Want to Get Rid of Your Lower Back Pain?

Has all this extra sitting down at home and work left you with lower back pain (LBP) that you just cannot get rid of? Have you jumped into to some HIIT training that has left you with back issues? You’re not alone, as it is estimated that over 30% of the UK’s working population have LBP, with over 20% of those affected having to consult their GP.¹ This works out to be 1 in 15 of the UK’s population. Worryingly, over 60% of people still report having LBP after 1 year of it starting.² It is therefore important to stop LBP quickly as possible.

For the individual, LBP is frustrating, and in addition to the discomfort of pain, it can lead to a reduction in your activity levels and an increased risk of developing psychological problems.³

For the business owners among you, it is worth noting that LBP is the number one reason your employees are likely to have time off work.  Lower Back Pain is the leading cause of years lost to disability in high-income countries for all age categories from 25-64 years old, with a growing prevalence.⁴ As far back as 1998, LBP healthcare costs were ~£1.6 billion, with the greater knock-on losses to GDP between £3-9 billion.⁵ Encouraging and supporting your employees to stay active and prevent LBP should be paramount.

Fortunately for individuals and businesses alike, the vast majority of LBP is classified as non-specific, which means that you do not have any serious pathological cause, with corrective exercise being a way to resolve LBP.⁶ However, reputable bodies state that the burden of LBP is yet to be fully acknowledged and call for better intervention measures to be implemented.⁷ EMS training to the rescue?

Where Does EMS Training Fit In?

Electro Muscle Stimulation can take on and alleviate this LBP burden for numerous individuals. EMS training has been shown to reduce the frequency and intensity of LBP in a short space of time.⁸ It is highly effective, time-efficient and has numerous secondary benefits.  The full spectrum of trainees, from the ‘new-to-fitness enthusiast’, all the way through to elite athletes, can benefit from EMS training being a part of their routine.

How Does EMS Work for LBP?

There appear to me multiple factors at play. EMS leads to:

1. ENHANCED POSTURAL CONTROL AND AWARENESS – Individuals with LBP that partake in EMS develop a greater level of proprioception and connection to their muscles.⁹  This ensures that you can reduce your kinesiophobia (fear of movement) and enhance your movement control, both of which lead to a reduction or eradication of LBP.
2. DIRECT PAIN RELIEF – EMS can directly reduce the feeling of pain in the muscles, increasing the chances you can have pain free movement during your training session. This pain reduction in turn facilitates greater movement and function, as individuals quickly gain confidence that their body is ready to move freely again.¹⁰
3. MUSCLE HYPERTROPHY AND ACTIVITY – Key lumbar muscles associated with LBP are switched on and increase in thickness as a result of EMS training.^11,12 This is important, as non-specific LBP is associated with a lack of stability in the lumbar spine, specifically due to poor motor control and weakness of the lumbar muscles: Transverse Abdominis, Multifidus and Internal Obliques. It has been found that individuals with LBP have delayed firing of these lumbar muscles when moving and is widely accepted that these muscles can be difficult to ‘switch back on’ and strengthen.¹³
4. WHOLE BODY STRENGTHENING – EMS training at Vive Fitness incorporates a whole-body approach. Resultantly, you not only strengthen your back muscles associated with LBP, you strengthen the rest of your body at the same time. The whole body is linked, so one weakness along the chain could be the cause of LBP. For example, it is well documented that the hip musculature strength is of particular importance to LBP, with weak or inactive hip abductors (glut med) and hip extensors (glut max) increasing your risk of developing LBP.^14,15 EMS helps strengthen all these muscles during your LBP specific session, thus mitigating the risk of LBP returning, all in a time-efficient and efficacious way.

What About Other Training Modalities?

Personally, I love other forms of exercise too, however numerous training modalities either require large movement to get a significant stimulus, or those that implement small movements, do not create a significant stimulus for quick improvements. Individuals with LBP are often kinesiophobic, and therefore fear trying exercise modalities that require too much movement or having to get up and down from the floor.¹⁶ Initial EMS training requires very little movement for those that are in too much pain, yet the strengthening you get is significant.¹⁷ EMS therefore offers the best of both by overcoming these limitations. As mentioned, EMS is time efficient and strengthens the entire body at the same time as reducing LBP.

Let’s Summarise

If you currently do EMS training, great, you are strengthening your chances of not getting LBP. If you have LBP, EMS can be what you are looking for. EMS training could work for you because:

1. It only requires 20 minutes a week to see the benefits
2. LBP pain and frequency can be reduced in as little as 2 sessions
3. Pain reduction during training decreases kinesiophobia
4. EMS does not require a large range of motion during training to see benefits
5. Stimulates key back muscles that are notoriously difficult to activate
6. Increased proprioception – Thus you have an enhanced ability to move
7. Each session strengthens your whole body  – Weaknesses throughout the body can cause LBP, so all areas should be strengthened 
8. Supports all other forms of training as part of a weekly programme to ensure LBP risk is reduced

References

1. Macfarlane, G., Jones, G. and Hannaford, P., 2006. Managing low back pain presenting to primary care: Where do we go from here?. Pain, 122(3), pp.219-222.
2. Hestbaek, L., Leboeuf-Yde, C. and Manniche, C., 2003. Low back pain: what is the long-term course? A review of studies of general patient populations. European Spine Journal, 12(2), pp.149-165.
3. Pincus, T., Santos, R., Breen, A., Burton, A. and Underwood, M., 2007. A review and proposal for a core set of factors for prospective cohorts in low back pain: A consensus statement. Arthritis & Rheumatism, 59(1), pp.14-24.
4. Vos, T., 2016. Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet, 388, pp. 1545–160.
5. Maniadakis, N. and Gray, A., 2000. The economic burden of back pain in the UK. Pain, 84(1), pp.95-103.
6. Steffens, D., Maher, C. and Pereira, S., 2016. Prevention of low back pain: a systematic review and meta-analysis. JAMA Intern Med, 176, pp.199–208.
7. Buchbinder, R., Van Tudler, M. and Oberg B., 2018. Low Back Pain: A Call for Action. The Lancet, 391, 10137, pp. 2384-2388.
8. Kemmler, W., Weissenfels, A., Bebenek, M., Fröhlich, M., Kleinöder, H., Kohl, M. and von Stengel, S., 2017. Effects of Whole-Body Electromyostimulation on Low Back Pain in People with Chronic Unspecific Dorsal Pain: A Meta-Analysis of Individual Patient Data from Randomized Controlled WB-EMS Trials. Evidence-Based Complementary and Alternative Medicine, 2017, pp.1-8.
9. Rojhani-Shirazi, Z. and Rezaeian, T., 2015. The effects of Transcutaneous Electrical Nerve Stimulation on postural control in patients with chronic low back pain. Journal of Medicine and Life, 8, 19-27.
10. Hicks, G., Sions, J., Velasco, T. and Manal, T., 2016. Trunk Muscle Training Augmented With Neuromuscular Electrical Stimulation Appears to Improve Function in Older Adults With Chronic Low Back Pain. The Clinical Journal of Pain, 32(10), pp.898-906.
11. Baek, S., Cho, H., Kim, S., Jones, R., Cho, Y. and Ahn, S., 2016. Changes in deep lumbar stabilizing muscle thickness by transcutaneous neuromuscular electrical stimulation in patients with low back pain. Journal of Back and Musculoskeletal Rehabilitation, 30(1), pp.121-127.
12. Sions, J., Crippen, D., Hicks, G., Alroumi, A., Manal, T. and Pohlig, R., 2019. Exploring Neuromuscular Electrical Stimulation Intensity Effects on Multifidus Muscle Activity in Adults With Chronic Low Back Pain: An Ultrasound Imaging–Informed Investigation. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders, 12, pp.1-9.
13. Hodges, P. and Richardson, C., 1999. Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Archives of Physical Medicine and Rehabilitation, 80(9), pp.1005-1012.
14. Kankaanpää, M., Taimela, S., Laaksonen, D., Hänninen, O. and Airaksinen, O., 1998. Back and hip extensor fatigability in chronic low back pain patients and controls. Archives of Physical Medicine and Rehabilitation, 79(4), pp.412-417.
15. Nadler, S., Malanga, G. and Bartoli, L., 2002. Hip muscle imbalance and low back pain in athletes: influence of core strengthening. Medicine & Science in Sports & Exercise, 34(1), pp.9-16.
16. Vlaeyen, J., Kole-Snijders, A., Boeren, R. and van Eek, H., 1995. Fear of movement/(re)injury in chronic low back pain and its relation to behavioural performance. Pain, 62(3), pp.363-372.
17. Weissenfels, A., Teschler, M., Willert, S., Hettchen, M., Fröhlich, M., Kleinöder, H., Kohl, M., von Stengel, S. and Kemmler, W., 2018. Effects of whole-body electromyostimulation on chronic nonspecific low back pain in adults: a randomized controlled study. Journal of Pain Research, Volume 11, pp.1949-1957.