What causes Low Back Pain?
Low back pain has many anatomic structure it can originating from. Each issue has its own corresponding symptoms with much overlap in between them. The most common issue relates to pelvic misalignments at the sacroiliac joint. This pain can be on both sides of the low back just above the gluteal region but it is usually located on one side. Above the pelvis are the different lumbar vertebra and any of these bones can have irritation of their joints. This type of pain is usually midline in the low back. In between each vertebra are discs which act as cushions absorbing shock to the spine. Discs are susceptible from injury due to trauma or wear and tear overtime to either bulging or herniating. Injured discs can cause a range of symptoms ranging from low back pain to pain radiating down the leg. Muscle spasms in the low back are a nonspecific symptom because they can be caused by any of the above issues. They can also be the result of straining the low back while doing strenuous activity.
Is My Low Back Pain a Herniated Disc?
This is a common concern for a new patient who is in a lot of pain. Many people know someone who had back surgery due to a disc problem. Although it is common to find disc disease, when an MRI is performed it does not always define the cause of pain. Having disc disease is a common part of aging which starts in the early 30's. Normal wear and tear of the spine results in degeneration of the the discs and the vertebral joints. In most cases these issues do not result in problems until later in life when the spine is greatly degenerated. Stenosis or narrowing of canals that nerves and the spinal column travel through can cause nerve compression and damage. I have seen many severely degenerated spines with no symptoms of stenosis, we can have quite a bit of stenosis with no problems.
When someone is unlucky enough to have a disc herniating and hitting a nerve it is a miserable condition. The low back pain associated with the herniation isn't always present. The herniated disc is only a problem is it is hitting a nerve or the spinal cord. When this happens you have pain in the down the leg. If it is a bad enough, nerve compression it can affect strength in the leg depending on location of the herniation. During an exam we can usually determine if the problem is related to a herniated or degenerative disc causing nerve compression. Herniated discs many times will respond to conservative Chiropractic care and Decompression therapy. Other conditions such as Facet Syndrome, Piriformis Syndrome, and IT Band Syndrome with or without Sacroiliac joint dysfunction can resemble disc herniation. When treated properly all of these conditions usually resolve with Chiropractic Care with no need for a surgical intervention.
The facets are the joints of the spine and are located on the backside of the vertebra. These joints can be injured and become swollen like any other joint in the body. The result is usually low back pain in the area of the injured joint. In some cases the swelling may be great enough to cause nerve compression resulting in similar symptoms as a herniated disc. When this condition is the cause it is very fast to respond to Chiropractic Care as we manipulate the spinal joints in the area to resolve the joint dysfunction causing the swelling.
The piriformis muscle is a deep muscle under the Gluteal Muscles. This muscle can get very tight and cause compression of the sciatic nerve as it travels from the low back down the leg. This is very common in runners from overuse and also is seen in people who have jobs requiring them to sit a lot. The usual symptoms are low back pain and aching in the gluteal area with leg pain. Chiropractic care and home stretching programs work very well to resolve this condition.
IT Band Syndrome
The IT band is a very long tendon that runs from the side of the pelvis down the outside of the leg to the knee. Multiple hip muscles attach to the IT band as stabilizers of the hip and knee. The IT band is very susceptible to problems when patients have misalignments of the pelvis at the sacroiliac joints. If the pelvis is not in the correct position it changes the line of pull of the muscles and we lose hip stability. This lack of stability causes radiating pain down the leg resembling a nerve entrapment. The pelvic misalignment will also cause low back pain. Chiropractic care and Massage Therapy work very well in resolving IT Band Syndrome.