Did you know 80% of the western population has suffered some form of low back pain (LBP), and 80% of the other 20% will at some stage suffer too? These are not new statistics, however, they most likely hold true today. So what are we doing that keeps this statistic so high. With all our modern comforts, and better lifestyles, surely we should not be getting this kind of problem.
Let’s first take a look at what back pain really is. In my experience both as a Physiotherapist and a person who has suffered LBP, I have found a common denominator with most types of LBP, and that is that the muscles of one or both of the hips are not working as well as they should. In fact, I have not only found this to be true of LBP, but also neck pain, shoulder pain, knee pain, and many more.
The hips are our centre of control. They support the upper body and allow the legs to work from a solid base. When any of the hip muscles become faulty, we have to compensate with other muscles in the area to maintain stability and balance. This, however, forces excessive load on certain muscle groups that do not normally have to work so hard, thus a pattern of compensation arises.
This compensation results in tightening of the tissues around the muscles, and thus reduced range of motion where we should have it. Now we are in a situation where even normal movements can irritate these tight tissues, which are highly sensitive by this stage, and thus pain occurs. The tighter the tissues get, the worse the pain.
This tightness then interferes with muscle function in the area, hence muscle weakness can result from the tightness. The problem can now get even worse, as to counter this tightness, the body tries to get the same movement somewhere else, thus another area becomes involved and the same process occurs: tightness – weakness – pain – tightness – weakness – pain, etc., etc.
So it is quite easy to see that the eventual pain area could be far removed from the actual site of initial distress. There is a saying amongst soft tissue practitioners;
“Find the pain, then look somewhere else for the cause.”
A typical and very common picture that I see in patients is a complaint of LBP, say, on the left hand side, and when testing is done, the weakness of the hip muscles is on the right. This is normal, as, if you look at how the muscles of the hips and back work, the right hip muscles work together with the left back muscles. This combined effort helps to keep the pelvis level when we walk or run.
Try this: place your left hand on your lower back muscles on the left, just above your hip. Now walk slowly and note when you land on the right leg how the muscles on the left side under your hands tighten. This is the normal action, but if your right hip muscles were weak for some reason (to be explained in future articles) then those back muscles will have to work harder, thus stiffness of those muscles and the soft tissues around them will occur.
The opposite will, of course, happen if the left hip muscles were weak. So when it comes to treatment, you can see that treating the pain, no matter what the treatment method, will only be treating the symptoms, NOT THE CAUSE. A complete treatment will include some techniques to strengthen the hip muscles, but exercises are the least effective for this! More on this later.
Despite there being so many people with back pain, there are ways to prevent this from happening as well as effective treatments to restore normal function. In later articles I will be discussing how we get into this state, what the body does to try and prevent it, and what treatments are successful and what are not (my opinion). Stay tuned…