Like it or not, lower back pain is likely to affect you to some degree throughout your life. The statistics are pretty damning, with up to 70% of people reporting some level of low back pain over their lifetime.
With this being the case, the lumbar spine has often been painted as the problem child of the human body, being blamed time and again for causing us pain.
Despite the lower back being the obvious site of pain, more often than not it is simply compensating for restrictions in other areas, which is all well and good, until the constant increased load causes it to fail.
Taking a look at the isolated motion available at the lumbar spine illustrates this well:
- Flexion (bending forwards) 40-60 degrees
- Extension (bending backwards) 20-35 degrees
- Rotation (twisting) 3-18 degrees
- Side-bending (we all understand that one) 15-20 degrees
As you can see there is actually very little movement available in the lumbar spine during rotational and side-bending!
So, where should all this extra movement come from?
Answer… The hips and thoracic spine (primarily). If these areas are not functioning correctly the lumbar spine will do its best to contribute, unfortunately forcing itself into vulnerable positions and repetitively over-straining over a long period of time.
Using rotation as an example, we are commonly told that flexing and rotating will injure your lower back. This may be true but it’s not because our lumbar spine is restricted, it is simply not built to rotate to such a degree. It’s much more likely that our thoracic spine above or our hips, below, are restricted in their rotational motion, meaning the lumbar spine has to take more of this load, a load well above its anatomical capabilities.
It’s no wonder that over time the lumbar spine gives up. You would too if you had repeated strain placed on you over months if not years. This is why it’s usually innocuous incidents, like putting your socks on, that eventually cause the low back to fail. It’s a classic case of the straw that broke the camel’s back.
In actual fact the pain response we receive from the low back is doing us a service, it is highlighting the fact that something isn’t moving correctly, and it’s our job as osteopaths to find out what and why.
Put it this way, if you are dining out at a nice restaurant and your meal comes out raw, there is no point chastising your waiter, he isn’t the cause of your problem! Look to the chef to direct your blame. We need to start getting away from simply addressing the symptoms and site of pain and look at why these issues are occurring. Always look for the root of the problem and don’t shoot the messenger!
James Shanahan
Registered Osteopath
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