The Thinking Practitioner

127: Low Back Pain Update (with Whitney Lowe & Til Luchau)


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In this episode, Til and Whitney dive into strategies for addressing low back pain (LBP) with hands-on work, exploring LBP's prevalence, causes, and treatments. Sharing the insights they've gained from experts such as Nikolai Bogduk, Stewart McGill, Paul Hodges, Lorimer Moseley, Helene Langevin and Antonio Stecco, they lay out the diverse views on both the structural and non-mechanical origins of LBP. Listeners will also learn about therapeutic approaches, the significance of practitioner confidence, and the importance of comprehensive evaluations. Tune in for a fascinating look at how practitioners and clients alike can better understand and work with low back pain.


Key Topics:

1. Prevalence of low back pain

  • Over 60-70% of people have episodes of low back pain at some point [01:51] 
  • Leading cause of disability worldwide
  • Huge economic impact
  • 2. Potential evolutionary factors contributing to low back pain

    • Transition to bipedalism and upright posture
  • Differences in spinal curvature and hip mobility between cultures [05:45]
  • 3. Causes and contributors to low back pain - [07:39]

    • Overemphasis on disc and structural issues in the past
  • Importance of comprehensive evaluation beyond just structural issues
  • Role of soft tissue, muscular, and neural factor
  • 4. Influence of practitioner perspective and confidence on outcomes [30:20]

    • Importance of the therapeutic relationship and rapport
  • Unexpected interventions can sometimes be effective [35:53]
  • 5. Personal experiences with low back pain

    • Overuse vs. underuse/immobility as contributors
  • Debates about the significance of posture, load, and context [41:31]
  • Limits of expertise vs. scope of practice for massage therapists
  • Get the full transcript at Til or Whitney's sites! 

    • Whitney Lowe’s site: AcademyOfClinicalMassage.com 
  • Til Luchau’s site: Advanced-Trainings.com 
  • Resources mentioned in this episode:

    • ABMPs’ CE Summit on LBP: live Oct 1, 2024 and free to everyone in the profession: abmp.com/summit
    Portions also available by recording to ABMP members and next year, to A-T Subscribers 

    Sponsor Offers: 

    • Books of Discovery: save 15% by entering "thinking" at checkout on booksofdiscovery.com
  • ABMP: save $24 on new membership at abmp.com/thinking
  • Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/,.
  • Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet
  • About Whitney Lowe  | About Til Luchau  |  Email Us: [email protected]

    (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)

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    The Thinking PractitionerBy Til Luchau & Whitney Lowe

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