When we talk about causes of lower back pain we are not talking about types of lower back pain. Remember the types of lower back pain that are most common are:
- Stenosis or Degenerative Disc Disease
- SI pain
- Disc herniation of bulge
The type of lower back pain gives you know information about the cause, it simply identifies the structure area that is symptomatic. It is important to be aware that we have three decisions when treating a patient. We can treat the symptom, the compensation, or the dysfunction. If you treat only the symptom the patient will feel good until that treatment wears off. The most common symptom treatment is medications. You could also treat the compensation. The most common example of this would be the use of heel lifts when someone presents with a leg length discrepancy or pelvic alignment problem. And finally my favorite is treating the dysfunction. If you treat the dysfunction then the compensation and symptoms resolve on their own. Its like magic! The problem is that it is usually fairly challenging to identify the dysfunction because it is often far away from the site of pain. Let me walk you through an example. I might have a patient with a Right SI pain problem. This patient also has a right pelvic upslip or alignment problem. The initial obvious thing to do would be to fix the alignment of the pelvis since the pelvis attaches directly to the SI joint. But often times when we do that we find ourselves needing to do that every time the patient walks in the door. The pelvic alignment problem is simply a compensation. The real dysfunction in this case lies in the right foot. The right foot lacks eversion or pronation and this is what creates the pelvic alignment and the SI pain. So if you don't look elsewhere for the dysfunction the permanent solution will not be found.
The top 3 Causes of lower back pain are
- The foot
- The Hips and
- The Upper spine
Now I know that statement is pretty general but I if anyone of these areas does not have the proper mobility and stability it will force the lower back to move more than it was designed to move. In the next episode we will talk about how the lumbar spine is designed to move. If you would like to learn more about how the foot, hips, and upper spine contribute to lower back pain I have created a report called 7 tips to eliminate lower back pain. You can get that cheat sheet by clicking the image below. Thanks for listening.