Many articles regarding Lower Back Pain concentrate on providing statistics on prevalence which can certainly be very informative.  However this article is intended to concentrate on the specifics of pain referral patterns as it relates to Back Pain.  This will lend some specific insight into a€œwherea€ the origin of the pain is in order to effectively understand it and therefore treat it.

As if lower back pain wasn’t hard enough to get rid of, did you know that where you feel your pain probably isn’t where the problem is (or the source of where your pain is)?  All muscles in the human body have the ability to refer pain. This means that when a muscle is injured, tight, in spasm or congested it will often cause pain far from where the problem is.  And the muscles in the Lower Back are no exception and can certainly have complicated pain referral patterns that can confuse a lot of people, even trained healthcare professionals.

To make this simple and precise, below is a list of common back pain complaints along with common muscle-based causes that have been derived from years of in-clinic and office treatments:

1. Lower Back pain and stiffness after sitting or bending or going from sitting to standing especially along the lower spine and across the waistline- Common causes: Hip flexor (muscles in the front of the hips) tightness, spasm or strain, especially in the Psoas muscle which attaches to all levels of the Lumbar Spine (lower back), including the intervertebral discs, and runs forward and down along the front portion of the pelvis to attach at the upper groin area.  Also involved is the Iliacus muscle which attaches at the pelvis and runs forward and down along the front portion of the pelvis to attach next to the Psoas muscle at the upper groin area.

2. Localized pain at the Sacroiliac joint (the bump you feel at the waistline just below your lower back) when you stand- Common causes: the Gluteal (buttocks) area and front of hips.  Tightness and or weakness in the Gluteals as well as Hip Flexor (front of hips) tightness/ spasm.

3. Pain radiating down the outside or back of your leg when you stand- Common causes: Piriformis muscle (a deep muscle located underneath the Gluteals) tightness and or spasm as well as Gluteal tightness, strain and overuse.

4. Pain in Lower Back while you sit- Common cause: spasm of the lower back paraspinal muscles (the small stabilizing muscles along our spine).

5. Pain in buttocks area- Common causes: quadratus lumborum (a muscle that attaches to the top back portion of the pelvis and runs up along the spine and attaches to the lowest rib) muscle tightness and piriformis tightness.

Now this is a small and partial list but it can give you an idea that where you “feel” the pain is not often where the problem is.

Once you can identify the true cause of your back pain, then the solutions are much more obvious. And your time spent trying to fix yourself is better utilized and more effective.  Most often treatment for low back pain consists of exercises to help balance muscle imbalances.  If the cause is understood, the exercises can be chosen correctly and performed correctly leading to a speedier recovery.


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