Lower Back Pain

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Distinguishing pain as serious or not?

Firstly, if your back pain is keeping up all through the night, you should visit your GP.

I shall firstly discuss a common self-diagnosed condition called sciatica; Commonly mis-diagnosed by doctors and heath professionals and is often wrongly described as arthritis. A disc bulge or arthritis can be seen often with specialised imaging but often there are no symptoms what so ever. Often there are no signs of degenerative processes on specialised imaging but there is an acre of pain..Normally, we look at the history and there is a traumatic incident, or simply repetitive micro-traumas that led to the disc bulge or arthritis. First signs are lower back or neck pain. The instability of the disc is aggravated by positions, diet and movement. The back pain is essentially not always a sign of sciatica and in all cases related to trauma but as a result of tension in the nervous system and tissues they supply including the discs.

What is the cause of this tension?

Although the body is a partially self-correcting organism, it can not ‘Solve’ the change of shape that the body goes through with age and trauma. The shape change results in pain and a reduction in movement or function. For example, a deep consequence of this in the hips will lead to lower back over-compensation and other things commonly in the body start to hurt. Unfortunately, it is now well known that exercise, injections and surgeries do not fix the cause of bulging discs.

Have you had back ache or pain that eventually went away?

Forgotten injuries! Such as tripping and your neck was sore for a few days, but eventually went away.

Some lower back or hip pain after sliding into an opponent during a football or netball match , but after a few days it went away. Maybe you were rear ended while driving home from work and didn’t think it was worth a trip to the hospital, again, after a few months the pain went away. Often times, your body does correct these things with wait for it, unfortunately, a few long term consequences. Your body alters the 

mechanics of your entire body by winding you up a little more to take the pressure off the painful areas. In other words, many of your old injuries that you thought were healed are actually  in your body in the form of twists in compensations. In fact, alot of my time is spent, unwinding people by repositioning the bones out of place that the body cannot self correct, a person can go back through these old injuries and completely undo the damage from those injuries. Of course, you’ll feel some of those aches and pains again, but once the primary problem has been re-aligned, you can say goodbye to that old injury forever. It’s gone. Here’s the key however. If the injury is not addressed you never unwind, these old injuries stay with you in the form of a twisted up skeletal frame. I visited somebody in hospital recently, a member of my family and they had teeth that were twisted so the whole body twists as seen in the elderly.  These old injuries can also present later in different forms with interesting new pains with them. The most well known compensation is arthritis, which is seen in clinic without imaging as a loss of range of motion or chronic pain. ” Arthritis is not a disease as such, the body lays down extra bone where it feels it needs this. This is a double edged sword!

Here are the most common areas of complaint for “low back pain”:

The first image to the left shows the most superficial muscles of the lower back. You might have this general ache covering the whole region. The middle image shows the next level of muscles which are the Erector Spinae muscles. You might have pain a little more specific to these muscles. The image on the right shows the Sacroiliac Joints which are a common source of pain and the Quadratus Lumborum(QL) muscles (The right QL is Shown in Purple and Green which I explain below).

If you are feeling tight and barely walking then the spasms you have are likely in these areas. When your muscles have to work so hard to hold you upright, and the pain can either be mild to severe,  spasms in the muscles and the sense of instability is what is experienced. So much so that you may not even be able to get out of a chair or bed.

Whether your low back injury came from lifting something wrong, sitting for a long time, sleeping wrong or driving too far. In this regard,  I can and often do relieve pain in one or a few visits.

Sacroiliac Joint Pain

In the images on the homepage (why my muscles hurt) you see a text book spine with as it was suppose to be, just like a nice car, fine-tuned alignment and function. If that is showing up as sacroiliac joints pain. I see the whole body as synchronous and there will always be a part of this system that is symptomatic, if it is unstable from forward and twisted posture. You may even go on for years without having pain and then one day it hurts and you’re almost paralyzed with pain. From a traditional chiropractic perspective, we were taught to  adjust the  joint that is restricted and locked up. You may have experienced this, it’s the maneuver where you lay on your side on a table, and they put one leg over your leg and they jump on you to move the joint. It definitely moves the joint and you feel relief afterwards.

If you’ve had this done before, you realize the relief is often short lived. It lasts for a few hours to a few weeks to a few months then the pain returns. What we have found out is that the joint is protecting itself by locking itself nice and tight. It’s a strong compensation that exists because something else is wrong that’s not being corrected. If your doctor understood what was really happening, they would find out what’s actually wrong and the sacroiliac joint would start moving again once its tightness wasn’t needed anymore.

You can often notice people with Sacroiliac Joint problems when they walk. You can tell their pelvis moves as one unit instead of three separate bones. They’ll walk stiff and rigid while their hip joints do all motion to get them to walk. Once they start postural therapy motion returns, albeit only slightly to begin with, but it makes a difference!

Quadratus Lumborum Problems Causing Low Back Pain?

You can see the Quadratus Lumborum (QL) muscles. You have one on the right and left side. It’s easier to get to the muscle from the side of the lower back than directly from the lower back. Above the right QL coloured a little oddly with the top half in purple and the bottom half in green. This is because this muscle can be tight for structural reasons which is by far the most common and also from organ dysfunction that causes a reflexive contraction of parts of the muscle. The top part can tighten when there are kidney problems and the bottom part when there is liver problems.

There is little point in massaging these muscles or trying to relax them if they’re needed to hold up your structure. Yes, you’ll loosen them a little and get relief, but it won’t last. The Quadratus Lumborum muscle is helping you significantly even if it hurts. The true problem needs to be dealt with, which we’re well versed at correcting.

Non-Specific Mechanical Low Back Pain?

This is a diagnosis is used today, here in the UK. Meaning the specific source of pain could not be identified. Since 2017 investigations including X-rays and MRI’s are not indicated initially as imaging is not a reliable source of data to use in isolation.

Physiotherapy

In Rehab or physiotherapy, exercises are given to strengthen the lower back and enhance core strength. While exercise may help with your motivation, even temporary mobilty and sense of well-being. Key here is the lower back muscles are contracting hard, trying out of desperation to hold you upright. But it’s your underlying structure that’s mechanically out of alignment. Treating the lower back by itself is almost always a waste of time, even though it does need direct treatment. The problem with today’s methods of treating this condition and many others is that we compartmentalize our body’s. We have a neck, an upper back, a lower back, hips, knees, feet, etc. Then if one of those areas hurts, all the treatment is given to the area that hurts.

I realized that this was a waste of time and created more new compensations.  I realized this because even though I would improve a person in terms of pain, it was often temporary and the function or intolerences to lift etc were not improved. It wasn’t until I realized that where a person hurts is just a strong compensation that I started searching for other ways to truly fix people.Correcting Non-Specific Low Back Pain can be straight forward.

Further glossary: Disc Degeneration/Disc Herniation/Slipped Discs

First of all discs don’t so much slip as they are they are attached to the bone and the bone below. Discs do bulge and eventually herniate. This is where the inner part of the disc gets mushed and pushed through the outer (more tough) part of the disc. Many of you, who have no low back pain at all, have this problem and you are completely symptom free. But if you have low back pain and get an MRI and then find out you have a disc herniation or bulging disc, this is often a reported cause with surgery only the answer.. If there is lost bladder or bowel control immediate surgery is definately indicated here as this is the serious back pain that we are talking about!  I personally have not seen this but you should report to your GP with this!.

Disc Degeneration can also cause pain and stiffness, loss of range of motion and pain.

Stenosis

Stenosis in the low back is a part of the thickening of the bone in response to stress on the bone. Stenosis is the result of Wolf’s Law. From Wikepedia…

Wolff’s law is a theory developed by the German anatomist and surgeon Julius Wolff (1836–1902) in the 19th century that states that bone in a healthy person or animal will adapt to the loads under which it is placed.[1] If loading on a particular bone increases, the bone will remodel itself over time to become stronger to resist that sort of loading.

The problem with spinal bones is that there are large, fat nerves running through large openings in the bone specifically for the nerves. If the bone is under abnormal loads on a regular basis, the bone has no choice but to thicken in every direction. This makes less room for the nerves and you can run into what is called Stenosis in the low back. But no one seems to know why the bone is under more stress than someone who does not have stenosis in the low back. I do. It’s simply poor structure throughout the entire skeletal system putting enormous pressure on the bones that have thickened. They’re following Wolf’s law exactly, but doctors are surprised to see this type of thing happen.

If a person has stenosis they need to get their entire body treated so that the pressure can come off the vertebra that have stenosis. Whether it’s low back stenosis or neck stenosis doesn’t matter. It’s all fixable provided there isn’t too much damage and you’re willing to get enough of the treatments to take the stress off the problematic bones.

Osteoarthritis

Osteoarthritis is the most common type of arthritis where bone grows and thickens in response to mechanical stress. This is also the easiest to prevent since the mechanical stresses can be removed.

Understanding the arthritic process. Joints that are on twisted bodies degenerate over time and grow more bone in the direction of the stress to compensate. The most dangerous version will result in a joint space between the neck vertebra decreasing and the joint may eventually fracture or become destroyed. Catching this process before it has gone too far is the key.

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