Low Back Pain: Causes, Treatments, & Tips from an Osteopathic Manual Practitioner

Written by Mark Boutillier, Manual Osteopathic Practitioner

Many people have experienced low back pain at some point in their lives. Whether it be from overuse, a sports related injury, or simply years of poor posture, most people are familiar with that achy, uncomfortable, occasionally debilitating feeling in some way or another. In fact, low back pain (LBP) is the most common form of musculoskeletal pain, affecting adults with a prevalence of up to 84 percent. However, the causes and symptoms of LBP are wide ranging and can be drastically different for each person.

Among the many causes of LBP are dysfunctions stemming from nerve root issues, muscles, fascia, bones, joints, intervertebral discs and even abdominopelvic organs. In simpler terms, the majority of affected people feel a general pain and tenderness in the muscles of the mid-to-low back, across the top of the pelvis, possibly in the hips and/or radiating down the legs. Often the pain becomes aggravated with simple day-to-day activities and can make standing, sitting or even lying down a challenge.

Here are some examples in which the dysfunctions of LBP may present themselves:

• pelvic rotations 

• leg length discrepancies

• uneven rib cage

• chronically tight muscles

• chronically weak muscles

Our bodies are one big functional kinetic chain. For this reason, an imbalance in one region can wreak havoc on the lower back as well as elsewhere in the body. Thus, oftentimes the cause of LBP may be a consequence of a dysfunction elsewhere in the body, and may have little if anything to do with the structures of your low back at all. For instance, fallen arches or flat feet can have a reverberating effect further up the chain, which may lead to a rotated pelvis and result in LBP (or even neck or shoulder pain). Therefore, until the underlying issue is addressed, in this case the fallen arches, pain further up the kinetic chain will continue and any relief will likely only be temporary. 

In order to properly assess and treat LBP, we must first understand its origin. For people who have experienced relief (albeit temporary) from certain stretches or exercises, the issue may be mechanical in nature, meaning that the pain is not caused by a serious pathology (like cancer or infection), but is due to abnormal or dysfunctional mechanics in the tissue. A proper musculoskeletal assessment and evaluation of movement patterns can help determine the underlying issue causing the LBP and help treat the problem. In fact, 97 percent of LBP cases are mechanical in nature, in which manual therapy is a proven effective form of treatment; therefore, there is a high likelihood that manual therapy may be the right fit for individuals suffering from LBP.,

An osteopathic approach is to treat each person in a holistic manner. The root cause of a client’s issue can be determined by both visual and physical assessments, in which unique physical attributes as well as lifestyle habits that may be contributing to LBP will be taken into account. 

Osteopathic treatment of LBP is individualized to every client, as no two people are exactly alike, and thus their treatment should be treated as such. Through the targeted application of joint mobilizations, soft tissue therapy, myofascial release, and muscle energy techniques, osteopathic treatments can help bring the body back into its proper alignment, allowing it to mobilize its natural healing resources and thus return to a state of balance. It is only once the body has returned to this state of equilibrium that the true resolution of pain can be achieved.

Are you struggling with LBP? Here are 6 tips that may help reduce your pain today:

• Maintain good posture: poor posture, both seated and standing, can aggravate  low back pain. Avoid slouching and keep the spine as erect as possible.

• Stretch: Stretching is a great way to help alleviate as well as prevent future LBP. Examples of effective stretches are the child’s pose yoga stretch, cat/cow stretch and knees-to-chest stretch. 

• Sleeping position: Sleeping on your side with your legs bent and a pillow between your knees can help keep the spine in a neutral position. If you need to sleep on your back, place a pillow under your knees.

• Ice and heat: Applying ice to the painful area can help reduce inflammation and heat can help relax and increase blood flow to the affected areas. Note: ice is typically recommended for the acute/initial phase of injury.

• Hands on therapy: A qualified health care practitioner can help identify why you are experiencing LBP and provide you with treatment and lifestyle strategies to address it permanently. (Click here to learn more )

• Supportive footwear: having appropriate and supportive footwear can help improve posture as well as provide additional cushioning and stability for muscles, thus decreasing your risk of LBP. 

If you have LBP that just won’t go away no matter what you try, then osteopathic manual therapy may be right for you. In the era of Covid, don’t let lack of access or fear of in-person appointments deter you from receiving the treatment you need. There’s much that one can do to promote the body’s own healing abilities from the comfort of your own home. Virtual appointments are also available through MRM (click here to book your appointment today).

Disclaimer: The information presented above is for educational purposes only and is not intended to treat or diagnose.

References:

1.  "Mechanisms of low back pain: a guide for diagnosis and therapy." 11 Oct. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926733/. Accessed 4 Jan. 2021.

2.  "Mechanisms of low back pain: a guide for diagnosis and therapy." 11 Oct. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926733/. Accessed 6 Jan. 2021.

3. "The correlation between pes planus and anterior knee or ...." https://pubmed.ncbi.nlm.nih.gov/18778669/. Accessed 17 Jan. 2021.

4. "What is mechanical back pain and how best to treat it? - PubMed." https://pubmed.ncbi.nlm.nih.gov/18973732/. Accessed 13 Jan. 2021.

5.  "Manual therapy and exercise therapy in patients with chronic ...." https://pubmed.ncbi.nlm.nih.gov/12642755/. Accessed 18 Jan. 2021.