This is a subject I feel needs some major clarification within the healthcare realm.  If I personally had to look at my future in terms of the genetics of my grandparents, I should just give up now, as I’m basically half way through my life! No grandparent lived past 67 on either side of my family due to various reasons (cancer, heart disease, diabetes).  So why am I not giving up hope that I could have a longer and more healthy life span?  Well, besides the fact that I ultimately believe that God has the final say so (vs. our genetics), I also know that the other strong component that can lead to a better quality & quantity of life are our lifestyle choices.  As Dr. Lloyd Jones, a cardiologist, states, “Some genes lead to disease, but by far, the biggest factor is lifestyle.”

Just like other pathologies affecting our organ systems, musculoskeletal problems are often thought of as being genetic.  I have lost count of how many times I have heard patients express, “my dad had bad knees, so I know I am destined to have the same.” I recently had a conversation with a patient about how her low back pain had affected everyone in her family (her mom and sister both had to have back surgeries due to similar complications) and she was terrified that her situation would be the exact same.  In fact, her primary care physician had told her she was doomed.  I wish I were kidding but that is actually what her PCP told her.  Just as the cardiologist mentioned above was expressing that genes do a play a role in heart disease, the same goes with musculoskeletal pain and disease.   Our exercise and postural habits throughout our lifespan matter so much more than just the genetics.

Because low back pain is something that 80% of the population will experience at one point in their lives, I will explain how our lifestyle factors can affect our low backs.  Whether you are among the millions of desk job employees or you are a blue collared employee lifting/bending on a regular basis to get the job done, back pain does not discriminate.  According to the National Institute of Neurological Disorders, the highest risk factors for developing Low back pain (LBP) are 1) Age 2) Fitness level 3) Pregnancy 4) Weight gain 5) Genetics.  Yes! Genetics is at the bottom of the list.  Age is at the top because our bone health can change over time (particularly for women) due to osteoperosis- which is also heavily influenced by weight bearing exercises.  Fitness level is so important because weak abdominal and back muscles lead to a high risk of the development of low back pain.  Also, it’s important to understand how to perform the correct exercises to strengthen the core muscles of the abdominals and back (disclaimer: Sit ups will not do it)!  Just as you would not try to self medicate for high blood pressure, it is important to realize that every low back pain patient I see are treated individually based on their specific needs.

So, whether you were born with flat feet, knocked knees, scoliosis, a leg length discrepancy or you just developed some postural abnormalities over time, there are so many things that can help you and the progression of your musculoskeletal issues.  This is where a physical therapist can help you the most.  Never accept the assumption that you were born with a “bad back.”  We can’t always control the hands we are dealt, but we can control how we face our adversities.  Never give up on finding a solution that works for you and your health!