Low Back Pain
Low back pain is something that comes up in my practice a lot. It is one of the top and most frequent pains I see and treat as a massage/ manual therapist and movement teacher. A lot of people will come in and have “non-specific” low back pain, which would be an unknown cause of back pain, or back pain that has occurred without a pathology ie: there is no diagnosable infection, tumor, disease, etc. A lot of low back pain can come from injury, such as an accident or fall, but more often people come in and they have hurt their low back from putting a sock on in the morning, or loading their kids into the car, or picking up a pen they dropped- all movements they have done a million times before. So what was so different about this one time you bent over to get dressed that morning your back “went out”?
I will preface this all by saying it is hard to pin down EXACTLY what is happening to every body in these types of situations. You are all individual people, living different lives, but there is often a common theme that I talk about when something like the above scenario happens, especially with non specific low back pain. And this common theme stems from HOW you use your body in day to day life, and how you are training (or not training) your joints through mobility and strength.
Your hips are made to do numerous ranges of motion, it is meant to be MOBILE. Your low back is made to be a STABLE section of the body, the large vertebrae are made to help absorb impact and distribute it. Often these two segments become inversed where the hips become tight and stiff and act stable so the low back begins to take on and try to make up for the lack of range of motion. So to counter this you need to start by looking at how you use your hips and low back and bring that in relation to one another. Sitting, and walking are two main things you accomplish daily, and these are very linear movements. These motions don't require as much lateral or side to side or rotational movement through the hips, so those muscles get tight and tense and underused. Your brain doesn’t register that we need the other ranges so it doesn’t bother with them, and your hips continue to get more stiff, your low back continues to try to make up for lack of range. Eventually you will lose the power and strength the low back had as it is being OVERUSED in ways your body was not designed for and this is where that injury or weakness or pain occurs.
If you are more physically active in your occupation and life, again you want to address the relationship of your hips and low back and then also maybe look into what your core is doing and how they are all reacting to one another. Even if you are physically active, this doesn’t mean that you’re body is moving in a way that is most productive to decrease pain, or decrease chance of injury. Our brain and body are smart and are constantly looking to conserve energy. To do this our brain creates muscle memory patterns that allow us to do and redo motions without thinking about them, and its not always in favour of how our hips and low back should move. Our body doesn’t always know how to move your hips, or activate certain muscles that should be activating during a movement. It can require a little more nuance and thought, especially if those muscle memory patterns are established.
If you have a specific diagnosis, like a herniated disc, or scoliosis, or Ankylosing Spondylitis, or another low back diagnosis, this can change things and these are likely the “reason” for your low back pain. But this does not change that you and your trainer, or health professional, or manual therapist should still be looking at how your low back and hips are moving. What does that relationship reveal and how can you make it more sustainable to decrease your pain.
Your body is all connected and constantly trying to be as efficient as possible. If you are having pain that is consistent and chronic, I encourage you to reach out to a practitioner you trust, or reach out to someone who might be able to refer someone to you. There are some basic ways you can DIY to help alleviate pain, and a lot of it is trial and error, but it can be hard and messy when you are in pain.