210. Low Back Pain: A Practical Guide w/ Marc Surdyka and Chris Hughen

Low back pain, defined as pain in the lumbar or sacral regions, requires a nuanced management approach that prioritizes individual presentation over rigid diagnostic labels. Imaging findings like disc bulges or degeneration frequently appear in asymptomatic individuals, making them poor indicators for treatment paths. Instead of focusing on "poor" posture or "weak" cores—narratives that often foster fear and unnecessary rigidity—rehabilitation should emphasize movement variability and capacity building. Effective management strategies include modifying aggravating activities, implementing graded exposure to feared movements, and gradually increasing load tolerance. Lifestyle factors such as sleep, stress, and general physical activity significantly influence symptom persistence and recovery. Because recurrence is a common feature of low back pain, building resilience through consistent, tolerable movement is more effective than seeking a single, permanent fix.