Low Back Pain and Chiropractic

  • low-back

Chiropractors deal with the musculoskeletal system, with joints, muscles and other soft tissue structures. Over 85% of people will suffer low back pain at some stage in their life, and the management of low back pain and the causes of dysfunction should be quickly implemented. Low back pain often has a complex cause with instability, poor core strength, compromised pelvic stability and muscular imbalances creating pain, disability and a variety of symptoms. Chiropractic treatment of the cause and the symptoms, as well as a preventative approach is what Sydney Sports Chiropractor provides to resolve low back pain. A thorough assessment to determine a definitive diagnosis is pertinent, as this allows chiropractic techniques and muscle therapy to be applied to the tissue in lesion.

Lumbar facet synovitis (Facet joint sprain)

Chiropractic techniques are typically applied to joints and can be well applied to a facet or zygapophyseal joint injury in the low back. A facet joint sprain occurs when the connective tissue or cartilage surrounding the joint becomes damage or tears when a excessive force is placed on the facet joint. The most common cause is overuse injury and it usually seen in patients who perform excessive amounts of bending, lifting and twisting movements. Symptoms will include low back pain, muscle pain, muscle tension and pain on movement- usually rotation and extension. Chiropractors can use a variety of techniques to reduce joint jamming, alleviate muscle splinting and hypertonicity and improve pain free movement.

Lumbar internal disc disruption (Disc protrusion, bulge or herniation)

Commonly called a ‘slipped disc’, this is a ‘catch-all’ term for a range of spinal problems that relate to the ‘discs’ or soft tissue which separate the vertebrae in the spinal column. In medical terms you may be suffering from either a disc bulge (protrusion) or a ruptured disc (disc extrusion or sequestrum). Combinations of low back pain, buttock, groin or leg pain can arise either from irritation in the disc itself, or when the disc causes irritation of the adjacent nerves. A chiropractic approach will target joint proprioception, maintenance of proper joint movement, encourage blood flow and can alleviate nerve compression or the “pinched nerve” feeling.

Lumbar instability (possible retrolithesis or anterolithesis)

Instability is defined as aberrant (erratic) motion during movement, for example an uncoordinated muscle contraction. Stability of joints in the lumbar spine is maintained by a combination of the structural (passive) system, muscular (active) system, and the neural control system. The interplay between these systems is thought to be necessary for neuromuscular control of spinal segments and disruption might lead to a lack of segmental control, leading to undue stress on the tissues in the body. Someone presenting with lumbar instability will tend to have low back pain, feelings of instability, muscular splinting and apprehension of movement. Chiropractic care aims to reduce low back pain, enhance joint awareness (neural stability), relieve muscular tension and prescribe evidence based exercises to improve stability and strength.

Quadratus lumborum syndrome

Quadratus lumborum is a muscle located in the low back and is connected to the ribs, spine and pelvis. When it contracts too much or too frequently, it causes hip elevation, and pain in the back, hips, and buttocks. Because the quadratus lumborum is part of the muscles which are responsible for movement of the spinal column, an injury to this muscle can result in low back pain on one side of the spine, restricted mobility and increased pain with a variety of movements- particularly lateral flexion. Chiropractic treatment is aimed to reduce leg length discrepancy, improve flexibility and length of muscles and to ensure proper joint movement in the lumbar spine and hip joints.

Lumbar erector spinae tightness

The lower back is inherently unstable when in pain. No matter what the original cause of the low back pain, the deep core gets inhibited; the more superficial muscles (erector spinae) become tight and can produce pain and stiffness. Chiropractors will aim enhance neural stability of the joints with joint techniques, release tight muscles and improve the activation of core muscles. Reduced low back pain, reduced muscle tightness and enhanced core strength is the ultimate goal with chiropractic treatment.

Lumbar related sciatica

When a ruptured disc causes irritation of the adjacent nerves, the symptoms can be low back pain and spread down the leg below the knee, calf and into the foot (termed sciatica). It can also arise when you have lateral recess stenosis or osteophytic growths compressing nerves. This may cause numbness, sharp shooting pain or pins and needles in the leg and may be associated with weakness such as “foot drop” (difficulty lifting the toes and foot up) or weakness when pushing off with the foot. Chiropractors endeavour to diagnose the cause of the sciatica (as it is a symptom, not a pathology) and chiropractic modalities can be applied to the tissue causing the sciatica symptoms.

Central stenosis

Stenosis means narrowing and central stenosis refers to the narrowing of the central canal of the spinal column. The symptoms of lumbar stenosis are insidious and may come and go, symptoms include low back pain, leg pain (sciatica), leg pain with walking (claudication) and neurological symptoms such as tingling, weakness or numbness that radiates from the low back into the buttocks and legs. Chiropractic treatment can not reverse central stenosis, but joint and muscle techniques can help with pain relief, improvement in stability and blood flow to nerves.

Non-specific mechanical low back pain

It is often difficult to be certain regarding the cause of someones low back pain and as such can be referred to as non-specific low back pain. Normally structures such as intervertebral discs, facet joints, muscles and ligaments will contribute to pain, stiffness, discomfort and sometimes radicular leg pain when neural structures become compromised. Regardless of the tissue in lesion, chiropractic care can be applied globally to all tissues in the low back, the goals of treatment is improved joint movement, reduced muscle tension, improved blood flow, flexibility of nerve tissue and reduced pain.

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Hip extension weakness

Activation of the hip extensors is critical to control of the head, arms, and trunk, without normal hip extensor strength it is thought that changes can occur in walking speed, stride length and cadence. Of all the muscles to weaken the hamstrings required greatest compensation from other muscle groups. The loss of hip extension strength will cause recruitment of a synergistic muscle, the erector spinae to initiate hip extension, and a altered motor pattern will ensue. This can cause excess loads on the lumbar spine and cause increased stress on the facet joints- the result is low back pain with the cause being poor strength of glut and hamstring muscles. Chiropractors with experience in exercise prescription can prescribe evidence based exercises to activate glut muscles and recruit the hamstrings. Further chiropractic techniques can help with symptomatic relief of low back pain caused from the joints and muscles.

Sacroiliac capsulitis (Sacroiliac joint sprain)

There are many different terms for sacroiliac joint problems, including SI capsulitis, SI joint dysfunction, SI joint syndrome, SI joint sprain, and SI joint inflammation. The most common symptom of SI joint dysfunction is low back pain, as well as other pain usually at the back of the hips to the left or right at the bottom of the low back. The pain is typically worse with standing and walking and improved when lying down, with pain and discomfort often referring into the groin and hip. Joint stiffness, restriction and limitation of movement are common complaints from sufferers of this injury and these can be managed with chiropractic treatments.

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