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"Back pain is nature's way of telling you that you have muscles you didn't know you had."

—Steve Martin

My back has been one of my biggest strengths when it’s functional and my biggest weaknesses when I don’t take care of it.

I’ve been told that I’ve been gifted a “bad back” through my genes but I don’t believe that. What you take care of gives back to you. The back is an impressive engineering feat that must be respected and nurtured. If it is neglected then it will succumb to the demands of the modern world and you will be a statistic falling under the category of most common musculoskeletal injuries that are preventable.

Knots And Flames: Under The Hood Of Low Back Pain

In this article, we'll focus on two common yet formidable adversaries of the back: muscle adhesions and chronic inflammation. These interrelated factors have a strongly interlinked relationship that contributes to the perpetuation of a pain and discomfort cycle. We will explore their mechanics and my favorite "tools" to disrupt this cycle and offer relief to those grappling with low back pain.

Muscle Adhesions: The Silent Aggressor

Muscle adhesions, scientifically referred to as myofascial adhesions, represent insidious culprits in the genesis of low back pain. These bands of fibrous tissue manifest among muscle fibers and fascial layers, leading to musculoskeletal mobility restrictions. The consequences include pain, stiffness, and a pervasive sense of discomfort around the low back.

Muscle adhesions, also known as muscle knots, can be triggered by things such as overuse injuries stemming from repetitive or strenuous activities or inadequate recovery following microtrauma, a scenario in which the body resorts to the production of collagen as a reparative measure. This collagen, however, tends to clump together in an irregular and disorganized fashion, lacking the structural alignment typically found in undamaged tissue. This irregular arrangement imparts a distinctive "stickiness" to the adhesion, setting it apart from the smoother texture of healthy muscles and fascia and creating restricted movements and trigger points.

Chronic Inflammation: The Persistent Agitator

Inflammation, a key part of the body's defense mechanism, can be a two-edged sword. While it's crucial for protecting us from injuries and infections in the short term, when it persists for an extended period, it can lead to various health problems, including chronic low back pain.

Chronic inflammation can result from a range of factors, such as autoimmune disorders, diets rich in pro-inflammatory foods such as the Standard American Diet (SAD), or metabolic issues like high blood sugar levels or being overweight. When inflammation lingers, whether due to internal factors or external triggers, it sets off a series of processes that worsen discomfort and contribute to the development of low back pain.

Whether it's the chicken or the egg, inflammation and muscle adhesions often work hand-in-hand to wreak havoc on susceptible areas of your body such as your low back.

Inflammation And Muscle Adhesions: A Vicious Cycle

Muscle adhesions, akin to tiny knots in muscle fibers triggered by microtrauma, initiate an inflammatory response as the body's natural healing process springs into action. Paradoxically, this inflammation, designed to aid in the healing process, can contribute to the formation of additional muscle adhesions. This sets in motion a self-perpetuating loop of discomfort.

As muscle adhesions proliferate, they constrict the normal range of motion in muscles, subjecting the lower back to heightened mechanical stress. This heightened stress intensifies inflammation, further exacerbating pain. The resulting mechanical stress and inflammation together lead to a reduced range of motion and increased sensitization in the lower back.

In response to discomfort, our bodies adapt by unconsciously altering our movement patterns, however, these adaptations often evolve into ingrained habits, perpetuating low back issues. It becomes a self-reinforcing cycle wherein the body's coping mechanisms inadvertently contribute to the persistence of the very discomfort they aim to alleviate. For instance, individuals with sedentary desk jobs might unknowingly adjust their posture to alleviate pain, only to find that these adjustments eventually lead to chronic lower back issues. Athletes may similarly modify their running patterns or lifting technique to accommodate muscle adhesions, unintentionally worsening their condition, impairing performance, and increasing the risk of injury.

Strategies To Manage Low Back Pain

Lifestyle Factors

While this duo is intricately intertwined and devious, we have the ability to break the cycle, limit chronic inflammation, and manage muscle adhesions to decrease your low back pain.  First and foremost, it's important to talk to your healthcare provider.  Inflammation can only get so much better if you're stressed, not sleeping well, and eating a low-quality diet.  So, start by hitting the basics:

• Lower your body fat percentage

• Prioritize sleep quality

• Eat an anti-inflammatory diet

• Move more

• Drink enough filtered water with enough electrolytes

• Manage your stress

Tools

While you're dialing those in, here are some of my favorite "tools" to help alleviate your low back pain.

Symbodi Vertiball

Soft tissue mobilization has proven to be an effective way to address low back pain by reducing sensitivity and targeting those hard-to-reach muscle adhesions or "knots." One of my top choices for allowing patients to perform self-mobilization on their hot spots is the Symbodi Vertiball.

The process is straightforward: identify the inflamed area, mount the Vertiball on the wall at this height, and then go back and forth over the problematic region until the muscle gradually releases tension.  If it's too sensitive then lean into it less.  Too easy?  Well....it won't be.🙂  I love it enough that we have one mounted in our kitchen, which my wife and I regularly use for our personal mobility work.

Magnesium

Magnesium plays crucial roles in muscle function, nerve transmission, bone health, and energy production within the body. Yet 75% of us aren't getting enough magnesium, making it an "invisible deficiency."  When it comes to low back pain, magnesium helps by promote sleep and relaxation, reducing muscle cramps and spasms, and potentially lowering inflammation.  One study on professional cyclists even found it to provide protection against damaged muscles.

• The best way to use magnesium after an injury to the lower back is to apply it transdermally to improve absorption using a topical one such as this. 

• Epsom salt is another form of magnesium that is great to use when you are soaking in a tub through a bath at home (use 2-3 cups). 

• Oral magnesium. Magnesium glycinate is the best bioavailable form. Two great types are Solaray Magnesium Glycinate and Life Extension Neuro-Mag Magnesium L-Threonate

Massage Trigger Point Cane

While this ranks well below the Vertiball on my list of effective back mobility tools, the massage trigger point cane (a.k.a. the back massager rod, the Shepard's hook) is another targeted way to address restrictive areas of your back.  Its curved design lets you hit all muscle groups in the body, including those in the lower back, allowing for self-massage that targets tight, spasmodic, and knotted muscles. 

For patients who have that very specific tender spot in their back, this is the perfect tool. The nub is smaller and pointier than the Verrtiball point of contact so you can go a bit deeper.  I give it to some of my patients when the session is finished and I'll come back many minutes later and their still sitting there using it with pure bliss on their faces.  It's extremely durable, easy to store away, and made of BPA-free material.

Sauna

The power of saunas.  There is a slew of research that links sauna use to everything from cognitive health to cardiovascular benefits to detoxing the body.  And, of course, the science backs up sauna use for low back pain.

Using a sauna is one of my favorite hormetic stressors for better health. They work through a variety of mechanisms to help treat low back pain.  First, the heat from saunas promotes muscle relaxation and increases blood flow, which can help soothe tense muscles in the lower back. Additionally, saunas induce sweating, a natural means of eliminating toxins and waste products from the body, potentially reducing inflammation that contributes to pain. Regular sauna use has also been linked to the release of endorphins, the body's natural painkillers, relieving discomfort.

If you have access to a sauna then take advantage of it.  I believe in the benefits of sauna enough that I bought an infrared sauna blanket.  After a lot of research, I went with the HigherDOSE sauna blanket because it uses infrared light, it's made with non-toxic materials, and it emits very low levels of EMF. I highly recommend it.

Acupressure Mat

Inspired by ancient healing techniques, the Shakti Mat is covered in small plastic spikes that stimulate pressure points across your body. When you lay on it, these points help to improve circulation, release muscle tension, and promote a sense of relaxation. Many people swear by its ability to reduce chronic pain, including low back pain, by targeting muscle stiffness and improving overall blood flow to the area.

So, I got one, tried it and I could literally only tolerate it for about 5 seconds. The sharp spikes felt like they were piercing straight into my back, and I thought, there’s no way this is helping. But I gave it a chance. Gradually, I worked my way up to 20 minutes, and it became a game changer and now something I incorporate into my nightly routine.

As a funny side note, while I was struggling to stay on for even a few seconds, my wife lay down on it like it was a pillow. She sighed and said, "This feels so good. I need to start doing this every night." I was blown away.

The Shakti Mat uses tiny, plastic acupressure points to stimulate circulation, relieve tension, and release endorphins, your body's natural painkillers. It’s a tool I never thought I’d rely on, but now it’s something I turn to regularly. You might start off like me—grimacing in discomfort—but it gets better, and it’s worth it.

Takeaway

Managing low back pain requires a combination of smart lifestyle changes and the right tools. By addressing inflammation, muscle adhesions, and adopting strategies to improve overall health, you can significantly reduce discomfort like I have. Start with the basics—sleep, diet, hydration, and movement. Then, explore tools like the Symbodi Vertiball, magnesium supplements, a massage trigger point cane, or even an acupressure mat like the Shakti Mat. These simple tools can be powerful allies in your quest for a pain-free back.

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