Low Back Pain

What do I do when I have low back pain?

Here is a quick list of red flags "worst case scenarios":

Pins and needles or numbness in the lower leg and foot
Unable to walk on your heels or toes - no pain will be present only a weakness in the lower body
High levels of pain in the buttocks
Worse case scenario: loss of bowel or bladder function or control

Outside of these symptoms, most other low back pain cases are related to mechanical dysfunctions in our movement system. Flaws in our ability to move efficiently and without compensation patterns. In other words, when you have pain your body will re-configured a movement pattern (not a good one, just a usable one) to allow you to exist in life, exercise or sport, until it finally gives.

Every time you have a bout of low back pain, the normal kind NOT the red flag kind, your discs and surrounding tissues weaken and become more susceptible to more damage and further injury. Remember, just because your pain goes away DOES NOT MEAN YOU ARE FIXED!!! Pain may "go away" but the problem, or the cause of your pain HAS NOT!

Your body has simply figured out a new (compensatory movement) pattern. As these episodes accumulate, your discs and surrounding connective tissues become weaker and weaker, ultimately putting yourself at a higher risk of the "worst case scenarios".

This is not a scare tactic only a message that you should always properly address the how's and why's of your low back pain and not assume it will just "go away" or "diagnose" it as a pull, strain or disc issue. While the diagnosis is important information it DOES NOT tell you the how's and why's, only that something is wrong.

The how's and why's are what need to be figured out to fix the problem and work towards eliminate low back pain for good!!!

Supine Pelvic Tilts

DO's:

Breath while you are performing this
Make sure you are bracing your rib cage and core properly, follow the cues and take your time
Tilt the pelvis with your glutes and ab brace
Hold this position in accordance with your program

DO NOT's:

Use your legs to create movement
Hold your breath
Use your neck or back muscles to create or hold any position
Have any pain while doing this
NO stiffness or tightness in the low back or neck while performing

Clams

DO's:

Breath!!!
Maintain ab brace
Move slowly and deliberately
Feel the muscles in your hip doing the work

DO NOT's:

Have pain anywhere
Hold your breath
Use your back or body to create movement
You should not feel this exercise in your quads, hamstrings, ankles or low back - ONLY your glutes

Hamstring Fascial Stretch

DO's and DO NOT's:

Relax your body - other than your quad
Stretch to tolerance
DO NOT cause pain in the hip, knee or ankle - though the stretch itself is uncomfortable to no push it
Breath continuously throughout the stretch
Hold the position for the duration of time

Low Back Pain with Disc Involvement

Symptoms

Pain, deep in the hip
Pins and needles down the leg, into the calf and/or foot and toes
Numbness in the lower leg, foot and/or toes
Weakness: you can not move your toes, walk on your heels or toes

Causes

As above, when the disc becomes involved at this level there have been micro-traumas to the disc over the years and it is finally weakened enough to bulge, protrude or herniate into the nerve root space

What to do?

Typically this one is an immediate spinal ortho referral, MRI to gauge severity and possible surgery depending on severity. NOT ALL DISC problems are surgical. Quite a few can be handled conservatively.

Sciatica

Symptoms

Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg
Usually only one side of the body is affected
Pain in the rear or leg that is worse when sitting
Hip pain
Burning or tingling down the leg
Weakness, numbness, or difficulty moving the leg or foot
A shooting pain that makes it difficult to stand up

Causes

Irritation of the nerve root of the lower lumbar and lumbosacral spine
Muscle spasms in the back or buttock
Sciatic nerve becomes pinched, usually by a herniated disk in your spine or by an overgrowth of bone on your vertebrae.
True Sciatica is generally linked to disc involvement but not usually as intense as far as pain and nerve symptoms (loss of feeling and strength in the lower legs and feet)

Piriformis syndrome

Symptoms

Acute tenderness in the buttocks and sciatica-like pain down the back of the thigh, calf, and foot
Symptoms often become worse after prolonged sitting, walking, or running and may feel better after lying down on the back

Causes

Lumbar herniated disc
Degenerative disc disease
Piriformis muscles runs from your lower spine to the top of your thigh bone. When this muscles presses on your sciatic nerve the pain is caused.