31 January 2024

Lower back pain: causes, treatment, and prevention of lower back injuries and pain - Dr Stuart McGill

Dr Stuart McGill is a distinguished professor emeritus at the University of Waterloo and the chief scientific officer at Backfitpro Inc. where he specializes in evaluating complex cases of lower back pain from across the globe. In this episode, Stuart engages in a deep exploration of lower back pain, starting with the anatomy of the lower back, the workings of the spine, the pathophysiology of back pain, and areas of vulnerability. He challenges the concept of nonspecific back pain, emphasizing the importance of finding a causal relationship between injury and pain. Stuart highlights compelling case studies of the successful treatment of complex cases of lower back pain, reinforcing his conviction that nobody needs to suffer endlessly. He also covers the importance of strength and stability, shares his favourite exercises to prescribe to patients, and provides invaluable advice for maintaining a healthy spine.

00:00:00 Dr. Stuart McGill
00:02:33 Sponsors: Helix Sleep, BetterHelp & Waking Up
00:06:23 What Causes Back Pain?; Genetics, Dog Breed Analogy
00:12:55 Tool: Skeleton & Body Type; Spine Flexibility & Discs
00:20:25 Flexibility & Exercises; Discs & Collagen
00:25:43 Sponsor: AG1
00:27:32 Stress & Tipping Point; Athletic Tradeoffs, Triathletes
00:36:17 Back Pain, Goals & Training Program
00:45:57 Spine Hygiene, Back Pain, Powerlifting
00:53:33 Genetics & Running
00:59:34 Sponsor: LMNT
01:00:46 Rehabilitation & Reducing Volume; Injury
01:07:42 Tool: Training for Lifelong Fitness, Injury & Joints
01:17:40 Pain Types, Biopsychosocial Model of Pain
01:26:15 Coaching, Explosivity & Endurance
01:32:43 Virtual Surgery & Rest, Pain Recovery
01:41:25 Tool: McGill’s Big 3; Building Back Strength & Stability
01:46:39 Inversion Tables & Spine Deloading, Disc Bulge, Tool: Lumbar Support
01:51:09 Tool: Daily Walking; Sitting
01:55:33 Deadlift & Bone Density, Glute-Ham Raise
02:06:20 Training & Age, Osteoporosis, Tool: Deadlift Alternatives
02:16:47 Tools: Biblical Training Week; Spine Stability & McGill’s Big 3; Shrinking & Age
02:24:16 Platelet-Rich Plasma (PRP); Disc Damage
02:27:56 Tools: Biblical Training Week & Strength Exercises, Neck Strength
02:35:24 Tools: Sword Play, Distal Limb Loading, Training for Symmetry
02:42:38 Tools: Biblical Training Week, Mobility & Cardiovascular Exercises, Athletic Panel
02:49:22 Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, YouTube Feedback, Protocols Book, Social Media, Neural Network Newsletter

0:00:00 Intro
0:00:30 Peter’s experience with debilitating back pain
0:14:11 Anatomy of the back: spine, discs, facet joints, and common pain points
0:24:48 Lower back injuries and pain: acute vs. chronic, impact of disc damage, microfractures, and more
0:31:30 Why the majority of back injuries happen around the L4, L5, and S1 joints
0:37:20 How the spine responds to forces like bending and loading, and how it adapts do different athletic activities
0:45:12 The pathology of bulging discs
0:48:33 The pathophysiology of Peter’s back pain, injuries from excessive loading, immune response to back injuries, muscle relaxers, and more
0:59:36 The three most important exercises Stuart prescribes, how he assesses patients, and the importance of tailored exercises based on individual needs and body types
1:12:46 The significance of strength and stability in preventing injuries and preserving longevity
1:25:33 Stuart’s take on squats and deadlifting: potential risks, alternatives, and importance of correct movement patterns
1:37:08 Helping patients with psychological trauma from lower back pain by empowering them with the understanding of the mechanical aspects of their pain
1:46:59 Empowering patients through education and understanding of their pain through Stuart’s clinic and work through BackFitPro
1:56:08 When surgical interventions may be appropriate, and “virtual surgery” as an alternative
2:05:48 Weakness, nerve pain, and stenosis: treatments, surgical considerations, and more
2:11:21 Tarlov cysts: treatment and surgical considerations
2:13:34 The evolution of patient assessments and the limitations of MRI
2:18:40 Pain relief related to stiffness and muscle bulk through training
2:26:49 Advice for the young person on how to keep a healthy spine
2:39:24 Resources for individuals dealing with lower back pain

Dr Stuart McGill's book: Back Mechanic by Dr Stuart McGill

In an age where a seemingly endless amount of gimmicky back products are in circulation, a definitive guide to self-assessment and rehabilitation is more essential than ever. Back Mechanic guides you through a self-assessment of your pain triggers, then shows you how to avoid these roadblocks to recovery. Then effective exercises are coached in a step by step progressive plan. Spine expert, Dr Stuart McGill used his 30 years of research findings and clinical investigations to create this evidence-based guide that has helped thousands reclaim their lives. This knowledge is now available to you in this richly illustrated book. You will become your own best Back Mechanic and advocate.