Low back pain

What is the real cause of your low back pain?

Ironically, some of the most common causes of low back pain are not primary problems of the lower back. Whilst many people present with a low back injury the primary cause or problem can often be somewhere else. While the causes of low back pain can be endless, the 3 big ones that I see daily in practice are:

1)      Forward head posture

2)      Rounding of the mid-back (thoracic spine)

3)      Loss of rotation in the thoracic spine

Let’s deal with 1 & 2 first. Forward head posture, rounding of the shoulders and mid-back both push the upper body forwards of your centre of gravity (C.O.G). Without any compensatory postural change this would basically have you falling onto your face. The way the body stops this is to increase the activity of the muscles of the lower back producing extension, increasing the lower back arch and in effect bringing the torso back over the feet. The good news is that you are no longer going to fall flat on your face and you are back over your centre of gravity. The bad news is that your facets joints are now also impinged (jammed up) and taking too much of the load leading to low back pain.

If you are one of these people the classic sign is getting low back pain when you are standing for any period of time. Subsequently a need to sit down and or bend your low back forwards is the only way you can relieve the pain.

Now point 3. Healthy rotation is very important. Fundamental movements like bending and twisting, looking over your shoulder and keeping your head straight whilst walking and running all necessitate a healthy range of rotation in thoracic spine. Spinal rotary movements should primarily come from the mid-back but if this is locked up rotation will work its way into the lower back. The facet joints of the lower back are designed to resist rotation. in actual fact the lower lumbar spine is only capable of about 4 degrees rotation which is not a lot. So a loss of rotation in the thoracic spine (as with points 1 & 2)  will lead to facet joint sprain and impingement.

In summary, when the primary problem is upper body posture and dysfunction, no amount of treatment directed to the painful low back area will give you a long term result. To use the site of pain as a guide for where to treat is the biggest mistake to make.

Now I hear some of you say, “When I try to stand up straight it makes the problem worse!”

This is because in most cases the attempts to stand up straight are creating more stress on your low back by way of further increasing the arch. Proper postural realignment with chiropractic adjustments and education is the way out of this dilemma.

First and foremost, regardless of where your pain is be sure that the clinician you see performs a complete postural assessment. If you have low back pain, are only getting therapy on your low back and the pain keeps coming back it is definitely time to look somewhere else for the cause of your problem. Call the practice on 02 9518 0722 before January 31st 2013, mention this article and receive a 50% discount off the cost of your initial consultation.

Yours In Better Health

Dr Andrew Richards (Principal Chiropractor)