Mechanical low back pain, what exactly is it?

The other day, a new patient asked me why they were experiencing low back pain. They wanted to know how something so intense had shown up so quickly. What a loaded question!

I happily launched into what is by far the most common cause and mechanism of lower back pain. Mechanical low back pain refers to an irritation of the joint surfaces of the lower back, specifically the lumbar spine. The joint surfaces of the lumbar spine, known as the facet joints, are best aligned when our muscles contract evenly, when neurologic input is optimal, and when posture is ideal. When facet joints are not optimally aligned, this can create friction and inflammation. These two side effects can result in postural changes, impact flexibility, and go unnoticed. That is, until it gets noticed, and usually in a big way.

The spine consists of multiple segments called vertebrae. What is necessary to consider is that our spines are extremely good at compensating, which can be a double-edged sword. On the one hand, little day-to-day stresses and nudges don’t stop us dead in our tracks due to our body’s unique ability to compensate.  The spine, as a dynamic entity, pulls movement from elsewhere when one specific vertebra is challenged, restricted, or irritated. Our present body appreciates this because we can go about our business and carry on. However, these compensatory changes are inefficient. The tipping point is almost always innocuous, such as grabbing a grocery bag from the trunk or brushing your teeth.  

When a patient ends up in my treatment room, usually it is because they are experiencing pain, limited mobility, and uncomfortable postures.  Sometimes, the condition has even impacted their ability to carry out their jobs or home duties as parents and caregivers. Pregnant patients can also experience mechanical low back during any trimester of the pregnancy. Chronic low back pain, chronic being lasting greater than three months, can escalate to a point where the patient is no longer willing or able to tolerate the intractable pain and discomfort.

Thankfully, as a chiropractor, I am ideally equipped to treat, manage, and educate to prevent acute (new) and chronic (long-standing) lower back pain. An office visit begins with a thorough history taking to rule out any signs of trauma, risk of fracture, or other serious underlying causes of the pain. A detailed physical exam consisting of postural assessment, orthopedic and neurologic testing, and spinal mobility assessment.  If there is no need for further investigations or referrals to other specialists, we then discuss treatment options.

It would be remiss not to discuss disc herniations and discogenic pain when we speak of low back pain. A disc herniation or disc bulge occurs with repetitive or traumatic injury within the spine. A disc is a jelly donut-shaped structure sandwiched between the vertebrae of the spine. The outer fibrous material protects the soft centre, the nucleus pulposus. When these fibres tear, it’s akin to tiny cracks in the wall of a damn. Add physical stress that compromises the integrity, and things bulge out. A complete break could allow a piece of the nucleus pulposus to pop out, much like the jelly of a squeezed donut. Either scenario can result in the compression and irritation of spinal nerves. This compression can then lead to pain, numbness, tingling, changes in gait, muscle weakness, and bladder issues. As a chiropractor, I can ascertain whether I can treat and manage a disc herniation or if the patient needs an MRI and surgical referral.

Treatment Options for Low Back Pain

For treatment options, a chiropractor can adjust the vertebrae in question. Chiropractic manipulations allow for better alignment of the articular surfaces and improved movement. Re-alignment of the vertebrae can also alleviate undue pressure on the nerves. We can also address muscular imbalances by recommending home-based stretches, yoga, pilates, and strengthening exercises. Whether it’s in-house or with their usual registered massage therapist and acupuncture provider, we can help speed up the healing process and minimize the inflammatory cycle by providing ancillary treatments. If necessary, we will refer our patients to physiotherapists, osteopaths, and medical doctors, to name a few complementary disciplines. 

Whether you’ve incurred a known injury or just sneezed and the pain appeared suddenly, the healthcare professionals at Complete Wellness Clinic are ready, willing, and able to work towards providing you with pain relief. We are here to help you on your path toward achieving Complete Wellness.