| A Holistic View Points Toward Skeletal Muscles | | | | The third cause of lower back pain is nerve |
| It is often stated in conventional literature that | | | | compression and entrapment. Nerve compression |
| the cause of lower back pain cannot be precisely | | | | is the pressure put on a nerve by a bone or an |
| identified. This perspective derives from a | | | | intervertebral disc. Nerve compression occurs |
| mechanistic, non-integrated view of the body | | | | when the spine becomes misaligned for some |
| which has been our legacy since the scientific | | | | reason (faulty movement patterns, injury, chronic |
| revolution. When the body is viewed as a | | | | muscular tightness) and one of the discs between |
| collection of isolated parts rather than an elegant, | | | | the vertebrae get squeezed on one side so that |
| integrated whole, the cause of lower back pain | | | | it bulges out the other side. If the bulging puts |
| becomes a bewildering puzzle. | | | | pressure on a spinal nerve, then you've got pain! |
| However, a holistic view of the body can begin to | | | | Nerve entrapment is when a nerve is caught or |
| sort out the confusion. By evaluating the | | | | pinched by the soft tissues. For example, the |
| relationship between the body's overall structure | | | | sciatic nerve (the largest nerve in the body) runs |
| in gravity and it's function in movement, the | | | | down through the buttocks and can become |
| causes of lower back pain begin to reveal | | | | entrapped by the piriformis muscle when that |
| themselves. | | | | muscle is very tight. This can result in pain down |
| A holistic perspective guides us to one of the | | | | the back of the leg. |
| most overlooked sources, not only of lower back | | | | 4) Structural Imbalance, aka Postural Distortion |
| pain, but chronic pain in general. That source is | | | | The fourth cause of lower back pain is structural |
| skeletal muscles. | | | | imbalance or postural imbalance. In a sense, this |
| As Drs. Janet Travell and David Simons made | | | | issue is the most significant of all. The reason for |
| explicitly clear in their exhaustive 2-volume work, | | | | that lofty status is due to the fact that structural |
| Myofascial Pain and Dysfunction: The Trigger Point | | | | imbalance is often the root problem responsible |
| Manual, a vast proportion of chronic pain in the | | | | for ischemia, trigger points, and nerve |
| body is not due to problems with damaged | | | | compression or entrapment. |
| nerves, disrupted bursae, and degenerative joints, | | | | If the body is distorted off its center line of |
| but dysfunction in the soft tissue, especially | | | | gravity, compensating muscular patterns can |
| skeletal muscles. | | | | result. To illustrate the point, put your elbow on |
| The cause of lower back pain can be broken | | | | the table in front of you with your forearm |
| down into five primary problems which | | | | pointed straight up to the ceiling. Now imagine |
| interconnect with one another. The following | | | | you've got a bowling ball resting in your palm. If |
| breakdown is adapted from the St. John | | | | your forearm is completely straight up and down, |
| Neuromuscular Therapy training, a method of | | | | the weight of the bowling ball will be supported by |
| postural analysis and clinical massage therapy | | | | the bones of your forearm. Theoretically, you |
| focused on musculoskeletal alignment and treating | | | | could hold that bowling ball there indefinitely. |
| compensatory muscular patterns. | | | | But if you shifted off that center line, even a tiny |
| Five Primary Problems | | | | bit, then the muscles of your arm would have to |
| 1) Ischemia (pronounced: Iz skeem ee ah) | | | | engage in order to hold up the bowling ball. Even |
| The first cause of lower back pain is ischemia. | | | | the strongest human in the world wouldn't be able |
| "Ischemia" means lack of blood. Without adequate | | | | to hold that ball there for long. This is precisely |
| blood to provide nutrients and oxygen, soft | | | | what can happen with your body. If your |
| tissues such as muscles, tendons, ligaments, and | | | | alignment is off such that your head is not |
| fascia build up lactic and other toxins and become | | | | centered over your shoulders over your hips |
| painful. Ischemia occurs when muscles are | | | | over you feet, then the core muscles of your |
| chronically contracted over a period of time. The | | | | body must perpetually engage in order to hold |
| most prevalent cause of lower back pain, by far, | | | | your body up! |
| is muscular strain and spasm due to ischemia.2) | | | | 5) Dysfunctional Biomechanics |
| Trigger Points | | | | The fifth cause of lower back pain is dysfunctional |
| The second cause of lower back pain is trigger | | | | biomechanics. This is often a secondary result of |
| points. A trigger point is an area of the soft tissue | | | | structural imbalance and is evidenced by faulty |
| which, after chronic contraction and reduced blood | | | | movement patterns. For example, if you've got |
| flow, becomes an area of high neurological | | | | nagging lower back pain you might hold your body |
| activity. For example, fibers in an ischemic muscle | | | | in a restricted way, walk differently, or reach for |
| (a muscle with low blood) can become an active | | | | things with limited range of movement. It's logical |
| trigger point in response to biochemical changes in | | | | to do that, and not recommended to fight against |
| the tissue. Active trigger points cause referred | | | | your body's self-imposed limitations. It's trying to |
| sensation to other parts of the body. That | | | | protect you from pain. Until the structural |
| sensation can be pain, tingling, numbness, thermal | | | | imbalance is addressed, and the pain is relieved, |
| sensations (hot or cold), weakness, a general achy | | | | there's wisdom in those limits. However, repetitive |
| quality, or the feeling that "it just doesn't feel | | | | movements can become patterned into your |
| right." For example, you might have a trigger point | | | | nervous system such that, even after structural |
| in a muscle of your lower back which refers | | | | and muscular problems have been eliminated, you |
| sensation down into your buttocks, or even down | | | | still move in a limited, protective way. This can |
| the leg. This is NOT same thing as the referred | | | | revive structural and muscular imbalances. That's |
| pain caused by nerve compression and nerve | | | | why even a minimum regime of daily stretches |
| entrapment which will be covered next. | | | | can be vital to full recovery. |
| 3) Nerve Compression and Nerve Entrapment | | | | |