GOLDEN NUGGETS ON LOW BACK PAIN

My grandmother use to tell me to work hard every day in order to stay healthy. She had wisdom beyond her years. What she was referring to was hard work that requires the use of the entire body. The evidence of people not following her advice lies in the fact that many of us now have constant back pain. People are using drugs, seeing a physical therapist or chiropractor or exercising and they still have back pain.

Today, I want to discuss one of the probable reasons for constant and chronic back pain. It concerns four muscle groups-the abdominal muscles, the erector spinal group, the hamstring structures and ilio-psoas muscles. Prolonged faulty posture is the primary reason these structures are at fault, but when that happens those muscles become weak and fascia strains develop. These conditions will cause pain and a loss of mobility. There are other problems that create back pain, such as ligament weakness, strained foot arches, arthritis and facet joint problems. I intend to discuss these problems in future issues of the Nuggets.

One of the major postural problems is the prolonged sitting in chairs. When that happens the hamstring muscles in the back of the legs shorten as does the spinal erector muscles in the back. When these muscles shorten, you cannot flex or bend at the waist and then the upper portion of the spine takes over with attempted bending. The ilio-psoas muscles, which attach on the upper lumbar segments and then re-attaches on the inside of the thighs are over worked due to the continuous muscle contraction. The abdominals become weak and will not support the pelvis, allowing it to rotate sideways and downward. (Posterior)

Because of all these chronic muscle contractions in the body posture, trigger points develop. As I mentioned in previous Nuggets, these are neurological glitches caused by strain patterns in the connective tissue. When they are stimulated with constant tightness due to spasms, they refer intense pain anywhere in the body, but especially into the back. For example, with an ilio-psoas spasm the trigger points refer pain to the inside of the upper groin. Sometimes the pain is referred to the lateral aspect of the joint capsule. In the case of the hamstring muscles, trigger points usually refer pain into the quadriceps, buttocks and low back muscles.

There are other muscle structures such as the quadriceps (rectus femoris), gluteus medius and the piriformis that are involved, however for simplicity sake, I will not involve them in this discussion, but they must be treated, even if they are not the primary structures of the problem.

The treatment is with slow stretching and strengthing exercises. The ilio-psoas muscle can be stretched and exercised with a pilates routine: first, kneel on the right knee. Your left knee is up. Slowly lean forward so that you feel the stretch in the right hip. Keep your pelvis from rotating. Move back and forth and than shift positions with the left knee on the floor. Do this exercise several times per day. Of course, there are other beneficial exercises for the ilio-psoas, but try this one first. If it doesn't work, other exercises will work.

The other muscle structures are treated with stretch and exercised in similar fashion. However, when you have back pain see let your clinician work with you, correcting your posture, but also teaching you how to stretch and strengthen your pelvic muscles. You will feel better initially, but the goal is to always eliminate your pain.

In the meantime, have a great day and know that God is watching over you.

Bud Golden
Physical therapist
Certified nutritionist and fitness consultant