Low Back Pain

Where does it hurt?  Low Back

As the winter weather approaches and snow shoveling becomes inevitable, we should speak about the subject of Lower Back pain. 

As I have mentioned in other articles, symmetry is one of the key factors in maintaining healthy joints.  The low back is not excluded from this tenet.  Symmetry is important between your left and right but is as important between your front and back.  Because of the inherent anatomical differences between the front and back halves of the body we will use the word balance instead of symmetry.  

One of my favorite visual metaphors for a very common complaint is a telephone pole with two supporting cables positioned on opposite sides of the pole.  When there is equal tension on the wires, the pole is supported, when one becomes tight or the other becomes loose, the pole will begin to shift.  Imagine our bodies being much the same.  We have muscles in the anterior (front) of our body whose action is to flex our trunks.  We also have muscles on the posterior (back) of our body whose action is to extend the body.  Our body is the telephone pole and the muscles are the supporting cables.  My parents always said I had a vivid imagination.  Since the beginning of time, we have evolved from quadrupeds to bipeds.  In other words, we transitioned from walking on all fours to walking upright.  The problem is that for most of us who sit at a computer for 8 hours a day, commute for an additional 2 hours, sit at dinner, then on a couch to watch 2 hours of TV, do not spend much of our time in the upright position.  This pattern creates dysfunction.  Those anterior muscles tend to shorten because of all of this sitting.  Specifically, we are speaking about our hip and trunk flexors (Rectus Femoris, Psoas, Iliacus, Rectus Abdominus).  People usually look at me strangely when we begin to explore these muscles. They regularly exclaim, “But the pain is in my back!”  A wise practitioner once told me that the least successful doctors only treat the area of pain.  We want to fix the origin of the problem, and not just the symptoms.  Let me explain why your back is where the symptoms manifest.  With the anterior muscles shortened, in order to maintain an upright position, the posterior muscles are under constant tension.  Not only does this constant tension lead to pain, but it also creates weakness.  If we just worked on the posterior structures with adjustments, or soft tissue work, we would most likely only temporarily resolve the symptoms.  For how long?  Who knows.  I can guarantee that the issue would return because the tight anterior musculature was not addressed.  When all the issues are addressed, patients can have years of relief.  When a patient returns after not being in the office for a long stretch, I always ask “Have you been doing your stretches,” and the answer is invariably, “No.”  Visit our website www.truesportcare.com to check out these essential stretches to help reduce lower back pain.