Why does my lower back hurt? By Osteopath Etienne
Have you ever wondered why you wake up with stiffness in your lower back?
A stiffness that could last more or less all day long, affecting your movement and occasionally even your focus at work when sitting in front of your computer...
For a lot of people, it is a constant questioning of “where has my fitness gone? Since when did my body mechanics become rusty? Wait, am I rusty already? How did I get here, can I turn things around?”
For us to understand where these pains come from, we need to acknowledge the fact that not all pains have organic causes such as traumas, injuries or musculoskeletal problems.
The second thing we need to acknowledge is that there is no “imagined pain”. Whether it is specific or not, local, general, referred, its origin needs to be investigated properly.
Let’s go over our structures and their function quickly to understand how we come to use them incorrectly.
The design of our spinal column allows adequate movement among the head, the trunk, and the pelvis. It also offers the capacity to transfer weight forces, bending movement from the head to the pelvis and a very important shock absorbing apparatus.
Without this structural organization, we couldn’t move evenly, smoothly and we would be incapable of supporting the weight of our own body.
For the spine to allow such flexibility and capacity to take care of the body’s weight, it is composed of 24 vertebrae separated by intervertebral discs; the whole balanced upon its base, the sacrum (five ossified vertebrae). During the standing position, weight is transferred across the sacrum, to both sides of the pelvis before going to the legs.
The way we distribute this weight is very important. Indeed, we do not share our weight equally in the spine. The lumbar spine will be subject to carry more load than the neck, being the end of the chain.
The first and major aspect of our spine which will be influenced is its curves.
Those are here as we said in order to resist compression forces and weight. Our spinal curves are complementary, opposing each other’s in shape: the cervical spine (neck) is slightly in extension, the thoracic spine (trunk) is slightly in flexion and the lumbar spine is arched in light extension. This structural organisation allows what we call spinal stability. Every step towards instability through curve changes gets us closer to injuries, and the chronic aches and stiffness that we are concerned about today.
With spinal stability our weight is in balance to the gravity line, allowing us to rest our weight on the force-absorbing curves of the spine and its discs. This is minimising the amount of muscular activity to help us carry that load.
As we get out of gravity alignment, we alter the functions of our spine. With accentuated curves, we will automatically apply more pressure on certain parts of the column. Therefore, some segments of the spine will find themselves with excessive loading or degree of motion, which is a major incidence for spinal pain.
With the neck the most mobile part of the spine, in case its curve of extension is increased through a slouched back for example, many dysfunctions will occur. The head being out of the gravity alignment, only the muscles will be able to hold your head on your shoulders.
Our head weighs around 5kg. Not using gravity anymore and your 7 neck vertebrates, we are asking about 20 neck muscles to overwork daily, leading to neck and shoulder pain as well as tension type headaches.
Same principles apply for the lower back. If the lumbar extension is increased due to an anteriorly shifted pelvis for example (common in pregnant women, overweight people, frequent runners and hikers), more effort will be asked of local muscles, and more weight will be put on the intervertebral discs for us not to fall from a standing position.
In the end, the accentuation of our spinal curves because of poor habits lead to the overuse of certain muscles and discs in order to compensate. We would not be able to keep our head on our shoulders otherwise, nor standing still without the consequence of falling.
Muscle overuse almost always leads to muscle fatigue and therefore pain, as well as restricted movement.
But as you can guess, those changes can be inverted: our discs can be offloaded, our muscles can be relieved in function as well as being reinforced. Let’s see how.
Many among us find ourselves in the situation described above. And the symptoms induced being unrelated to degeneration (yet), it is logical to ask ourselves what we can do to reverse the situation?
The first approach and most important one would be “movement”. Indeed, our worst enemy, in this case, is the immobilization of certain parts of the spine due to sedentary activity (desk-based for example) or the isolation of others (during running we tend to isolate our lower back).
Movement is therefore both a prevention and a solution for chronic spinal aches.
Yoga, swimming, pilates, lightweight or functional exercises are simple examples of ways to preserve good spinal integrity.
In these cases, manual therapy, such as Osteopathy is an efficient way to unlock the situation through certain manipulations that will enhance the mobility of the spine, allowing the soft tissues (ligaments and muscles) to regain their original state.
In the long term, this will also allow a postural enhancement which will prevent the overload of certain parts of the spine.
Osteopaths are capable of identifying which part(s) of the spine have been neglected and/or used the wrong way, giving you these chronic and constant aches.
Indeed, treating a fatigued or weak muscle will only relieve our aches for some time, while treating the restrictions of the spine will allow full recovery.
Etienne Simonnet - Osteopath DO, MHKOA (HK)
Etienne is an Osteopath from France. Based in London from 2014 until 2018, he graduated from the British School of Osteopathy in the United Kingdom.
He accumulated wide experience while in the UK through private clinics as well as sport, pediatric clinics and public hospitals.
Etienne is a Registered Osteopath both in the UK and in HK.