Many adults at some time in their lives will be troubled by low back pain. In some cases the pain will disappear as quickly as it came, in others low back pain can become an ongoing issue which seriously interferes with their lives.

Low back pain has many different causes and no two people are the same.  To simplify the classification of low back pain we can divide it into two categories.

1. Low back pain caused by problems within the mechanical/musculoskeletal system. This includes pain arising from muscles, ligaments, joints, degenerative changes (wear and tear) discs and poor posture.
2. Back pain originating from serious pathology. This means that there may be a disease process or a serious abnormality which is causing the symptoms.

When a patient consults an osteopath a detailed case history is taken including questions about the onset and progression of symptoms, medical history, accidents, illnesses etc and then a physical examination is performed.  Taking into account all the information gathered from this process an osteopath will reach a diagnosis and decide whether the patient is suitable for osteopathic treatment.  If your symptoms fall into the first category it is likely that osteopathic treatment can help.  If an osteopath suspects that you fall into the second category you will be referred back to your GP for another opinion and some tests may be necessary.

Mechanical causes of low back pain

The main culprits!
The spine is like a finely tuned piece of mechanical equipment.  Mechanical stresses and strains over and above which the spine can cope may cause injury, such as when we lift an object which is too heavy or lift in an awkward manner.

Minor strains such as repeatedly bending can cause injury (similar to repeatedly stretching and relaxing  a piece of elastic; eventually it loses the ability to spring back into shape.)

Muscles

The lumbar spine has strong muscles which run on either side of the back.  There are also small muscles which run in between the individual vertebrae.  The big muscles are made up of muscle fibres which when contracted give us the power to move.  It is possible to tear the muscle fibres during movement which results in pain, restricted movement and inflammation.  The most common cause of muscle pain in the low back is when the muscles go into spasm (hypertonic) which is often secondary to another injury such as a ligament or disc strain.  The muscles over contract as a protective mechanism; the body’s way of trying to prevent damage by immobilisation.  The strong contraction of the muscles results in pain and restricted movement.  This muscular spasm tends to lesson in severity as the underlying injury resolves.

Ligament Strains

Ligaments connect bone to bone and in the low back they run from the top of one vertebrae to the bottom of the vertebrae above helping to contain the disc.  Ligaments also connect the pelvic bones to the spine and run in between the small facet joints.  Ligaments can be strained by traumatic injuries such as falls, sudden unanticipated movements, repetitive movements or postural fatigue.  Ligament strains in the low back are common and can be slow to recover if there is poor muscle tone such as weak abdominal muscles.

Disc strains/prolapses

The discs in the spine function as shock absorbers and are housed in between the vertebrae
of the spine – Disc Problems.

Sciatica
Sciatica is a medical term which means pain felt in the course of the sciatic nerve –  Sciatica

Postural Problems
The lumbar spine has a curve in it from front to back which is called a lordosis.  For optimum function this curve needs to be maintained within normal limits.  An excessive lordosis (described as a lordotic spine) can place an increased mechanical strain on the ligaments, discs and joints resulting in strain.  Someone who has this condition will be likely to experience pain when standing for long periods of time.   Weak or unconditioned stomach muscles can contribute to this problem. As an osteopath we commonly see this condition after abdominal surgery or in women after they have had children.  Sometimes it can simply be as a result of the way in which your individual spine is constructed.  With careful treatment and advice regarding exercise this condition can usually be brought under control.  Sitting slouched at work or when relaxing in the evening curves the spine outwards and can strain the ligaments at the base of the spine. - Postural Problems

How osteopathy can help

The conditions described above give examples of how back pain can originate.  An osteopath looks at a person as an individual, taking into account how the problem has arisen, posture, life style and any on-running mechanical stresses and strains which may be preventing the injury from clearing up.

Osteopathy aims to alleviate back pain by improving the mechanical function of the spine using gentle manual techniques delivered using the hands and by supplementing the treatment with individually tailored advice regarding exercise, posture and how to use your spine.