Low back pain is commonplace today. Almost everyone has or will have a bout of low back pain in their life. Many have chronic low back pain. Some people have been to many practitioners with limited or no relief at all. They are resigned to the “living with it” mentality. What they don’t know is, it does not have to be that way!
Why are so many people living with low back pain and back pain?
Many physical therapists or chiropractors tend to look at low back pain as displacement of the vertebral bodies in the spine and/or spasm of the muscles surrounding the spine in the low back as causes of low back pain. A patient may also hear that they have “overused” their back or that they have “bad posture” or alignment. These are ok theories as to why people may have back problems but, if they were correct, there would be a great deal less back pain. That is not the case, and these theories are very flawed. These things mentioned above are symptoms of the true problem.
So, if spasm or malalignment is not the problem, what is?
In most cases of low back pain, a patient has damaged tissue and soft tissue tension patterns in the fascia, ligaments, organs, connective tissue, discs, etc. in the region of the low back and/or pelvic bowl. This damage needs to be protected. That is when a muscle spasm is employed by the body. This muscle spasm cradles the injury, protecting it from further damage by holding it and preventing excess movement. A physical therapist needs to assess and determine what tissue or structure is damaged, assist in the healing of that tissue, and unwind the tension patterns. Only then does the muscle spasm reside. Integrative Manual therapy is very effective at this. Now one can address the malalignment as well.
Then, if there are other structural issues such as a vertebral body out of alignment or a disc problem, they can be addressed using manual therapy, Integrative Manual Therapy or muscle energy techniques. Craniosacral therapy and Neural Tissue Tension Techniques and neural mobilization can be used to loosen the nerves and spinal cord. A physical therapy must determine what is going on and the correct techniques to use in the correct order to assist in rectifying the tension pattern, the protection, the structural imbalance, and the damage.
So, what is the secret to healing low back pain?
In addition to what was discussed above, after removal of tension patterns, damaged tissue is healed, there is a secret to obtain movement in the low back and pelvis that is very effective. It is mobilizing the accessory joints, which are the joints where the superior pelvis and sacrum meet. This is the secret to obtain greater movement, better biomechanics and improved posture. Patients have had wonderful improvements after opening the accessory joints and it is a necessary part of the treatment of low back pain.
What about exercises or strengthening?
When mobility is improved, damage is healed, structure is more aligned. Now is a good time for stability exercises. Strengthening the pelvis, L-spine, and pelvic floor can be very helpful in prevention, well-being, and allowing appropriate strength for further function. Too often exercise is used as a treatment to “support” damaged tissue by increasing strength around the problem. This is only a compensation. It is important to rectify the problem and the tension patterns with manual therapy and not just utilize exercise or the problem with come back next week, next month, or next year.
Call us at Dynamic Health Physical Therapy to learn more about the accessory joints and how we can solve your low back pain problems.