Low Back Pain


The muscles in your low back and your pelvic region, are capable of causing agonising pain that can incapacitate you, or cause a consistent nagging ache interspersed with sharp twinges on certain activities, or somewhere in between. It is the unseen misery suffered by millions of people every day.


The interesting thing is that excruciating pain can be caused by both simple mechanical dysfunctions in the joints or muscles, or by serious pathology (disease process or wear and tear), since pathology is by far the rarer of the two, there are literally millions of people suffering needlessly every day.


Typically a person suffering from low back or pelvic pain will first visit a doctor, the doctor should examine you to rule out any pathological conditions, and will then usually prescribe pain killers or anti inflammatory drugs such as diclophenic or voltarol. These may or may not ease the symptoms, but they certainly will not help the cause of the problem.


If symptoms persist the doctor may recommend a physiotherapist who will, (if they can see you before 12 weeks) often prescribe exercises and/or electrotherapy.


The back pain sufferer might then go to a chiropractor who may diagnose ‘twisted pelvis’, ‘scoliosis’ or ‘sciatica’. Many osteopaths will diagnose the same things.


All being well, the symptoms will ease. But often, not...


In the majority of cases of low back or pelvic pain I’ve seen, the cause has been clearly a case of muscle imbalance and soft tissue dysfunction. (soft tissues are the ligaments that hold the joints together, connective tissue which fills all the spaces in your body, or muscle tissue) In the cases where pathology has been present, the most common underlying cause of the pathology has been chronic long term muscle imbalance and soft tissue dysfunction!


Even if the original cause of pain was some kind of damage from trauma, the current cause of pain may be the way your soft tissues and muscles have reacted to the damage. (see case histories)


Most of us know what it feels like to have a cramp in our calve or hamstring, we can normally ease the agony by forcing the leg to stretch out, but imagine that same pain in a back muscle, and you can't stretch it out! The pain can become unbearable and debilitating, sometimes totally incapacitating.


Luckily most don’t get to that stage, but many suffer serious pain every day, either in their low back, buttocks or down one or both legs.


So what can be done? Firstly, I will ask you to tell me everything you can about your pain. When it hurts, what eases it, how long you’ve had it. I'll ask about the nature of the pain (what it feels like) and many other questions. This is vitally important in order to arrive at a potential reason for your symptoms. Ideally I want to confirm that your problem is of a body structure nature, and not a pathology, but even if there is a wear and tear or disease process going on, significant reductions in pain can be gained through treatment. However it's still very important for me to try and assess the reasons for your discomfort based on what you tell me.


Causative factors can range from muscle spasm, adhesions between layers of connective tissue and ligaments or tendons, (tendons connect muscle to bone). There can be inflammation of these tissues, joint restriction, joint inflammation, there could be nerve pressure or nerve root pressure(at the spine). Irritation from other sites such as the bowel or uterus through nerves that supply both  the back muscles and these organs, and have a common origin in the spine.. There could be damage to discs, tendons or ligaments. Or there could be arthritic changes. (luckily these are all relatively rare). It could be that the underlying cause of your pain originates in your feet, knees, hips and sometimes even in your neck, shoulders or upper back!


So you can see, taking 15-20 minutes to ask about your condition is very important.


To confirm or deny this initial assessment, I will then need to examine you, ideally in your underwear, but if you are self conscious then shorts and bikini top are fine. Men need not worry about the bikini top... I will be looking for clues to confirm or deny my assessment from your consultation, or to shed new light on the problem, (for instance recently a 44 year old man had low back pain and his symptoms made little sense until he stood up before me and it became immediately apparent he had an anatomically short leg (ie literally a short leg bone) by an astonishing 30mm! All the compensations his body had taken to allow for this had finally reached their limit and begun to break down, leading to his leg and back pain.


Clues can be picked up from the way your spine moves as you bend, and the way in which the muscles contract as you move. Folds in the skin and bony prominences all tell a story, even the colour and texture of the skin can provide subtle clues as to the cause of your problem.


I may then ask you to sit on the couch while I carry out some more tests. Eventually when you lay down, I’ll cover you with a towel and do some more tests that may be needed to provide the clearest picture of what’s going on.


By this point usually I will have enough information to start the treatment. It’s important to start with the most appropriate areas and the order in which I work will depend on what I’ve discovered during the consultation and examination.


Sometimes, in fact most times, a definitive diagnosis is simply not possible. It is a fact that most people need a name fo their pain, such as Sciatica. The reality is that the body is the sum of all its parts, and there may be multiple factors involved in a particular pain pattern and all have to be considered. So giving the pain a name becomes difficult. Even then, a fair proportion of the final assessment will depend on how you react to the treatment. Different reactions will again confirm or deny previous assessments.


Most people respond well to the first treatment, but I will always explain to you any possible adverse reactions.


During the treatment, we will learn to become a team. Both of us will be involved in recreating the harmony of pain free function that is your birth right. I will be asking you constantly for feed back, this is not a passive process for you! You will be telling me exactly what you feel and how it changes during treatment. I will explain to you why you’re in pain and how my treatment will be changing the various functions in your body that will lead to a reduction of your symptoms. See: What happens during muscle manipulation?


Some of your treatment may be uncomfortable but you are always in complete control, the more information you share with me the more we can work together to help your body heal itself.


Its not unusual for weeks, months or even years of  pain, to dramatically reduce after your first session, the wonderful reason for this is that your body always wants to work and function at 100% efficiency! Your body really is your friend! Everything you feel and everything you don’t feel, is your body doing its absolute best for you.


For the most part, we only get symptoms when all the body’s attempts to compensate for injuries, trauma, (both emotional and physical) posture, chemical abuse (food and substances) and stress, finally break down. See: Me 'an muscles. And even then, the pain is your friend! Try not to dismiss it out of hand or banish it with pain killers without first asking what its trying to tell you.