How You are Giving Yourself Low Back Pain

This is the opening article in a series examining low back pain and injury in the performing arts.

Low back pain is one of the most common – and potentially debilitating – musculoskeletal problems. In performing artists, thankfully, most instances of low back pain do not involve serious injury. However, this does not mean that low back pain can be ignored when it does occur.

Many injuries to the low back have the same initial symptoms, making it difficult to distinguish significant injuries from less severe ones when symptoms first develop. Low back pain can indicate a range of pathologies, including muscle strain, lumbar sprain, contusion, stress fracture, fracture (with or without displacement of the fractured bone), vertebral dislocation, and lumbar disc herniation. These conditions have varying degrees of severity and “curability,” but any one of them can be disabling and can, at any time, lead to something significantly more severe. Nearly all acute low back conditions are the result of gradual tissue degeneration over a relatively long period of time that is aggravated by a sudden trunk motion. This is how people “throw out” their backs (not a medical diagnosis, but that’s a whole other article) doing something as mundane as reaching for a roll at the dinner table.

Effects of Mechanics and Posture

Most cases of low back pain and injury can be avoided through reducing stresses on the lumbar spine and associated tissues. Thanks to gravity’s effects on bodyweight and the fact that the spine is the only skeletal structure between the rib cage and the pelvis, physical stresses on the spine are always present – even while laying down or simply standing still. Avoiding or reducing unnecessary stresses is best accomplished through using proper posture and mechanics in all activities.

Proper posture for the spine focuses on maintaining the spine’s four natural curves. The lumbar spine (the part in the low back) is naturally concave posteriorly (called a lordotic curve), meaning that, if you think of the lumbar spine as a crescent, the open side of the crescent faces backward. Therefore, proper posture for the lumbar spine focuses on maintaining this natural lordotic curve, even during most motions.

Common Causes of Low Back Pain

Physically active individuals, like performing artists, often suffer low back pain as a result of misuse and overuse of the low back’s structures, resulting in strains and/or sprains. These onset of these injuries can be precipitated and accelerated by poor posture or faulty mechanics (the “misuse” mentioned in the previous sentence). Obesity can also increase the stress placed on the low back’s tissues and can interfere with maintaining proper alignment and posture.

Poor posture, faulty mechanics, and obesity can also hinder performance ability. Exercising to obtain or maintain a healthy body weight while using proper mechanics can help refine and improve performance ability and quality.

Low back pain is most famously caused by lifting: lifting something that is too heavy, lifting something difficult to hold securely, using improper lifting mechanics, or losing control of the lifted object while it is overhead. Low back pain can also occur due to an accident (fall, collision), carrying something that is too heavy or unwieldy, or pushing/pulling something that is too heavy or immovable.

In nearly all cases, low back pain and injury can be avoided through following safety guidelines, using correct lifting mechanics, maintaining proper posture and positioning, and using common sense. The remaining articles of this series will examine proper lifting techniques focusing on applications in the performing arts world, debate theories on using a weight belt (recreationally and occupationally), and discuss special considerations for avoiding injuries while carrying objects (or people) in the performing arts.