Our lower back connects our entire spine to the pelvis. All changes in posture can affect the lower back.
Lower back pain used to be a very simple phenomenon. You strain it, we fix it, you walk out and you’re fine. Over the past years however more complex conditions affecting the lower back have started creating back pain patterns too rather than it being just mechanics. In general, mechanical lower back pain tends to be worse when you are physically doing something. With mechanical pain there are a few differences between simple pain and more serious mechanical pain. Simple pain will generally respond well to pain killers or anti-inflammatories and you will be able to point exactly to where you feel your back pain. Similarly it will respond very quickly to treatment. Complex mechanical pain will generally be more severe, require more treatment and respond poorly to pain killers and anti-inflammatories. Both can be addressed through osteopathic treatment.
With more complex pain you will either be unable to say where it is exactly or there will be significant pain, numbness or pins and needles in your legs. A couple of examples would be as follows. Very specific, sharp pain - especially if it’s worse with bending backwards - tends to most often be a small joint in your spine which is restricted. If you experience most pain when getting up out of a chair, turning from side to side in bed or putting on shoes, socks or pants - then most likely your sacroiliac joints are in trouble. It the pain eases with a few minutes of movement it’s more likely muscular. With joint based pain, it will more or less always be painful with the same type of movement or position. More complex mechanical problems may involve disc damage or nerve compression which can cause the familiar problem of sciatica. Not all pain, tingling or numbness down the leg is serious or disc related. There are peripheral nerves which can be irritated by a tight muscle rubbing over them for example can also cause sciatica. These patterns are quite different from patterns which originate from a spinal pathology such as a disc bulge/prolapse, bone growth or swelling of various sorts and can be easily distinguished in clinic without the need for any imaging. If, however, at any point there is a lack of response to treatment - we will always investigate further. Structural osteopathy can help ease or resolve most mechanical issues and most versions of sciatica. We can also tell with simple neurological testing whether your pain comes from a serious problem, or a simple mechanical issue. If it is coming from a problem which we cannot fix, such as a severe disc prolapse, we will organise a referral to a specialist or for further imaging such as X-rays, ultrasounds or MRIs so that we can get you the best care possible.
Our nervous system has two main divisions. One division allows you to voluntarily control your movements. The other division controls certain body systems automatically - such as your heart beat, breathing or your digestive processes. This division is called the autonomic nervous system. One part of the autonomic system speeds up your body functions and one part slows things down and puts you to sleep. The latter is only present at the very top of your neck and at your sacrum (pelvis). When you undergo very stressful periods the part of your autonomic nervous system which calms you down is working overtime to try and keep the balance. Cranial osteopathy can be a significant aide in coping with stress and resolving such issues.
The increased autonomic activity leads to a number of possible symptoms. Upper neck tightness, digestive distress and / or lower back pain / sciatica. If your pain pattern is from a psycho-emotional issue, you will notice that your pain gets worse when stress levels increase. The break down leading to lower back pain can be quite complex and work in any of a number of ways. For example some patients tend to get stressed which upsets their digestive system which in turn causes their lower back pain. So the back pain is just a symptom really not a problem. In other cases patients will have a bad diet for a while which causes a visceral dysfunction that floods the body with toxins and overloads the nervous system which then fights for control and causes tightness in the lower back. Again in that case the back pain or sciatica is just a symptom. In any case we will consider your issue in detail and get you the best care possible.
Cranial osteopathy is a great modality to help ease some of the neurological distress in these instances. With structural osteopathy we can relieve the symptoms of tightness where ever they may have taken place. Should any digestive distress have also developed and is not resolving after the other systems have been returned to a state of harmony, we can address them through visceral osteopathy.
Your lower digestive system sits on the inside of the pelvis right in front of two big joints at the back of your pelvis called sacro-iliac joints. If the large intestine is inflamed, or if it is suffering from constipation, diarrhoea, colitis, etc. just by virtue of being positioned right in front of the sacroiliac joint on the left side - it can transfer its inflammation to the joint too. This is just one example of course, but it illustrates the importance of visceral health with relation to lower back pain.
The kidneys sit in front of the upper part of the lower back and tend to cause pain in this region. Generally if the condition affecting them is serious enough to cause pain, there will tend to be urinary symptoms - either an unusual smell or colour to your urine. Or if you are suffering from kidney stones and passing one the back pain will come is spasms as your ureter cramps around the stone. There isn’t much we can do osteopathically for such an issue aside form help ease the symptoms of lower back pain until the main condition is resolved. We would usually also work together with other health practitioners to resolve the main condition too.
Another example would be the two bends of your large intestine which can cause pain in the same region as the kidneys and this can be quite confusing to you when you try to work out what is hurting. With a bowel issue it will generally take place around the time of or after a meal, or when you need to have a bowel movement or the bowel is backed up.
Often individuals with 'grumbly' lower back pain who have seen a variety of different practitioners in the past but never had full relief can have a visceral issue as the cause. It may not be a serious one, but one which none-the-less needs to be addressed in order to give you a chance at a painfree lower back. In any case, we always consider, and discuss with you, all the potential options when addressing your lower back pain in order to give you the best care possible.