Untangling the Mystery of the back pain

 There are unfortunately many different reasons why someone may be experiencing low back pain. If we’re experiencing low back pain, then it’s only natural for us to mentally cycle through the most popular reasons this could happen, which are usually the worst possible scenarios we can imagine. 

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There are unfortunately many different reasons why someone may be experiencing low back pain. If we’re experiencing low back pain, then it’s only natural for us to mentally cycle through the most popular reasons this could happen, which are usually the worst possible scenarios we can imagine.

Here are some questions that you may want to ask yourself as you read this article. You should write down the answers to these questions in the hopes that it paints a more objective picture of what is going on so you can work your way to the source of the problem and not just deal with the symptoms. Clearly identifying the details of your low back pain situation is also very important if you decide that it is time to seek out an assessment from a wellness or medical professional.

• When does your back hurt? Does it hurt when you’re sitting, standing, forward bending, backbending, or at some other time?

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• What type of pain is it? Would you describe the pain as sharp, dull, achy, shooting, or as something else?

• Is the pain constant or intermittent? Does it always hurt when you do X or does the pain seem random?

• Is the pain always in the same place or does it seem to move around?

• Can you find a particular spot that mimics the low back pain you experience?

• Is there anything that you do that definitely makes the pain worse?

• Is there anything that you do that definitely makes the pain better?

There are plenty of individual structures in the low back. However, we can group them into three main structures: the pelvis, the sacroiliac joint, and the group of lumbar vertebrae. These structures represent the main bony structures and joints that transmit force up and down into and from the lower back. 

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The pelvis itself is three bones that are fused together and is a central hub, or crossroads, in the body. The pelvis receives load from the spine above that is transferred down through the legs, and it receives force from the activity of the legs that is transferred up into the pelvis and then upward into the lumbar spine. The muscles in the lumbar and pelvic areas of the body are in multiple layers and have fibers running in different directions. This keeps the right balance of tension while transferring the forces of movement up and down the body. 

If that balance of tension is off in some way, more force can be transferred to other areas of the body, like the lower back, and we can feel pain or tension in the low back area as a result.

 Sitting in the middle of all of this is the sacroiliac joint (SI joint). Those same tensional patterns that cross through the pelvis are crossing the SI joint as well. As a result, if the SI joint gets “out of place” or tensionally held in a less than optimal position, this affects the low back and the sensations you feel there. The importance of this joint for helping to transmit forces through the pelvis, up to the lumbar, or down to the legs below, should not be underestimated, which is why I’ve separated it from the pelvis. 

Finally, we have the lumbar spine itself. Although there are technically five lumbar vertebrae, it’s easier to think of them as a group. They are larger and thicker than the vertebrae that are above them, implying that they are designed to hold more weight than those above. This downward force from holding additional weight, along with the curvature of the lumbar spine is, in a sense, less than ideal. Our bodies are trying to balance out strength in structure and freedom of function. The low back is a good example of where evolution had to work hard in bringing us upright.

If you have lower back pain, it could be due to different reasons such as tight hip flexors, thight abdominals, pain originated from the QL called the quadratus lumborium, discs disfunction,  degenerative discs disease. 

Here are a multitude of reasons why discs are involved in dysfunction: 

• Genetic
• Postural (scoliosis)
• Accidental (lifting a heavy object)
• Repetitive movement (work-related)
• Lack of movement (sitting)

 Disc dysfunction common location

This is probably the most common and well known dysfunction associated with low back pain, for good reason. If you have dysfunction of a disc in the lumbar region, this can be extremely serious and painful. The discs that are most often involved in dysfunction are in the lumbar region. Of those, the discs sitting between L4/5 and L5/S1 are the most commonly involved.

However, it’s important to note that essentially everyone’s discs are slowly degenerating. In the case of this particular diagnosis, what is typically seen is that there is a loss of space between the vertebrae themselves, or that the fluid inside the discs is decreasing. 

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The vertebral discs like any of them, listed in this article, are worthy of an article themselves. So, whether you have degenerative discs, a bulging disc, a herniated disc, or a ruptured disc, suffice it to say that any of these can create low back pain. But I will also note that there are people with these conditions who do NOT exhibit low back pain. I don’t say this to confuse you, but instead to point out how complex low back pain and any other condition may be. 

To conclude, keep in mind that one very large contributing factor to lower back pain and how it relates to the lumbar spine is the loss of this curve. Yoga & Pilates can help  to bring this fluidity back in the body.