The Tweaky Lower Back: Management and Prevention of Low Back Pain for Belly Dancers

In addition to being the founder and director of Greenstone Belly Dance, Siobhan is a Rehabilitative Exercise Specialist and Strength & Conditioning Coach. This blog post was originally written by Siobhan for her Safe Dance Column in the Middle Eastern Dance Association of New Zealand (MEDANZ) January 2019 Newsletter. You can join MEDANZ to access their newsletters and find out more about MEDANZ here.  Photo by Vera of love.vera.nz.

Belly dancer or not, low back pain is common, with 85% of people experiencing it at some point in their life.1 Unfortunately, the cause is often unable to be determined,2 which can cause frustration when it comes to deciding how to treat it. However, low back pain can be broken down into a few different categories, which, when you know the recommendations for each kind, can help you manage it.3 If you’ve seen your healthcare provider and know that your low back pain is not related to any serious illness or spinal issue (in most cases, it’s not, so no need to panic if you haven’t seen anyone yet!), here’s a quick introduction to the different categories of low back pain, and how to manage them.

Managing a Dance Injury_ A Blog Post (1)

How do we define low back pain?

First of all, we decide if it’s “acute” or “chronic” low back pain. Acute low back pain is back pain that has lasted for less than 3 months, while chronic low back pain is pain that you’ve been dealing with for longer than 3 months. We usually put low back pain into one of these two categories, but there is a third category: “Chronic back-related leg pain.” Sciatica (nerve pain that starts in your low back but can be felt down the leg, often as a tingly, tight kind of pain) falls into this category.

So what’s recommended for my low back pain?

Acute low back pain (less than 3 months)

If your pain has only occurred in the previous 3 months, it’s recommended that you stay as active as you can (or make steps to become more active; think cardio exercise like swimming or cycling, as well as general strengthening and stretching exercises) and get advice on improving your posture. It is important to note that non-drug methods are recommended to be tried first before you try medication to manage your pain3. However, you could consider using a non-steroidal anti-inflammatory (like ibuprofen) to help with pain when it’s bad.4 Paracetamol has been found to be less effective, so isn’t recommended.5 If your pain is really recent, it may be also important to consider if you’ve made any recent changes in your lifestyle; have you moved to a higher stress job? Are you no longer as active as you were before? It may be worth considering what physical and/or emotional factors may have contributed to your pain so you can address them.

Chronic low back pain (more than 3 months)

Much like with acute back pain, it’s recommended to stay active and get advice on improving your posture. However, there have also been a series of particular exercises specifically recommended for chronic low back pain, including mobility (exercises that help your back feel less stiff and more free to move), stability (helping your back stay in a more stable, safe position), strengthening and stretching exercises.3 You can find a YouTube channel of all of these exercises here. Spinal manipulative therapy (think of the “cracking” a chiropractor performs on your back) has also been suggested to helpful in the short-term to reduce pain, and pain medication has been found to be most effective when used in the first 6 months.

Chronic back-related leg pain (e.g. sciatica or radicular leg pain)

If you’ve been diagnosed with sciatica, or if you recognise some of the symptoms of what it feels like described above, you might fall into this category. Staying active and improving your posture is still important, and similar exercises to the ones mentioned for chronic low back pain are recommended, especially postural and stabilisation exercises. Spinal manipulation therapy may also be worth trying alongside using some of these exercises.

What about belly dance? Will it help or harm my low back pain?

One key “rule” I tell injured clients to pay attention to is how their body feel 24 hours after an activity. If you go to belly dance class and your back feels a little tweaky at the time, notice how it feels the next day. Is it feeling the same as before the dance class, better, or worse? If it feels the same or better, then the dance class was probably just the right amount of movement to help “loosen up” your back a little. If it feels worse, you may have pushed it a little too far for your current level of back pain. It’s been found that belly dancers participating in any kind of exercise program outside of dance are less likely to be injured,6 so it may be a good idea to consider working on your strength and fitness outside of belly dance to help your back cope with some of the particular movements of the dance form. Pay attention to your technique and posture, and try to make sure you’re not too tired when you arrive at dance class, as fatigue is also linked to injury.

It’s important to know that even exercise alone (no matter whether it is aerobic, stretching, or specific core-strengthening exercise) may help reduce the chance of low back pain occurring again by 30%.<7,8 So it’s worth keeping moving, and if you find belly dance doesn’t aggravate your back pain, then there’s no sense in stopping.

References

1Hoy D, Bain C, Williams G, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012; 64(6):2028-2037.

2van Tulder M, Koes B, Bombardier C. Low back pain. Best Pract Res Clin Rheumatol. 2002;16(5):761-775. 27.

3Bussières, A E et al. Spinal Manipulative Therapy and Other Conservative Treatments for Low Back Pain: A Guideline From the Canadian Chiropractic Guideline Initiative. Journal of Manipulative and Physiological Therapeutics. 2018;41(4):265-293.

4Qaseem A, Wilt TJ, McLean RM, Forciea MA. Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017; 166(7):514-530.

5Low Back Pain. Comparative Effectiveness Review No. 169. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290-2012-00014-I.). AHRQ Publication No. 16-EHC004-EF. Rockville, MD:Agency for Healthcare Research and Quality; 2016. Available at: https://effectivehealthcare.ahrq.gov/topics/back-pain-treatment/cmece/.

6Milner S C, Gray A, Bussey M. A Retrospective Study Investigating Injury Incidence and Factors Associated with Injury Among Belly Dancers. Journal of Dance Medicine & Science. 2019.

7Steffens D, Maher CG, Pereira LS, et al. Prevention of low back pain: a systematic review and meta-analysis. JAMA Intern Med. 2016;176(2):199-208.

8Shiri R, Coggon D, Falah-Hassani K. Exercise for the prevention of low back pain: systematic review and metaanalysis of controlled trials [e-pub ahead of print]. Am J Epidemiol. 2017. Available at: https://doi.org/10.1093/aje/kwx337. Accessed February 14, 2018

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