"You begin with anatomy, and you end with anatomy, a knowledge of anatomy is all you want or need" — A.T. Still MD DO Philosophy of Osteopathy
This week's blog is going to be looking at the lower back (hence the title! - one day I'll get bored of puns...). I shall attempt to give a basic look at...: - the anatomy
- an idea of the complex and varied list of things that can happen to it
- why these might happen
- tips for possible prevention
- what osteopathy can do to help
Vertebra - 5 of these bones are found in the lumbar spine (lower back), they are the building blocks of the whole spine.
Facet Joint - The joints between vertebrae.
Disc - They are ligamentous cushions filled with a toothpaste-like substance that act as shock absorbers, helping to prevent the bones rubbing together and distributing the stress through the spine.
Intervertebral foramina - The gaps between the bones that nerves run through.
THINGS THAT CAN HAPPEN
Familiarised yourself with the anatomy? Well, most of that can be injured, damaged or cause issue in more than one way... Which makes my job much more interesting! Let's be honest though, the human body is complex, it would be remarkable if it didn't have problems. A few of the most common lower back issues Osteopaths (myself obviously included) deal with are:
#1 Degenerative joints:
This is when the joints or bones of the spine wear away and rub together causing pain, inflammation and reduced movement. They're designed to move over each other smoothly, not scrape together when you move. This is not usually a "sudden onset" problem, degeneration happens over a long period of time.
#2 Disc prolapse/ hernia
A lot of force, stress and pressure goes through the discs in everyday life. A problem with the disc can be anything from slight tearing of the fibres on the outside, to leaking of the toothpaste-like stuff inside into the tube that the spinal cord runs through. N.B. Discs cannot just be "pushed back in". In many cases, Osteopathy can help reduce symptoms and give you tools to help manage the problem, however, surgery may be necessary depending on severity and location.
#3 Nerve root irritation
This can go hand in hand with either of the above issues. The nerve roots can be affected by any narrowing of the intervertebral foramina, whether that's a disc bulge, degeneration, fracture, postural changes etc. - the area they exit is effectively smaller so they can get swollen and cause weakness of the legs, pins and needles, shooting pain, numbness.
~BEWARE : Numbness of your saddle area, weakness of your legs (both sides) and/ or a significant change in your toilet habits could be a sign of spinal cord compression (cauda equina) - this needs to be checked out!~
#4 Muscle spasm/ tension
Not to forget the muscles! There are loads that attach to pretty much anywhere on the lumbar spine so any change in structure or function could lead to muscle tension - leading to discomfort and potentially worsening any underlying issue.
How long is a piece of string... Any number of reasons can cause lower back issues from
wear and tear from sports,
change in gait from damage or arthritis in the leg,
to systemic issues or
other forms of arthritis.
All of these can cause a change in the way the spine moves or works which can cause compression, irritation, inflammation and pain.
TIPS FOR PREVENTION
Not strictly lower back related but valid nonetheless! Take a look at my 5 top tips:
OSTEOPATHY CAN HELP!
The NICE standards accept that Osteopathy is a beneficial form of therapy for those with lower back pain. We always need to take a full case history (medical and specific problem related) in order to assess how we could help and that it is safe for us to treat. We use a combination of soft tissue, articulation and manipulation techniques to help increase mobility of the joints, relax muscles and restore functional movement. These will be adapted to you as an individual, the same treatment doesn't always work for everyone! Our job is to help ease discomfort, help you to understand your problem and provide you with the tools to minimise the chances of your problem happening again.
Take a look at my video for more information about lower back techniques.