Low Back Pain Decoded: The 5 Usual Suspects

Low back pain – we’ve all felt it at some point. Whether it’s that nagging ache after a long day at work or a sharp twinge when bending down, it’s one of those things that can really throw off your day (or week!). Today it's my mission to give you the Reader’s Digest version of 5 of the most common causes of low back pain.  Here’s what you need to know…

1. Muscle Strain

A muscle strain to one or several of the muscles in your lower back is one of the most common reasons people experience back pain. I always say “muscles are the dumb jock of the body” this is true because they really only know how to do one thing…contract. At first this response is protective, especially when we are lifting a heavy object improperly, performing a sudden twisting movement, or even doing something simple such as bending down in the wrong way. However, our muscles often don’t know how to relax…After a lengthy period of being contracted our body can start to suffer from what we call a Pain-Spasm-Pain cycle. This means that our body recognizes pain, then our muscles spasm and so our body is in more pain! Often time to treat these muscle strains we desensitize the aggravated tissues with hands-on techniques such as cupping, dry needling, soft tissue massage, etc. 

2. Herniated or Bulging Disc

Your spine is cushioned by discs that act like shock absorbers between the vertebrae or bony segments of your spine. When one of these discs herniates or bulges, the gelatinous material inside the disc can push through its outer layer and press on a nerve nearby. This can cause pain, numbness, & tingling in the low back that can also radiate down the legs. Most of us know this as sciatica…the truth is this is just one of the causes of sciatica. This is why it's important to know what the cause of your low back pain and sciatica is. We treat herniated discs differently than other causes of sciatica, oftentimes we use an extension-based approach to treat herniated or bulging discs. This means that we use your spine's ability to extend backwards to offload the nerves that are angry and decrease your symptoms. 

3. Osteoarthritis

Osteoarthritis, which in the spine can also be referred to as Spondylosis, is a degeneration of tissues in the spine. The vertebrae wear down over time leading to inflammation, stiffness, and pain. In severe cases, as the arthritis progresses, the development of bone spurs and even spinal stenosis can occur which can then lead to sciatica-like symptoms. This is typically more common in older adults. However, just because it is considered normal for the spine to suffer from some degeneration over time, we have the tools to combat the pain that can be associated with these age related changes. You should not have to settle with living a life of low back pain!

4. SI Joint Dysfunction

Your SI (sacroiliac) joint connects your spine to your pelvis and helps your body absorb shock. Dysfunction or inflammation at this joint can lead to low back pain that can potentially radiate down your leg. Oftentimes instead of causing pain down your whole leg, sciatica caused by the SI joint will not radiate past your knee. The cause of SI joint dysfunction is typically different for each individual. Sometimes this joint has too much movement (hypermobility) and sometimes this joint can be too stiff (hypomobility). I see SI joint dysfunction most commonly in my female patients, often those who have been pregnant or are progressing through puberty. To treat we often use a strategic strengthening approach to stabilize the SI joint and support the surrounding tissues. 

5. Hip Flexor Dysfunction 

Did you know that dysfunction of your hip flexor can lead to low back pain?! In fact, hip flexor dysfunction is one of the types of low back pain that I treat almost every day. Due to the sedentary nature of our world today, our hip flexors are prone to becoming shortened and tight. Your hip flexor (iliopsoas) originates from your mid/low back and then crosses the hip joint, so when it is tight it can put pressure on your spine and affect the way your low back articulates with your pelvis and hips. This muscle is also typically very weak in this shortened state. We address dysfunction of the hip flexor by lengthening the muscle and then strengthening the hip flexor and surrounding muscles. 

Low back pain might be common, but it doesn’t have to be your normal! If your back is giving you trouble and keeping you from the activities you love, don’t tough it out alone. A personalized approach from a physical therapist (like yours truly!) can help you get to the root of the problem and get you back to feeling your best. Remember, every type of low back pain is unique and shouldn’t be treated with a cookie cutter approach. Ready to kick your low back pain to the curb? Let’s talk!