Ask Dr. B Episode 10: What Causes Lower Back Pain

And What to Do About It

By Dr. Erin Boynton, MD, FRCS

What causes low back pain and what should you do about it? Back pain is one of the most common musculoskeletal disorders, affecting up to 80% of the normal population at some point in their lifetime.

In Part 1, Dr. B starts with a review of the most common reasons for pain in the lower back, offering a few strategies to treat and prevent this issue.

In Part 2, Dr. B and Eric answer the following questions:

  • 1:05:00 – How should I sleep with lower back pain?
  • 1:08:00 – My PT diagnosed me as being flexion intolerant with excessive SI joint mobility (perhaps from a combo of sitting all the time for my work and too much yoga). What is flexion intolerance? the question on what is flexion intolerance. Part of that question is…is this a disc damage problem OR is it just that some of our spines aren’t designed well for flexion? For me, too much yoga with too many forward bends with tight hamstrings has created (a tiny) bit too much flexibility in my SI joint which has created a whole suite of evil problems for me.
  • 1:15:00 – Pain on the back of my leg. I was walking and felt a slight tightness on hamstring. After a week it aches on the entire back of the leg, like internal swelling/heaviness.
  • 1:16:00 – How much core exercise, to primarily protect the spine, is too much, if any? Assuming a moderate-to-intense 35 min session, or an intense 10-20 min session? Also, I can’t do bicycle crunches. Any tips?
  • 1:20:00 – I have lumbar stenosis as well as a herniated disk at the L-3-4 levels. Is there anything I can do to maintain/reverse the stenosis? ​I do a lot of mobility and stabilization work as well as Feldenkrais, which has been very helpful. I have little nerve pain and decent ROM, but avoid extreme spinal flexion and extension.
  • 1:23:00 – The truth of the matter is once you develop back issues – wear and tear on discs, bad posture, bad neck etc. – it cannot ever be resolved or be fixed. It certainly doesn’t sound like there’s much hope for improvement. lots of understanding the source of problems, but little understanding of solutions.
  • 1:31:00 –  Has much progress been made in disc replacements? I’ve always wondered why a surgeon cant simply replace a worn out/damaged disc with an artificial new one.

Previous Episodes:

Ep 06: Surgery, Rehab, Movement and Mobility Q&A (Part 2)

Ep 07: Femoroacetabular Impingement (FAI) Causes & Treatment to Avoid Surgery

Ep 08: Understanding Musculoskeletal Pain: Types and Common Causes of Pain

Ep 09: Shoulder Instability: Signs, Symptoms and How to Prevent Dislocation

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About the Author

Dr. Erin Boynton, MD, FRCS is an orthopedic surgeon who was the team surgeon for the Toronto Blue Jays for 10 years and has worked with other professional teams and athletes from many different sports. She currently serves as the Chief Medical Director of the Rogers Cup WTA Tennis Tournament and is the ITF Canadian Champion in tennis for her age group (we won't say which group that is!).

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