In a previous blog, we explored the anatomy of the low back and how these structures play a role in the body. However, what happens when they are injured? In this blog we will discuss the most common causes of low back pain. They include: muscle imbalances, Degenerative Disc Disease, and sciatica. Continue reading to learn more about these impairments and pathologies.
Muscle imbalances are a very common source for low back pain, especially in individuals who spend time in prolonged positions such as sitting, standing, or walking. When our spine and pelvis are “stuck” in the same position for a long period of time, the muscles, ligaments, and joints begin to adapt to these positions causing lengthening and shortening of various muscle groups along with changing the normal resting position of joints. As physical therapists examine a patient's low back, they commonly assess pelvic position. If the pelvis is tilted forward, it is referred to as an anteriorly rotated pelvis. This is common when hip flexors and spinal extensor muscles are tight and abdominal and gluteal musculature are weak. Similarly, if the pelvis is tilted backward, it is referred to as a posteriorly rotated pelvis. Here, the gluteal and abdominal musculature are tight.
Another common pathological condition of the low back that physical therapists treat is Degenerative Disc Disease. This occurs when the disc in between each vertebrae slowly shrinks due to age, dehydration, and natural processes of the spine. The disc itself contains two portions, the nucleus pulposus that is filled with a gelatinous material and the annulus fibrosis which maintains the structure of the disc and is filled with collagen and water. If this structure is damaged due to repetitive movements, age, or injury, the gelatinous material from the nucleus pulposus may leak out and compress the spinal nerves that control the muscles of the legs. This is called a herniated disc!
The last commonly seen pathology of the lower back is sciatica. The sciatic nerve is the largest nerve in the body and controls many of the muscles of the leg and feet. Since the nerve is so large and long, it is prone to injury in many different spots along the body. Individuals with sciatica may experience pain, numbness, and tingling that runs down a person's leg. A common place for compression of this nerve is under the piriformis muscle which is located underneath the gluteus maximus muscle which is often affected by sitting a large wallet or checkbook in the back pocket of pants or shorts!
If you or someone you know is suffering from low back pain and are looking for answers or relief, please don’t hesitate to call us at 515-416-8822 to set up an appointment with a Doctor of Physical Therapy today!