Lower Back Pain

In this post, we'll be looking at lower back pain - Some of the key areas that it manifests and what is going on in these areas.

First we’ll look at the sacrum – the large flat bone right at the base of your back – and then move up to the lumbar vertebrae, the five large flexible bones at the bottom of the spine.

What is the sacrum?

This consists of five bones that are fused together to form a flat, triangular shape. This is a very important part of the spine as it is a connecting point for the pelvis bones on either side, the base of the spinal column at the top and the coccyx below. There is little movement within the sacrum itself but each of the joints to the other bones are under a huge amount of stress as they form part of the pelvic girdle upon which our whole upper body is supported.

Why do I feel pain here?

The sacrum is an attachment point for many of the deep muscles in the buttocks, particularly the gluteus group, the piriformis, the core stabiliser muscles of the lower back and the hamstrings of the back of the leg. As you can imagine, if any of these muscles tighten and shorten there will be an effect on the sacrum, often a tilting or rotating pattern that then puts the lumbar area under strain.

Pain around the sacrum may be a hot, sharp pain or it may feel more a dull ache. If the pain has been caused by muscular tightness – poor posture or a sedentary lifestyle can be contributors to this – then a few sessions of physical therapy may be all that is needed to encourage the release of the tight holding pattern they may have got stuck in.

Sacral pain may also be due to damage to the ligaments that hold the structures in place and keep the attachment points strong. The ligaments that connect the sacum to the illium of the pelvis – the sacroilliac joint – can be susceptible to the usual soft tissue injuries of strains, sprains and inflammation leading to restriction in the movement of the joint. Sacroilliac joint dysfunction commonly presents as pain across the very lower back, the buttocks and sometimes radiating down towards the knees. It may also refer across the hips or as groin pain in the front of the pelvis.

Stress to the sacroiliac joints may be the result of a trauma such as falling and landing hard on one buttock, jarring from a trip or overextending (as in kicking something), or it may occur over time due to a leg imbalance or repeated, long term, poor posture.

What is the lumbar spine?

This section of the spine, that sits just above the sacrum, has to be strong enough to support the weight of the body above as well as being flexible to act as a shock absorber during movement, so these five lumbar vertebrae are larger than the rest of the bones that make up the spine.

Why do I feel pain here?

Due to the extreme stresses this section of the spine is exposed to, it is a common area for back pain to occur. Muscularly, the quadratus lumborum and erector spinae take a lot of the strain and these often become extremely tight, or hypertonic. Muscle spasm frequently occurs as a protective reflex and the back ‘locks’ up.

There are also shallow facet joints in between each vertebra which can become compressed or overstretched, both of which can cause symptoms of pain and discomfort. 

Prolapsed (‘slipped’) discs occur when the disc, which acts as a cushion between the vertebrae, gets squeezed out of place. Herniated discs are similar, but the strong outer casing of the disc tears and the soft tissue bulges out. Both can cause severe symptoms – including pain that spreads to the buttocks and legs, tingling or numbness, muscle spasms or weakness – but equally both can present no pain symptoms at all. It all depends upon whether there is contact with the nerve roots or spinal cord.

How can I get rid of my pain?

At your initial session we will carry out a thorough assessment to determine what is likely causing your pain and that will inform the care we recommend. 

Approaches such as chiropractic, soft tissue work, Dorn Method and a regular exercise and stretching programme to encourage the muscles to release and relax back to ‘normal’ function have been useful in addressing this type of low back pain and we will work with you to create a care plan tailored to your needs and health goals..

Do you have a low back issue that needs addressing?

Book in for a consultation now – if you are in pain, we can work to ascertain the possible causes and discuss a recommended course of action. If you are not in pain, and would prefer to keep it that way, then a preventative approach of physical therapy and exercises will help keep you in the best possible shape.