So, how do you know if your back pain is serious? You know, when you have ever experienced really severe back pain, you can feel really concerned and really worrying and actually think my goodness, what have I done? What does this mean? Will it ever go away? Does it mean something more sinister than just normal back pain? And there’s no such thing as normal back pain. And you know, I see, I hear this question a lot. I see patients when they first come to visit us at the clinic here and they go you know, the pain’s just like, not even 10 outta 10, they’re like saying 20 outta 10, 30 outta 10. So if the scale and they get really worried. And so the way that we know whether it’s serious or not is first of all, when we go through four case history, we’re determining what’s called red flags.
So clinically we’re looking at things that are a little bit more sinister, things that could be related to other parts of their body, things that would be non cullet. But also things that might be a bit more concerning that might need further investigations. So that’s one way of telling. Secondly, there is not really a good correlation between severity of pain and severity of the condition. So symptoms are not great indicator of how bad a condition is or how serious a condition is. So you know, that some, some ways is better not to be fooled by that. What I would suggest is definitely seeking professional help, but other con other things that we look for a red flag, just like, what are the associated symptoms for it? So if your back pain changes, according to your position, thinking of about things, aggravate your pain.
So is it certain movements? So is it certain specific movement? Is it certain activities? Does it start at a certain time of day? Does it change by certainly body movements? Body functions? Does it change according to what you eat the change, according to how lie down things of that nature. So those are kind of big clues that when you come along to us to have your first initial consultation, to have it investigated, we’re looking for those sort of clues as to what’s going on there. The other thing is, is to look at what medications you’re taking as well. Sometimes you can have side effects of medications that can be quite severe. And so that’s worth, first of all, reading the leaflet inside. Secondly, speaking to your prescriber about, is this a normal response, or when I say normal response, is that a, a common response?
The other thing is actually that releasing on to commonality. So often people say to me, oh, you know, I’m sure you see back pain here all the time. And I’m sure that that’s a common thing just because that pain is common, doesn’t make it normal. And that’s true for a lot of things just because it’s common, doesn’t make it normal. That’s really important that we appreciate that because what happens is with otherwise get into this mindset that, oh yeah, I can live with it. And actually we’re not designed to live with pain pains, a really important indicators not to ignore because that’s a sign of something else going on underneath that’s worth investigating. But before you go seek any professional advice what I would always like my patients to have done is not only thought about what things are making it worse, making it better thinking about what’s caused in the past.
Have they had a history of this in the past? Is it recurrence? This is the first time. And also thinking about you know, what, what is it stopping them from doing in their daily activities? What is it like to be able to do again? Cause that really gives a good indication on where they are with it and how it’s going to affect them going forward. So I hope this is useful to you. If you have any questions, please do leave me a comment in the, in a comment section, please do reach out to me. I’d be more than happy to ask any questions or across any of my socials to you. And otherwise I hope you have a PainFREE but a health.
So here we are again, on a lovely evening, and I want to be talking about what research is, what it isn’t, how you can use research in your own mind, in your own life to help out with regards to what you’re looking for. So for example, you know, the reason I’m talking about this is because I had a patient come to see me last week or week before. And they came along and they were like, yeah, I get it. I got the treatment plan. I’ve been to other practitioners before. I understand that, you know, I need to get my back sorted. I need to get the back pain fixed and so on. Hey, just one thing. Can you do me a favor? Can you just write down the diagnosis for me? I’m like, cool. I’ll write it down for you.
I just want to do some research. So when this research, before I stopped, I’m like, Hey, that’s fine. By the way, whilst you do your research, if you want me to send you anything that might aid you, it is your research. Let me know now, respectfully this person wasn’t in the same field as me. So they didn’t really know what they were looking for. But anyway, I’ll say, listen, you’re you’re right. You’re, you’re a patient. And you have a right to say, yes, no, just treatment when you’re under barista and so on. So you’ve got to respect that. And the reason they said they didn’t want any of my health is because they work in a, in a, in a job where they have access to research articles. I’ll split it that way. And then I got worried. I got worried when they said that, because I was like, well, hang on a second.
Just because you’re able to read research articles that are likely done in a more clinical type environment or not in the field as such necessarily not always when necessarily, you know, typically what is that going to really tell you? How much does it give you? And by the way, research is one part of official research, published research is one part of how you come to clinical decisions and how you decide what’s right for the person in front of you. Yeah, no, how I choose to use the word person, because that’s how I treat my patients or my guests. I actually like to call them into my clinic, but we treat people, we look after people. And so, so it got me worried because I also have heard this term thrown about so loosely over the years, you know, whether you look at it in the media, or you look at it in conversation, you know, our research says, this says that, oh, isn’t it true that the quality of research for manual therapy is poor, but there’s a problem with this.
You see, because in terms of the entire research world, well, I considered the gold standard in terms of healthcare research to be the double blind trials. So what this means, the double blind trial is essentially where you’d have a potential patient. And you’ve got a person who is going to buy a sham treatment or a real treatment. We don’t know which of those two it is. So the researcher who’s sitting in the room back there would tell the, the, the person in the treatment, Hey, go give this tablet to that patient. And so the person giving the tablet doesn’t know if it’s a real chemical drug or whether it’s some sort of like a placebo, like a sugar pill, that’s called a double, double blind trial. Now, when you’re doing manual therapy, hands-on work. If I was the practitioner and a researcher told me, Hey, listen, you’ve got to do sham treatment.
It no longer becomes a double blind trial because I’m, I know if I’m performing a real treatment or a sham treatment. So in the world of research, suddenly that quality of research drops down to here is deemed. So we’ve got to then be careful about that bit of research. You’re right. If I expand that now, what’s the quality of research in that world? That’s number one. First of all, that’s number one thing. Second thing. What I’m a big advocate of is also how, when we take research and apply it in the field, what the results are like, you know, does it work? Does it not? And so as that’s called anecdotal research, and because for me, it’s all about if I can change that one person’s life, they don’t really care. Oh yeah. This can help in one, in 1,001 in 10,001 in a hundred and care about that.
But that one person cares, wow, you changed my world. So why would I give up on someone if I can change this one person’s life? So that’s super cool. So anecdotal research is a separate thing that often gets cost aside because we think, oh, it’s not got a good quality research, actually one person. Well, it’s life-changing. And so the thing is, is that then you’ve got people who will just simply Google things or search on a search engine or ask a few of their friends. Now, I don’t mean any disrespect, but unless your friends or colleagues, your ability to search on search engines is high quality enough to then be able to match and mirror the experience the, the, the, the education, all that sort of stuff. And by the way, an expert isn’t someone who gets it right, but knows what to do when things go wrong.
So you want to be going to the right expert for this thing. So I wanted to ensure that, you know, we’re not getting lost with this word research and getting lost with what it actually means. What research actually means is it’s much more complicated than that. And it’s too broad a word to just go, oh yeah. Research says, because we’ve got to be taking some time to consider what type of research it is, how does it apply to me? What are the chances of these things working for me, not working for me and so on. And having that conversation with someone who is, who actually is an expert in the field, what, what results have they had? What is their anecdotal research in terms of the results we’ve had when we’ve applied? In fact, it’s true. We, when we’ve applied, published research, as in peer review journals, I’ve applied some of those techniques and ways of working in our, in our connection, man, we’ve been blown away by the results.
One particular example of this, which actually is a double blind trial of manual therapy using an instrument. And I’m such a big fan of this now, and you can do a double blind trial because simply, but you can in this instrument, which does an adjustment and treats the body, it can actually make it so that it doesn’t do anything. And so therefore you’ve got the researcher telling the PR practitioner, he goes to perform, do treatment on this person. And the person performing doesn’t know whether it’s going to work or doesn’t work. This is the kind of thing that I get really excited about. So I think we’re going to take a much broader view of what research is, how it affects, what decisions we’re making clinically and also for our personal lives as well. So I hope you found this useful. I’m hoping that you’re now able to see research in a different light than you did before. And also, I want you to come back tomorrow. I want to tell you all about how a key ring has got something to do with your own health. So make sure you follow me and make sure you are turning on the notifications. So you don’t miss any of my broadcasts and I’ll see you next time. Peace out people.
I was preparing for my Sunday evening ritual and I thought, “Hey, you know what? This might be valuable to some people out there.”
So here’s the thing : we are prepared for an amazing week. The way I get ready for it is actually it doesn’t start on a Sunday.
It starts way before, even like sometimes Friday evening, sometimes it might be on a Saturday and I would just start preparing, reviewing, thinking about what happened in the past week, past few days and start thinking about why to plan for next week already.
So then what starts happening from a Friday evening? Saturday afternoon time is when I’ll start thinking about, okay, what do I need to do on a Sunday? What do I need to get taken care of? If I need to, I’m going to read something, listen to him, watch something, learn something. Do I need to write something? Do I need to create something?
What do I need to do to get me ready for the week ahead? I’ll have a look to see what meetings I have with the head who I’m going to be speaking with and my team as well. And this is really important. I’m a big believer in you are only as good as your team. And so we get our team at the clinic to prepare themselves mentally as well for the week ahead. So we’ll get them to send us information about what their goals are for that week ahead. And so I will read that first thing on a Monday morning. So that’s one thing that I leave sort of a little bit last minute, but I prepared everything else for myself. So for example, I’ll ensure that I’ve eaten right over the weekend. Now eating right, first of all means either having highly nutritious food, but it also sometimes means I just want to splurge, want to eat stuff that I shouldn’t be eating, but I enjoy eating and it makes me feel good.
So I’ll do that sometimes. I should quite a lot to be fair. Other things I’ll do to prepare myself are to make sure that it really stretches out my body during the week. I have long, long days. So I find it hard to always get the time to stretch out my body as much as I want. It really takes me a good 30 to 45 minutes to stretch everything. And normally during the week, I’ll do a quick hybrid version of that if I haven’t got time, but I’ll do something. But definitely during the week, during the weekend, especially on a Sunday morning, I will ensure I stretch out every single part of my body because I use physical movements. I have physical techniques and it’s important that I I’m able to use my body to perform the techniques that I need to perform so I can get the best outcome from our clinical goals that we have with our patients, but also with regards to being physically active during the day, you know, I’m not at a desk all day long, I’m on my feet all day long.
I clock easily 12 to 14,000 steps a day just being at work. And that’s, you know, that’s physically can be a little bit taxing on my feet and my legs and my back as I want to make sure I look after myself. So that’s a few things I will do. And then of course I definitely want to make sure that I block out time like today. I had planned to do a whole bunch of stuff and things didn’t always go to plan and we ended up going to the supermarket for longer than we planned to end up buying so much stuff. And I just took that as well. Yeah, that’s cool. That’s just a little bit of family time preparing to buy stuff for the week. So I didn’t have to be running out of food and doing an extra last minute shop in a week that I didn’t have to, it takes out time for my day.
So these sorts of things are important as well, just to make sure that I’ve got it right. So it’s like this, this is really important to me. They say, you know, failing to prepare is preparing to fail. It’s so true. And it makes me feel like, you know, we, we just need to take some time. So it’d be like I always like to use, and I like to use the idea of a, a bow and arrow and sometimes the arrow needs to get pulled back further away so that it can be launched further forward. And I take the weekends or what I like to call a strong ENS. That’s something from Jim Rome. And I like to prepare for things in that sense. I also like to make sure that, you know, things that I didn’t get done in the last week that I will try and see where I can fit it in, in this week, because every week it’s not perfect as, as much as I’d love for it to be things aren’t always great.
And so I’ve got to make sure that, okay, what do I do now? Do I need to adjust it? Is that important? I like to use the ideas of, you know, what’s important urgent compared to what’s important and not urgent compared to what’s urgent and not important. And then what’s not important and not urgent is that quadrant if you guys have ever seen that, that’s really cool. I love using that. And it really gets me focusing my attention and my goals of getting things. So feel free to write in the comments, any questions you have, anything that I can help with, anything that I’ve used or anything that you’ve found that’s been helpful, it would help me. I’d love to learn from you. I’d be happy to take that on, but certainly there’s a few things I’d like to do and over keep adapting and tweaking it.
I think there isn’t a perfect way to prepare. Sometimes I look at all these mentors and successful people around the world, and I think about what’s the goal. What’s the, what’s the morning routine. Like what’s the evening routine, like what’s the weekend routine, like, and, or strong and routine like, and and sometimes, you know, you got to keep tweaking it and adapting it depending on what’s going on, what goals you’re trying to achieve. Sometimes, like this morning, we did not go to plan at all for me. So I woke up a little bit later than I was planning to. And then suddenly I just, well, you know, Coleman was awake and I thought, well, I just want to hang out with her for a little bit and just, you know, just dawdle about and just don’t really do much. And then when know, calling members of our family and catching up with them on FaceTime, and then it ends up becoming like 10 or 11 o’clock and I hadn’t even gone for a run yet where normally I’ve done my run by 6:00 AM and I’ll say, wow, I’m even done that yet.
And so I was like, oh, okay. Procrastinating and kept procrastinating. And I was like, look at the weather. And I was like, oh my gosh, she’s going to rain in like an hour or so. So I need to go now, cause I’d rather rain in the running than the rain. And so things like that, I had to just find ways that would get me back on track because I knew it was important for me to get my run done today. Because if I didn’t do it today, one day becomes two and suddenly two becomes a week and then a week becomes a month. And before you know it, you haven’t even done what you want to do. So I was like, man, his first of the month, it’s Sunday, I’ve got to go and just make this happen. And all the time, all the while I was like, and actually, funnily enough, I didn’t sleep so well.
We wrote for a couple of hours in the middle of the night because there was some noise from the neighbors and we could hear all sorts of things outside. I thought, oh man, we’re awake now, but I didn’t let that affect me. And then sometimes, you know, suck it down to discipline. You know, we have to get, we have to learn to be disciplined and do things when we don’t feel like doing, because we have to get done at some point. And then whether you get them done, somebody else that’s important. But also because I can’t delegate my running to somebody else, so I have to do it myself. That’s something that you have to get done. And so that was important that I learned that lesson. It changes your mindset, switches things going. Yeah. You know what, even if it’s late, better, late than never, but earlier than on time, I always believe.
But you know, sometimes it isn’t good to plan and, you know, reflect on things that have happened in a week. And, and one of the things that comes to mind is, you know, patients or people I’ve met, who just dabble, who just kind of, you know, they think they’ve gone through certain things. They think they’ve, you know, the answers and, and they seek help initially, but don’t quite, don’t quite take on board everything and then don’t get the results. And I’m like, man, I wish she just knew that we could have prevented this from beginning. We could have prepared for this beforehand. And actually, what did we prepare for it not to get even worse the next time round? And so I take on lessons from all of my patients and all my team. And I was telling my team last week, I said, you know what?
It’s great to be part of an awesome team and awesome culture. And, and we do amazing work, but there, you know, like with anything, there’s going to be times when it doesn’t go to plan. And I think that’s the, the, the strength of the culture is not when things are going right. But when things are going wrong, how does it work? How did the team come together? How do you handle it yourself? And that’s really important to know and learn and be around an environment because environment dictates performance. We know this and in sync, it’s so important to do that. And so I have to, as a leader, not see a leader for my patients, I have to do so much more to be sure that I step up and be prepared for everything. I will create a huge buffer for myself so that I can protect my own health and mental health and, and goals.
But also I’ve gotta be, you know, I’m a family man. I like to be with my family. I like to be around my team. I like to help them. And like, there’s nothing that excites me more than seeing people achieve their goals. That’s, that’s like my number one thing. I love doing that. And I love going in and just problem solving, problem, solving, problem solving as soon as things like that happen. And so, you know, sometimes it’s so funny because you know, the, you know, the advice that you should take because you give it. And it got me thinking about a concept where we think we should practice what we preach, but I think we should flip it on its head and actually preach what we practice because that makes him so much more authentic. I think that’s certainly how I live my life.
I don’t preach something that I don’t know, I’ll preach what I do, where I practice, what I put into reality. And most of the time, Hey, it’s pretty cool. It works, but, oh my gosh. Some of you know, there’s good times a good number of times, it doesn’t work. And I just think he’s going to keep going. He’s going to keep trying it out and give it a go. So my weekend, and I’ve still got to finish preparing a few more things. I’m going to prepare my lemon water. I get some lemon juice, get fresh lemons, blend it all up. I started actually adding ginger to it now. I think it’s really cool. And then I just freeze them in ice traits. So when you wake up in the morning, the first thing I do is get a glass of water like this, but that lemon ice cube, and now grow lemon and ginger ice cubes in there.
Boom, straight away you start the day with a fresh nutrient rich drink and just floods your system and cleanses the system from inside. And you feel like you already start the day with making the right decisions. I did that with the lemon and ginger last weekend and everyone loved it. So we’ll definitely get some more of that too. So things like that are really important to do. So make sure you take some time to prepare for your week ahead, but, but start by reflecting on the week you’ve had, so you can get a little bit better. You don’t have to get hugely better. Don’t do massive things. Just do a little bit more this week, this coming week then needed the week that’s just gone. And that very gets into such an addictive success winning mindset. It becomes very easy to then start doing the more you do that, the easier it gets.
And yeah, I can’t wait till tomorrow morning or the first thing I do on Monday mornings, I grab my phone as soon as I wake up and get a bed, check my emails because I’m looking out for the emails that my team will be sending me about what that goes off for the coming weekend. It’s not just about their work related goals. We actually want to know where their personal goals are so that we can support them. You know, whether it’s, they’ve got family members, special events to celebrate, or if it’s something personal, like what recently? One of our team wasn’t drinking water. They felt like, oh my gosh, my goal is to enjoy a drink with the waters. Every time I passed them, they were like, Hey, how about a water, water and cool cooler that it’s actually quite fun. So I hope that’s been useful for you.
And if you’ve got any questions, please do put them in the comments below or DME, or ping me over on Twitter. I’d love to hear from you. And I’m looking to come on live a little bit more frequently. So you’ll see a little more of me and a few more things that can help share from what I’ve been doing is my struggles, my wins, all those sort of things and kind of rind. That’s pretty cool. I like that. I might have to create a little, little tagline, but hope you have an amazing week. Hope you’ve learned something that you can take on board. And I wish you all the best, have a great week.
This week a dentist sent me a message about what the best form of exercise was for them, especially to prevent back and neck problems.
They had already tried improving posture and wearing special glasses called loupes, which magnify what the dentist is seeing, and prevent them from hunching too far forward to look into their patients’ mouths.
Being married to a dentist, having written articles in dental journals for and successfully treated several dentists and their teams since 2006, I naturally felt I had some expertise in this area.
The interesting thing about when a dentist asks me a question like this, is not that I don’t have the answer, but that as healthcare professionals, we fall into the patient trap.
That is where when we are seeking out advice for our own health, we go into a patient mode ourselves.
You see, if a patient of this dentist was to ask them “what’s the best toothbrush or toothpaste?” the response is dependent on a number of factors:
Do they need soft bristles to reduce any trauma to already weak gums?
Are they vegan, and therefore looking to avoid certain ingredients in their toothpaste?
In much the same way, there is no one particular exercise in my experience that a dentist must do to prevent back and neck problems.
“Problems”… now I like the way they asked about this. You see, most of the time we are looking for “pain relief” which is way too vague.
WARNING: Unpopular opinion about to be unleashed!
Too often I see adverts for products or articles stating they have found “the cure for back pain”.
Which is utter nonsense! Purely because pain is a result of a condition.
However, two people can have exactly the same back pain, but due to two completely different reasons.
What I find most people who ask me about their problems is they are searching for the ONE THING.
SECRET SAUCE: The truth is that it is often a multi-factoral problem.
Here’s a checklist that I work through when a dentist visits me as a patient:
How many hours a week do they do dental work?
What type of dentistry do they do most of the time?
What are they doing with their body for the rest of the week when not performing clinical dental activities? (with there being 168 hours a week, and most dentists spend 40 hours working, there’s a lot of time when the dentist is not doing dentistry)
Are the loupes they have comfortable? Do they use them? (A surprisingly high number of dentists invest a lot of time searching for the correct loupes, only to then stash them away in the bottom drawer to collect dust)
Not that this is a complete list, but you can see that already, there is a lot more to cover than simply which exercise is going to remove a vague symptom.
The next time you visit your dentist, share this information with them.
They will be hugely grateful that you did.
But more than that, I will be way more grateful to you.
Because I know way too many dentists, who are so passionate about the work they have dedicated their lives to, to have to be forced into early retirement when they had had enough of their PREVENTABLE neck and back problems.
So you have woken up with back pain and you have probably also searched online to see what the best solution is for it. Some of the advice may have recommended for you to be active and keep moving. Following this if you have gone for a walk you quickly realise that your back pain is still there or even getting worse.
So what should you do? Do you keep walking and have the mindset of “no pain no gain”? Or do you take rest to stop the pain getting further worse?
There are a number of things that can cause low back pain. Until you find the source of the problem it’s difficult to provide specific advice for your current symptoms.
However in most cases if your pain is being aggravated, even by advice you have read from seemingly reputable sources online (or anywhere else) you must stop that activity. That pain is your body’s way of telling you that this is a crisis situation and that it must be addressed and resolved properly.
You must avoid anything that is aggravating your lower back pain, even if it is walking or moving. So get into a position that makes the lower back pain more comfortable. This allows the body to start healing those tissues, rather than further injuring and aggravating that problem.
If you’re finding yourself to be describing your symptoms as “constant low back pain”, that it is always there, then let’s check and see what the cause of it really is.
A lot of the time when we have pain or discomfort we often get confused and our bodies, brains and nervous systems get scrambled, and end up misunderstanding the signals they are receiving. They often get into a much more worried state as this is the worst thing that is happening to the body at this moment, and it can often misinterpret it for being constant, even if it may not be.
So consider what activities or movements affect your constant low back pain, that aggravate it and relieves it. Start making a list of what makes it worse and what makes it feel better. This will be really helpful to present to your health professional when you seek to have your constant low back pain resolved.
If you are suffering with constant low back pain, which is truly constant, meaning it will not even allow you to sleep – this is quite rare, for a pain to be so constant that it does not even allow you to sleep. Often in these cases, people are only able to sleep by taking heavy medication, which of course has other health implications too.
The other problem with constant low back pain affecting sleep is because it affects the quality of sleep, it means that the healing phases of sleep are never achieved. The healing phases of sleep are when the body is able to regenerate itself and recover from any tissue damage.
If you are suffering with constant low back pain my first (ironic) advice is to stop looking online for tips & tricks. If it really is that severe you must seek out professional health immediately. There is no need to waste any time and risk your condition becoming permanent if not handled correctly.
Causes of constant low back pain may include a fracture, a break in the bone. If this is the case, then you definitely what to get it checked without delay, because if it is an unstable fracture you can cause some serious damage and injury to the tissues and blood vessels around that area.
If you have been compressing a spinal disc for a number of years due to extreme lifestyle choices of spending long working hours sitting which can cause the spinal discs to pop, burst or bulge. This can lead to the disc pressing on spinal nerves. Combined with that you may have muscle spasm which is trying to protect the area from further damage. However the muscle spasm itself can often be so severe that it causes pain itself.
Please avoid asking loved ones who are not professionally qualified for what they found helped if they have suffered with constant low back pain. It’s just as easy to seek professional help to get the best treatment for your condition.
There’s a few things you can do. Before we get into what we can do to help your low back pain, we need to think about what your low back pain is.
See if we think about the definition of “low back pain” it’s a pain, a symptom and it is subjective – meaning that everyone experiences low back pain in different ways, and the meaning each person gives their pain is different too.
That makes it much more complex than simply saying “ah, this is the one thing to fix your low back pain.”
First of all we need to find out exactly what the cause of the low back pain is. In order to do that you need to go to an expert because unless you know what to look for, what to examine for, what to test for, it’s very difficult to determine what the cause of the pain is. There’s many different structures within the body that can cause the low back pain.
Low back pain may be caused by your organs, it could be some bones or joints, some ligaments that have been strained, torn muscles, bulging discs, pinched nerves and a whole host of other things in that area.
So the first step to determine which of these things are causing your low back pain you must first get a consultation. A diagnosis based on just an extremely thorough consultation alone is likely to be very accurate. When you then add tests and an examination to a consultation the accuracy of the diagnosis improves significantly more.
Once you know what that diagnosis is, it’s easy. You simply flip it, reverse what has happened, and that makes your treatment plan to resolve the cause of the low back pain.
It’s not just about getting rid of the pain, but to restore normal and optimised function to help prevent conditions coming back in the future.
The way to think about how to achieve relief for lower back pain is to think about a building that is on fire.
See if a building is on fire, the way you know about it is the smoke alarm is going off. The smoke or fire alarm is just like the pain that you experience in your body letting you know there is a serious problem here.
Painkillers act like taking the batteries out of the smoke alarm. You would never take the batteries out of a fire alarm to stop it beeping if the building was on fire.
We know that what you really need to do is find the source of the fire, stop that making things worse, whilst still reducing the flames burning the rest of the building.
So with your health you want to make sure you avoid anything that aggravates your lower back pain, such as any activities, movements or postures.
What we need to consider is why has that problem occurred and why has it occurred NOW? This is an extremely important question I ask myself when working with a patient to help me determine the source of the problem.