Almost all of us have had lower back pain. If you haven’t, you’re either quite young or really lucky! Lower back pain can present itself for many reasons, it can vary in severity and duration, and it can be specific or general.
The dull, generalized pain can often be frustrating. We don’t always know what is causing the back pain. The term for a generalized, lower back pain, without medical cause is referred to as “lumbago”. It’s a fun word, but not fun to deal with. It isn’t crippling, but it’s there nonetheless, being its nagging old self. Many seek out a Physiotherapist or Registered Massage Therapist to help with this lumbago, and many may not be able to give an answer as to why it may be happening, simply stating “it’s just been there since I can remember”.
Now, let’s take the focus away from the lower back for a moment, bring it down to the lower extremity. If you can recall any injury to one of the lower limbs that caused you to develop a limp, it may be the underlying reason as to why that nagging lumbago just won’t go away.
The human body is designed and built to function in a certain way, and is (usually) evenly balanced and stacked. In a vague description, we stand evenly on 2 legs, with a pelvic bowl sitting nicely between the hips, and a Jenga-like tower of vertebrae stacked upwards from the back center of – the pelvis. When an injury occurs to one of the lower limbs, our weight is shifted off of that limb for a period of time to ease pain and allow healing without stress. What was once a job for 2 legs has now become a job for one leg, and a compensation pattern develops through the musculature of the unaffected leg, hip, and, yes, the lower back. To paint the best picture, here are a couple case scenarios:
A woman partially tore a ligament in her right knee 3 years ago. When standing and walking on it, her knee felt very unstable. To compensate for this, her body shifted more of the weight distribution over to the left hip and leg so as not to overwork the compromised tissue and to ease the pain. The damaged ligament of her right knee eventually heals, but the neural pattern developed of overusing her left lower limb has not been corrected. Over time, her right hip and leg muscles remained weaker from underuse and didn’t learn to properly support again. This causes a subtle tilt of the pelvic bowl, and thus a lean in the Jenga tower. For 3 years, the muscles in the left side of her back, hip, and leg have taken on an increased weight load trying to keep that Jenga tower straight. Overused muscles tend to result in pain and tightness.
Next, we have a young man who tears his left Achilles tendon playing basketball. He gets it surgically repaired and starts the rehabilitation process. It’s been one year, and although his Achilles has healed well, the left side of his lower back aches chronically. When we walk, the calf muscles (continuous with the Achilles tendon) play a very important role in pushing off
when walking. After a trauma like a severe tear, the calf muscles aren’t quite as strong as they used to be and may have difficulty giving a full push off. To compensate, the same side lower back muscles can activate to excessively lift up the hip and get that leg through the full swing of your gait cycle. Again, the muscles are overused and display pain.
There are endless case scenarios that could be used as examples, but hopefully you can see how your back pain could be caused by something other than an injury to your back.
Through a proper assessment process, your RMT can help to correct the cause of the improper alignment, and release the muscles that have been holding on too long. The cause can be something as simple as flat arches, or as severe as a previously fractured femur. In either case, a domino effect occurs up to everything that is stacked above it. The importance of the assessment process and proper rehabilitation can make the world of difference when it comes to relieving your lumbago.
Cassie is an RMT who took her training in Vernon through Okanagan Valley College of Massage Therapy. Before working with Sun City Physiotherapy, she gained experience working as a Locum Massage Therapist, moving around BC and working with a wide variety of clientele from geriatrics to athletes. She worked alongside many different physiotherapists, yoga teachers, and acupuncturists, absorbing and sharing knowledge in the process.