What Causes Lower Back Pain?

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In the past few months, both the Chiro and Physio at our Marrickville clinic have been seeing an influx of people complaining of lower back pain. This condition can be set off from a variety of factors including working from home, deconditioning from decreased physical activity, being a couch potato and the recent rainy and/or cold weather.

Between 60-80% of people will experience low back pain in their life. These individuals commonly present with tight lower back muscles such as the erector spinae, quadratus lumborum, glutes, deep hip rotators, hamstrings and hip flexors. Manual therapy such as trigger point therapy, myofascial release, adjustments and acupuncture are effective at relieving the tension in the lumbar region. However it is important to find out what causes this dysfunction in the first place to ensure a long-term solution to this problem.

So although each individual may present with similar complaints, the causative factors can differ. These are the most common issues that we see at our clinic

Poor Posture

Being in a flexed position (like the picture above) for prolonged periods of time puts abnormal strain on the normal curve of the lower back. The natural curve of the lower back aka lumbar lordosis, allows for the most efficient load transfer when doing different activities, such as sitting and walking. This is because it allows the body to bring the bulk of their mass over the pelvis. Having too much or too less of a lumbar lordosis can alter the biomechanics of the spine, leading to increased tension as other structures try to compensate.

Leg length difference

Leg length differences (LLD) are very common, occurring in 90% of the population. LLD may not always be symptomatic, meaning pain and discomfort does not always follow. However when pain does occur the most common area of pain is in the Sacroiliac joints (SIJ).

When assessing lower back pain we always check your leg length to identify what the cause is. A few factors are involved in LLD such as:

• History of fractures in the lower limb
• History of ankle sprains resulting in restricted mobility of ankle joints
• Differences in Lumbar spine mobility
• Differences in Hip joint mobility
• Differences in foot arches

Core Stability

Having a good level of core stability is essential for lower back health. This is because the ‘core’ cylinder is actually composed of four main muscles: the transversus abdominis, diaphragm, pelvic floor & multifidus.

These muscles work together to provide stability to your lumbar spine. If any of these muscles are weak or have reduced control, lumbar stability is compromised. The most common pattern we see is weakness of the anterior abdominal wall - so the transversus abdominis and rectus abdominis (i.e. your abs). Because the abs aren’t pulling their weight, the muscles on the lower back (or the posterior abdominal wall) compensate, which leads to increased tension and lower back pain. The diaphragm and muscles of the pelvic floor/hip flexors are also sometimes involved.

This cause is often responsible for moderate - severe low back pain after a seemingly minor movement, such as bending forward to pick up something off the floor. You can read more here.

Disc Bulge

A disc bulge, also referred to as a slipped disc, Is when the supportive structure of the intervertebral discs have been compromised which can potentially cause the disc itself to press against and compress the nerve root. This nerve compression can cause back pain, spasms, cramping, sciatica, numbness, pins and needles, or pain in your legs.

Thoracic spine stiffness

Having a stiff mid-back, or thoracic spine, can be one of the reasons for lower back pain. When bending forward with your spine, the different vertebral levels all contribute a small amount of movement (approx 14 degrees each) to cumulatively create a larger movement. However, the problem that occurs when the thoracic spine is stiff is that there is less movement in the thoracic vertebral levels. That means that there is compensatory increased movement in the segment between the thoracic and lumbar spine aka the thoracolumbar junction. This pain may manifest as pain in the upper lower back, and lower mid-back.⠀

Lumbar facet

The Lumbar facets, when put in a strenuous situation can flare up resulting in facet capsulitis. This usually occurs when bending over and picking something up while the body is fatigued, restricted in movement or from reduced core strength. In most cases when you are performing a simple task but in that moment your body did not have the capacity to act on stabilising your facet joints, Your muscles will seize up as a way of guarding the spine from further injury.

Symptoms will include:

• Tight lower back muscles
• Pain on movement but in a localised area
• Reduced lumbar spine curvature

Nutrition

Essential vitamins and minerals are needed to sustain life. Our body requires these micronutrients to perform various functions in our body and maintain homeostasis. In relation to musculo-skeletal health there are a few micro-nutrients that are essential in maintaining healthy nerve and muscle functions.Magnesium - may help with conditions associated with muscular tension (e.g. headaches) tremors, spasms, twitches. May also help with hyper-excitability, Insomnia and Anxiety.Potassium - Can help with low nerve energy, Conditions in physical, mental and nervous exhaustion, low mood, fatigue, weakness, poor memory and concentration

Calcium - is required for bone health and can help with irritability and cramps

These are only a few examples of micronutrients that are required to maintain neuromusculoskeletal (nerve/muscle/bone) health.

These are only a few examples of reasons of lower back pain, as it is a widely multifactorial condition. We at Hyper Health understand that individuals may present similarly, but actually have different causes which will require personalised approaches. It is important that you see a skilled Physiotherapist or Chiropractor who is able to properly assess and diagnose your injury.  

Our clinic is located in Marrickville, servicing the Inner West suburbs of Sydney. If you have any further questions about how we can help with your low back pain, head over to our Contact Us page, or book in now to make an appointment.

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