Back Pain and Low Back Pain Relief
Studies estimate that 80% of the population will suffer from low back pain at some point in their life. There are many things that could cause your low back, hip, and sciatic pain, and also many approaches to relieving that pain.
We’re highlighting four of the most common causes of low back pain we see in our office.
There are more conditions than those listed here, but this is a great primer on the structure and function of the low back, as well as what can go wrong.
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Lumbar Sprains and Strains
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Lumbar Disc Disorders
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Lumbar Facet Syndome
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Lumbar Stenosis
Lumbar Sprains and Strains
A lumbar strain is an injury to the muscles of the low back, while a lumbar sprain is an injury to the ligaments and/or joints of the low back. That said, both have similar pain, symptoms, and causes.
When the body starts getting pain signals from structures, it starts to guard those areas to avoid moving them. This can lead to dysfunctional movement and potential instability.
Common symptoms of lumbar sprains and strains include pain with walking, sitting, exercising, and often sleeping.
The main causes of sprains and strains are:
Overexertion and Fatigue
Heavy Lifting
Slips and Falls
Poor Movement Mechanics
Poor Posture
With proper education, many of these sprains and strains can be avoided.
Most often, people who suffer from these conditions are not in top physical shape, with poor muscular control and weak stabilizing muscles. Stabilizing muscles act like guidewires for your spine, supporting it and keeping it in place as you move.
Desk work and poor posture are both factors that can contribute to this condition. Desk work, particularly sitting in a hunched-over posture over your computer, can create muscular imbalances in your core and spinal musculature, typically weakening your spinal muscles and tightening your abdominal muscles. Proper posture and an ergonomically correct workstation are vital to maintaining proper health.
Lifting technique is another important factor for avoiding low back sprains and strains. A rounded spine and lifting with weight too far from your body are common mechanical errors that put you at risk for an injury.
Staying active and maintaining proper posture, both while sitting and while moving or lifting, will help reduce your risk of spraining or straining your lower back.
Lumbar Disc Disorders
Throughout your spine, you have vertebrae, the bones of your spine, and intervertebral discs, which are shock absorbers sandwiched between all the vertebrae. Muscles and ligaments attach to the vertebrae and the discs, providing additional structure and support for movement while protecting the spinal cord.
The discs are made up of a tough outer ring called the annulus fibrosus, and a soft, jelly-like inside called the nucleus pulposus. When you hear someone discuss a disc bulge or a disc herniation, they’re talking about these structures.
With a bulge, the inside of the disc starts to push into the outer ring, without pushing all the way through. A herniation occurs when that inner layer does push all the way through, entering the area around the spinal cord. When a herniation occurs, this can create pressure on the spinal cord or spinal nerves, creating low back or sciatic pain, numbness, weakness, or other symptoms in one or both legs.
As we age, our discs dehydrate and degenerate. This is a completely normal aspect of aging. Research shows that many people without pain or other symptoms show signs of spinal and disc degeneration on MRIs.
But, in some cases, this degeneration can create pain and other issues, like the disc bulges and herniations we described above.
The main risk factors for lumbar disc disorders include:
Age between 30 and 50
Obesity
Smoking
Sedentary Lifestyle
Poor Posture
Repetitive Spinal Motions and Activities
Excess Driving
Symptoms of lumbar disc disorders can show up suddenly or gradually after an injury, or the symptoms can worsen gradually over time without any specific cause or event.
Common causes of lumbar disc injuries include heavy lifting, twisting, straining, or repetitive spinal movements like pulling and bending.
Symptoms of a lumbar disc disorder can include sharp, shooting, stabbing, or electrical pain that is worse when straining, coughing, or sneezing. Weakness, numbness, or tingling in one or both legs is common as well. Standing or sitting for extended periods of time can also cause problems. Rest, especially laying down, will often relieve the pain.
A conservative approach is generally the best place to start when dealing with lumbar disc issues, though your specific treatment plan will be based on your clinical presentation and symptoms.
The major goal when addressing disc disorders is to reduce or centralize any radiating leg pain while decreasing inflammation. After the pain is reduced and we’re out of the woods, creating proper lumbar control and stability to avoid reinjury is essential.
Treatment plans can include directional preference exercises to relieve pain, stabilization exercises to promote proper movement and biomechanics, soft tissue mobilization, and gentle spinal adjusting to increase mobility while reducing pain. Lifestyle factors, including regular walking and proper lifting, are also key to managing your lumbar disc issue.
If you don’t respond well to conservative care, or if the symptoms of your disc issue are severe enough or worsen throughout treatment, a surgical consult may be necessary. A key factor to responding well to conservative care is sticking to the treatment, plan, including the lifestyle and exercise recommendations.
Lumbar Facet Syndrome
Facet Syndrome is a common spinal injury that causes back pain, affecting as many as 45% of people with low back pain.
In your spine, there are small joints on the backside called facet joints, which help with rotational and bending movements of the spine while limiting how much the vertebrae can slide or translate from side to side. These joints are highly innervated and can be sensitive to problems in and around the joint.
When you extend your spine backward (like when looking up at the ceiling), you push these facet joints together. If they get pushed together too often or too hard, they can get irritated and inflamed, limiting motion and creating pain.
Risk factors and causes of lumbar facet syndrome include:
Excess body weight
Overuse of the spine, as in sports or work
Sitting for extended periods of time
Hypermobility of the spine
Motor vehicle accident trauma and whiplash
Osteoarthritis of the facet joints
Aging
Symptoms of lumbar facet syndrome include:
Pain in the lower back
Pain traveling down your leg into your thigh, but not traveling past the knee
Increased pain when extending your spine
Increased pain while standing for long periods of time
Less pain after walking
Less pain while lying down with knees bent
Less pain while leaning forward on a counter, table, shopping cart, etc.
Lumbar facet syndrome is manageable and preventable.
With the proper education, training, and treatment, the causes and risk factors associated with lumbar facet syndrome can be addressed.
The overall dominant cause of lumbar facet syndrome is deconditioned, weak, or injured spinal stabilizing muscles. When these muscles get injured (like in a motor vehicle accident or after being overused), they can become less effective at stabilizing the spine because your brain does its best to avoid using injured muscles. In other cases, such as people working desk jobs, these muscles get weak from the hunched-over posture we often use while sitting at a computer. In either case, when these muscles are weak, they cannot stabilize the spine well, requiring the bones and joints of your spine to do more stabilization than usual. This means that the bones and joints are often getting smushed together or pulled apart more than is ideal, leading to the irritation and inflammation associated with lumbar facet syndrome.
Strengthening your core and spinal stabilizing muscles is a key aspect of managing and preventing lumbar facet syndrome. Spinal adjusting and soft tissue mobilization also help to reduce pain while encouraging proper motion and motor control of the affected area.
A multifaceted treatment plan, including a combination of chiropractic care, postural and movement changes, and rehabilitative exercise is an essential part of managing lumbar facet syndrome.
Lumbar Stenosis
Lumbar spinal stenosis is a condition associated with aging and trauma, affecting about 10% of people over age 60.
It occurs when the spinal canal in your lower back narrows, generally due to “bone spurs” or degenerative changes.
When your spinal canal narrows, your spinal cord has less room to move and can get squished in the spinal canal. Your nerve and spinal cord don’t like to be squished, as this can affect communication from your brain to your body and vice versa. This squishing of the cord is called “neurogenic claudication,” which causes many of the symptoms associated with stenosis.
Risk factors and causes of lumbar spinal stenosis include:
Being over 55 years of age
Being female
Having advanced osteoarthritis of the lumbar spine
Certain inflammatory disorders like rheumatoid arthritis and ankylosing spondylitis
History of lumbar spinal injury or surgery
Certain congenital conditions of the lumbar spine
Scoliosis
Symptoms of lumbar spinal stenosis include:
Pain in the lower back
Pain traveling down the leg into the thigh, calf, and foot
Pain that is worse with walking, or pain that limits how far you can walk
Numbness or tingling in the legs and feet
Weakness in the legs and feet, or a foot drop
Pain that lessens with rest or when leaning forward on a counter, table, shopping cart, etc.
More serious symptoms can include loss of control of your bowel or bladder function and numbness between your legs and along the insides of your legs.
Note: Degeneration of your spine is a normal part of aging!
Often when we hear “degeneration” or “degenerative changes,” we get concerned that there’s something wrong. Research has suggested that this just isn’t the case; as we get older, our spine tends to look a little rougher and grow some extra bony spurs. This is NORMAL and these changes may or may not be related to any pain you have.
Sometimes, these age-related changes can reduce mobility or cause pain, in which case we correlate what we might see on your medical images to what you’re telling us about your symptoms, such as in the case of lumbar spinal stenosis.
Completely stopping these normal age-related changes is difficult or impossible, but there are things you can do to continue enjoying your life and activity.
Proper posture and lifting techniques can help avoid undue stress and strain on your spinal structures, while regular exercise and physical activity will support your muscles and your overall ability to continue doing what you love well into your golden years.
As far as managing your spinal stenosis, gentle spinal adjusting, traction, nerve flossing, and general strength and mobility exercises can help reduce pain while improving your overall function. Lifestyle modifications can help as well, like limiting aggravation motions like extending backward or reaching overhead.
At Northbound Chiropractic, we work with you to find the cause of your low back pain and create an individualized treatment plan targeting your specific problems.
We’ll make a plan with you to get lasting results, so you can continue doing the things you love.