Low back pain is very common and anyone who has dealt with it knows how limiting it can be. It is scary to lose your ability to carry out day to day tasks and be self-sufficient. I constantly have patients who think it is just a part of life or “getting old,” whatever that means to them. It could not be further from the truth.
What is Low Back Pain?
Using low back pain to describe a condition is silly. You rarely read of studies on arm pain, hand pain, or foot pain. These areas are typically broken down into specific injuries and specific conditions. Low back pain is treated like it is a thing. Low back pain is self-descriptive, but what is causing the low back pain? Why is it happening?
There are a lot of causes of low back pain, some serious and even life threatening, and others more benign. Ruling out serious causes of low back pain such as tumors, fractures, and systemic conditions like inflammatory arthritis are important, but we will focus on a broad category generally called Mechanical Low Back Pain or Non Specific Mechanical Low Back Pain. Those names sound like no one knows what is going on. This occurs when pain comes from the joints and their surrounding tissues like discs, ligaments, muscles and tendons. The best case scenario at this point is you have a silly name for your low back pain that you already knew was low back pain, and know that it is not “serious”. It actually is serious, just not life threatening.
WHY is it Hurting?
“Why?” is my favorite question. It is also my 2 year old’s. However even knowledge of the exact tissue that is hurting won’t fix your pain. We need to know why it is hurting so we can find a solution. There could be a huge number of different tissues that hurt and a huge number of reasons that they hurt. If you look at healthy, strong, and properly functioning bodies, they all work the same. On a most basic level, your low back is hurting because it is not working properly. It has moved away from the healthy ideal into some sort of compensation and break down. The pain is your body letting you know that something has gone wrong.
There isn’t a single cause of low back pain, and there is no single solution. There is however, a reasonable approach to restoring proper strength, mobility and function which will deal with most mechanical low back pain issues. Like any other joint in your body, your spine is healthy and happy when it is moving properly and stable. It needs proper motion to feed the joints themselves and send normal healthy movement information to your brain. It needs stability to be able to control motion and protect itself under load.
If you can work your body towards moving properly and being stable, many low back pain issues will resolve. We will develop this more in Low Back Pain II: Restoring Motion.