My clients most often present with, and complain about, lower back pain. Getting out of bed should not be a dreaded experience because your back is stiff, and you shouldn’t be counting down the minutes until your shift is over or work day is coming to come to an end, just so you can get off your feet to find some relief. No; you should be counting those minutes down to get home to spend time with loved ones, binge watch a favourite tv show, head to the gym or anything else that you love to do.
Over the years I have had the privilege of working with many clients who were suffering from chronic low back pain. Each client had their own unique back story about how and why they were suffering from low back pain, but, the interesting thing for me was that the history intakes were so very different. I saw clients who had spinal fusions, suffered traumatic motor vehicle accidents, slipped on the ice, fell down the stairs, rolled their ankle, had undergone childbirth, had kidney disease, etc all suffering with low back pain.
That being said, although there are many different causes, there are definitely a few stand out causes that I see over and over again in my practice.
Spinal Dysfunctions or Spinal Injury:
- Falls on the hips or bum
- Prolonged sitting and desk work
- Motor vehicle accidents
- Sports injuries
- Spinal fusion
The spine is a very important structure as you know. It connects the upper and lower body, provides safe passage for nerves, arteries, veins and lymph, and it also plays an important role in movement. When the integrity of the spine becomes compromised, the functionality of the entire structure changes. The majority of the time the low back, an area dedicated to supporting the movements of walking and weight bearing, will lose mobility and impact the structures around it, causing a cascading effect of movement dysfunction, visceral disturbances and pain.
- Awkward lifting of something at home
- Diaphragm (Stress)
- Strength training injury
- Positional stress (Sitting for long periods of time)
- Motor vehicle accidents
- Running injuries
The framework of our musculoskeletal system is complex. Muscles provide movement and support for our skeleton, as well as a kind of armour like property for our unprotected internal vital structures. Primarily, in my experience, if a muscle is in dysfunction it is because the areas it attaches to (bony structures) have become compromised. This is not always the case though; If a trauma occurs to a muscle, perhaps it was strained or pulled, it will impact the bony structures to which it is attached. Most commonly acknowledged, hamstrings or hip flexor muscle injuries cause stiffness of the low back because of their attachments and integration with the low back. A less commonly talked about issue is that often the pain is due to dysfunction from high stress or injury to the diaphragm. The diaphragm attaches to low back, ribs and sternum, and communicates with a lot of structures above and below. It is a very important structure for breathing but also mobilizes the organs below to keep hormones regulated and digestion flowing. It is often overlooked when it comes to low back pain.
Visceral (Organ) Dysfunction:
All the viscera and organs in the abdomen and pelvic girdle have a connection to the low back. It is extremely important that the suspension of the organs and the pressure in the body are favorable for the viscera so that they can operate optimally. Specifically, looking at low back pain, the kidneys are located and move with the deep hip flexor muscles that attach to the low back, kidney disease, or direct trauma will impact the attachments of the muscles onto the low back. The digestive organs are anchored by the low back and any food intolerances, celiac disease, IBS, etc place stress on the tissues causing them to stiffen and reduce mobility. The uterus attaches to the sacrum on the back, hips on either side and the pubic bones on the front. Childbirth is a leading factor for chronic back pain. After delivery, these structures need to return to a position of normality which often can be problematic. Hysterectomies and other pelvic surgeries leave scarring and impact the low back.
The systemic inter-relationship between all the structures of the human body is incredible. Following the breadcrumbs is important to truly understanding why someone is suffering from back pain. It’s not always black and white, so exploring different approaches can offer great success.
I spend the time understanding the history of my client, assessing the body from head to toe and removing the strains / restrictions holding the dysfunctional patterns. I think it is important to educate my clients on how the issue most likely occurred in the first place, how to best prevent further discomfort and provide at home mobility exercises to increase the success of our sessions together. If you have any questions, I encourage you to reach out and ask, I look forward to chatting with you.
Mike is an Osteopathic Manual Therapy student at the Canadian School of Osteopathy in Vancouver. In addition to his osteopathic training, Mike has an extensive background in athletics and holds a Bachelors of Kinesiology from University of Calgary. Mike has trained with clients ranging from elite athletes to post-surgery rehabilitation. His true passion lies in aligning his osteopathic treatments with each individual’s goal for the betterment of functional movement and fitness in their day to day life. You can learn more about Mike here.