Common causes of Back and pelvis pain are detailed below
Lumbar spine facet lock/strain
Facet joints are articular surfaces in the spine of which the function is to guide and limit movement between each of the adjacent vertebrae. A facet sprain is typically caused by damage to ligaments, cartilage or capsule of the associated joint. During individual movements, stretch and compression type forces are placed on the facet joints, if these forces are too great, damage to the structures may occur. i.e. lifting heavy weight (deadlift/squat), poor sleeping position or posture.
Patients typically present with a fairly intense, localised area of pain distinct to one side of the lower back. The sensation of pain may radiate into the glutes, thigh and in some cases even down to the ankle. Surrounding musculature will often go into spasm and lower back movement may feel restricted and uncomfortable.
Disc prolapse/herniation/pain
Between adjacent vertebrae and fibro-cartilaginous structures called discs. They consist of a tough, durable outer layer and a soft, jelly like centre. The prime function is to act as a shock absorber, protecting nerves and spine. A disc prolapse occurs when the soft jelly like centre bulges through the tough outer layer. This is commonly caused by activity which includes bending forwards, whilst twisting i.e. placing the baby seat in the back of the car.
Symptoms can depend on the location of the prolapse, but in majority of case would consist of a diffuse, consistent ache spanning across the low back. Pain, pins and needles, numbness or weakness into the legs and feet may be observed. Typically symptoms are worsened by inactivity, weight bearing (sitting or standing for extended periods) mornings and coughing or sneezing.
Symptoms can often be quite intense and understandably worrying. If you wish to discuss your symptoms for advice or pain relief please call on 07813580576
Muscle strain/spasm
In a similarly manor to other areas of the body, soft tissue structures in the back, can easily become subject to overuse, trauma and postural fatigue. Damage to these tissues may occur when they are exposed to excessive forces, such as whiplash type injures or when they are held in stretched positions for an extended period of time i.e. sitting in a slumped posture.
In response, musculature may spasm, tear or become inflamed. Patients may experience ‘knots’ or sharp and tight areas of restriction.
Rib dysfunction
The ribs are required to move in a continuous, rhythmic, upwards and outwards motion to assist in both diaphragmatic and respiratory function. They attach at three points, at the front of the chest via a cartilaginous attachment to the sternum (breast bone) and posteriorly to the spine to form two articulatory surfaces (joints). Many people imagine the ribs to be immobile structures; however the ribs have to move every time we breathe and considering the average respiratory rate over 24 hours is around 17000-28000 times, it means they endure a heavy workload.
Rib dysfunction is a mechanical problem caused by irritation at the attachment site, at either the thoracic spine or at the front of the chest, at the sternum. In the majority of cases, pain is experienced at the back.
Causes may be due to trauma, postural fatigue, structural anomalies of the spine (scoliosis) or heavy workload and excessive ‘push and pull’ use of upper extremity.
Patients may experience a sharp and tender area around an inch from the centre of the spine and will commonly describe this as a ‘knot in the back’ or a ‘pulled muscle’. Pain can often radiate around the side and front of the chest. Symptoms are typically aggravated by bending away or towards the area of pain, flexing the neck forwards and taking a deep breath in.
Sacroiliac joint syndrome
The sacroiliac joint is located at the base of the spine and joins the sacrum to the pelvis. The joint delivers only a small amount of movement as its main function is to dissipate forces from the upper body and spine into the lower extremity. However, during certain movement of the spine and hips, the sacroiliac joint and neighbouring ligaments may be subjected to stretching and compressive forces. If these forces are beyond what the Sacroiliac joint can endure, then dysfunction may occur. These forces can be delivered via bending, lifting, running, jumping etc.
Patient may experience pain at the base of their spine in the gluteal region, typically pain is felt on only one side and may radiate down the back of thigh, but rarely below the knee. Symptoms may be aggravated by crossing legs, going from seated to standing, ascending/descending stairs and running.
Alternatively, a pelvic misalignment, where one side becomes upwardly or downwardly rotated can also occur, causing similar symptoms. This may be associated with a muscular imbalance, joint stiffness or laxity associated with pregnancy.
Sciatica
Sciatica is in fact, not a diagnosis. It is a term commonly used to describe a symptom of an underlying medical condition such as a lumbar disc herniation, spinal stenosis, spondylolisthesis or piriformis syndrome. ‘Sciatica’ is usually used to label symptoms which consist of a line of pain which travels down one, or both of the legs. This can be accompanied by weakness, pins and needles or numbness.
