am Osteopath Assoc, 116(3), 144.

Cherkin D.C., et. al. (2016). Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual care on Back Pain and Functional Limitations in Adults with Chronic Low Back Pain. JAMA. 2016: 315(12):1240-1249.