This post is part II about back pain from last week.
One note of caution, please do not use the below information to self diagnosis. The best thing you can do for yourself if see your health care provider or a Physical Therapist if your state is Direct Access. If you need a referral feel free to e-mail me.
As I mentioned last week, there are so many sources of low back pain. And, treatment depends on the structure(s) involved. For example, one exercise or treatment can help to alleviate one person’s low back pain, but totally flare up another person’s problem.
If you decide to see a health care provider regarding your pain they will use some tools to help evaluate the spine. Sometimes an X-Ray, MRI and CTscan are warranted.
Sometimes a Physical Therapist, Chiropractor or Orthopedic MD can look at your posture and use other objective measures to determine the root cause of your pain without any imaging.
In the meantime here are some commons sources (in no particular order) of low back pain:
Stenosis: Narrowing of the spaces between the vertebrae due to degenerative changes, disc protrusion, inflammation, osteophytes, scars, positioning of vertebrae.
Muscle strain or imbalances in strength and length of surrounding musculature
Ligament sprain- injury to a ligament(s) of the spine usually from a trauma
Disc degeneration- breakdown from repetitive movements over time, especially forward bending and lifting
Disc herniation-Any change in the disc causing it to bulge larger than it’s normal size. Then there are worsening degrees- a protrusion, then prolapse. Healing from these injuries, if there is an acute incidence can take a long time due to lack of blood flow.
Radiculopathy- Nerve pain originating from the spine, but can travel down your leg. There are a few reasons why this occurs and you should follow up with your health care provider to prevent nerve injury.
Segment Instability-too much motion between the segments of the spine
Segmental Hypomobility- too little motions with the vertebrae and facets of the spine
Osteoarthritis, Spondylosis, Degenerative Joint Disease and other bony changes such as Osteophytes- degenerative changes of the spine leading to abnormal changes sometimes causing decreased motion and pain.
Compression fracture- fracture of the endplate of a veretbrae
Spondylolisthesis- forward placement of a vertebrae on another. Common with athletes such as gymnasts and volleyball players
SI instability- too much motion in the SacroIlliac joint causing pain, usually one sided
Scoliosis- abnormal curve of the spine
Facet Sprain/Joint Capsule Injury- inflammation and irritation usually from a traumatic injury leading to decreased motion and muscle guarding
Reference: Kisner, Colby. Therapeutic Exercise Foundations and Techniques 5th edition. Davis Company, Philadelphia. 2007.
With all these problems that can occur is it any surprise that there are so many incidents of low back pain??
Once you determine which structures are affected, then you can determine the best plan of care. If you do not figure out the root cause first you are at risk for making the issue worse….