Lower back pain is a condition that pretty much affects most of us at some point in our lives. Some find:

• Sitting
• Standing
• Walking can be painfully difficult or helpful, depending on the position or the activity they’re involved in.

Low back pain varies from person to person, yet there remains no consensus on the optimal way to diagnose and treat patients.

Lower back pain can be caused by a multitude of factors and can be difficult to diagnose the exact cause. However, there is an advanced method of diagnosing and treating individuals with musculoskeletal conditions/injuries.

 

 

Successful treatment

Dividing patients with lower back pain into more similar groups based on the same factors that aggravate and alleviate the pain means that a more custom-based treatment plan can be created.

The one size fits all method just doesn’t cut it. A more focused approach for every individual leads to better results.

Patients find that placing their bodies in certain positions and certain physical activities can:

• Activate
• Aggravate
• Deactivate their back pain.

Patients also find the pain being either better or worse.

Understanding why sitting, standing, and walking can change the severity of low back pain can be helpful in diagnosis.

These are important cues that help to diagnose and treat low back pain.

People sit, stand, and walk all day. This is why so much research has been conducted on how these specific positions and activities contribute to low back pain.

Spine Anatomy

The alignment of the spinal column, from the skull to the pelvis, is S-shaped.

The cervical and lumbar spinal segments curve towards the front of the body, and so are lordotic, while the thoracic spine curves towards the back of the body and is kyphotic.

 

 

The amount of curvature does not stay in one place and changes based on body position.

Compared to standing, sitting decreases lumbar lordosis by about 50%.

Changes in lumbar lordosis can relieve pain from certain forms of back pain but can aggravate others.

Picture The Spine Bending

Imagine you are holding a garden hose. Holding it vertically in front of you. The hollow part of the tube represents the spinal canal, the part of the hose facing you is the posterior spinal column, and the part of the hose facing away from you is the anterior spinal column.

Bend the hose in half. The hose on the outward-facing side of the curve will stretch out, while the hose on the inward-facing side of the tube will be compressed.

This exercise helps visualize that an object being bent will experience two forces, either:

1. Compression
2. Tension

Increasing lumbar curvature will compress the posterior column and stretch out the anterior column vertebrae and discs.

Decreasing lumbar curvature will stretch out the posterior column and compress the anterior column. This is the basis of why certain body positions can relieve back pain symptoms for some people and make it worse for others.

• Prolonged sitting, and especially if poor posture is involved, can cause overstretching of spinal muscles.
• Arthritis can affect the joints.
• The facet joints are posterior-based structures and can become compressed with increased curvature. When the facet joints are the primary cause of back pain, patients usually find that sitting improves the pain, while standing and walking make it worse.
• When the discs are the pain generator, sitting seems to aggravate the pain as there is more compression in the tissue.

With certain types of disc herniations, sitting can compress the disc to the point that the herniated tissue starts to press against a nerve root causing radicular pain or pain that radiates out to another area of the body like the legs. In this case, walking seems to alleviate the pain.

Spinal Conditions

Various spinal conditions definitely contribute to back pain and have the same presentations and alleviations.

• Spinal Stenosis means the narrowing of the spinal canal. Patients with this type of spine pain improve with leaning forward and sitting. This is because the posture increases/opens the size of the canal and decreases the nerve root compression.
• Spondylolisthesis is when one vertebra slips forward over the vertebra right underneath. This is more commonly known as a slipped disc. There are various forms of this condition. But the pain occurs immediately when sitting, bending, or walking and is usually relieved when standing still or in a neutral position for short periods.
• Sacroiliac Joint Dysfunction comes from the sacroiliac joint becoming inflamed. Pain is usually aggravated when sitting or about to sit. especially when there is added weight on the affected side. This can be difficult to diagnose because of trying to figure out if it’s the hip or low back causing the pain.

Locating the Pain Generator

Sitting, standing, and walking low back pain causes are different for everyone. But finding the root cause helps to prescribe the best treatment possible. A chiropractor uses many different techniques to relieve pain. These include:

• Applied pressure
• Massage
• Hands-on manipulation (adjustments)
• X-rays
• MRI’s
• Lab work
• Health coaching

Chiropractors don’t prescribe medications, but they do recommend therapeutic, rehabilitative exercises and nutritional lifestyle counseling to help the body heal itself.

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Low Back Pain Chiropractic Care

 

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NCBI Resources

A chiropractor sets up treatment approaches based on the individual. This begins with the natural, non-invasive treatments before moving on to more aggressive techniques. And as an added bonus patient’s who have received chiropractic treatment have experienced improvements to their digestive health and have reported better and deeper sleep after a chiropractic visit.