There are two scenarios that we commonly see in our office that cover the majority of back pain patients. The first is usually a constant ache while the second is a sudden stabbing pain.
Stiff, achy pain
This kind of pain is a constant nag that will become worse during certain activities such as standing or sitting. General exercise usually makes it feel better but the pain will come back within a day or a week. This is the easiest to ignore and covers the majority of back pain patients. To better understand what this back pain really is, it is important to understand the anatomy and how muscles work. The back consists of hundreds of muscles that branch up and out like a tree, these are called the erector spine muscles. The muscles of the arms and legs also attach to the back so they need to be in balance with the erector spinae muscles. An intricate balance in these muscles keeps us feeling healthy and strong but unfortunately this changes when we do a certain activities repetitively throughout the day. Below is listed some of the common activities that cause muscles imbalances.
Sitting: We all have to do it. In a perfect world we would only sit for a few hours a day instead of 8 to 12, therefore it is very important to get regular exercise so that we can have proper muscle balance. When we sit there are several muscles that become out of balance because the hips are flexed, the spine is slouching forward and the knees are bent. With prolonged bending of these joints this means that those muscles will be shortened causing them to stiffen in that flexed position. Tension in the muscles will cause a deep ache that is made better with movement, such as exercise. Most people think that exercise is great for losing weight or making a better appearance but the most important benefit of exercise is to improve muscle health. We recommend to our patients that in this scenario they come for 4-8 visits (depending on the severity) and we will workout the muscle tension so that they can return to exercising with less risk of injury and the exercise is more enjoyable. The muscles that tighten are the hip flexors (psoas), knee flexors (hamstring: biceps femoris) while the muscles of the back (erector spinae) and pelvis (gluteus medius) will become rigid because of the lack of use. The most symptomatic of all of those muscles is the gluteus medius. When we apply pressure to that muscle then it sends pain up into the lower back and down into the back of the leg. The manipulation helps to relieve the muscle guarding and begins to loosen these muscles, then the massage is applied to complete the muscle relaxation. The two go hand in hand to deliver a quick and lasting relief to the lower back pain. If left untreated, the muscles will hold on to that tension because muscles have memory and will continue to carry on as they have for years to come.
Standing: Prolonged standing is usually seen with bartenders, servers, teachers, machine operators and sales associates. The most common muscles to tense up are the hamstrings (biceps femoris, semitendinosus, and semimembrinosus), the lumbar erector spinae and quadratus lumborum. Because most people stand in shoes that have some sort of higher heel than the forefoot this causes the lower back to arch forward, causing strain on the lumbar facet joints and tightening up the erector spinae muscles. Treatment for these patients is the same as for sitting but the focus of the massage is on these tense muscles. Recommendations for proper shoes are given by Dr. Abe Medlong in order to help align the spine and promote muscle balance.
Sudden, stabbing pain
This sort of sharp pain is not as common as the dull ache but when it comes on, it is severe. The good news is that this pain, even though it starts out intense, it usually does not last as long as the nagging, achy pain described above. This sort of scenario usually occurs when there is some stiffness in the muscles of the spine already but then the person does something that requires a forceful contraction of those muscles such as bending over to pick something off of the floor. This will cause the muscle to go into spasm, which leads to severe pain that will lock the back up. As the next three days go on the surrounding muscles will start to tense up so it is also common to feel the pain radiate up the back or down a leg. This is a crucial time to come in for treatment because the chiropractic manipulation and massage therapy will help to reduce this muscle tension allowing the back to loosen. This leads to a significant loss of pain and the ability to move more freely. Left untreated, this sort of condition may develop into a constant achy pain that never quite goes away, which may lead the person to have similar flare up for years to come. With treatment though, the muscles may relax allowing for a resolution of the muscle tension and getting right to the cause of pain: tense muscles.
At Chiro Cleveland, we look at the cause of pain differently then most chiropractic offices and it fits the medical model that back pain is typically a musculoskeletal pain syndrome. By using chiropractic manipulation and massage therapy, you are treating this mechanical condition with a mechanical therapy, which can help many back pain sufferers.