6 Common Causes of Low Back Pain: Symptom vs. Problem

Video Transcription

Hi everybody. Dr. Brad Holden from HealthFirst Spine & Wellness. We’re here to teach you how to take control of your health by optimizing the core four of spine, mind, food, and move. Today we have a topic, the top six causes of lower back pain. Today’s video has a lot of information that we’re going to go through, because we want to give you the resources that you can start using to help solve why is that lower back pain there, and maybe give you the answer of why it has not gone away with other treatments yet.

Before we dive into today’s topic though, it’s important that we go over a couple terms. As I’m turning this I want to encourage you. If you like what we’re sharing with you today go ahead and subscribe to our channel, where we can bring you content each week on how to optimize the core four of spine, mind, food, and move. If you really get a lot out of today’s topic, go ahead and give us a thumbs up so we know we’re on the right track.

So the two definitions that are critical for us to know are the difference between a symptom and a problem, or the alarm and the cause. See lower back pain in itself is never a problem, it’s only a symptom. It’s only an alarm, so there’s something else going on that is actually causing the pain to be there. Yet so many times we get trapped and tricked into treating only the symptom, which allows a problem to go unresolved.

A real life example I can use is that of a car. Let’s say you’re driving down the road, and your oil light comes on in the car. Would you ever think you’re fixing that problem by putting a piece of tape over the light? Well the light is off, the problem must be gone. Of course you wouldn’t. You’d realize, okay, there’s something wrong with the oil. But I’m going to encourage you as we go through the different causes of the lower back pain that we’re always asking the question, what is the why behind the cause? What is the why behind that?

So for example in our oil analogy here, if the oil light comes on we know we’re losing oil. If we just start rushing to put more oil in the top of the engine, but we don’t figure out why it lost oil in the first place, we’re then again just treating the problem at a superficial level. Versus if we dig down deeper and we go, okay, do I have a oil pan leak? Do I have a hole in the oil pan? Is the engine block cracked and maybe leaking oil? Is the gasket bad? Why am I losing oil? When you figure that out and fix that the light will go off on its own.

That was a bit of lengthy explanation, but I think it’s important that we understand this before we go further. Let’s go ahead and dive into these top six causes, number one being muscle spasms. So for certain, muscle spasms in your lower back will cause pain. But I would bet if muscle spasms were the root cause that is causing the back pain, you’re probably not watching this video. Simple muscle spasms go away within two to three days without doing anything. We have this, everybody gets this periodically from either working in the yard too much, or maybe an increase in athletic events. You don’t do anything, and it heals up on its own. That’s not a big deal. What is a big deal is when muscle spasms are lasting for days, weeks, months, and many times years. There’s where we really have to put our detective hat on and dig deeper to find out why are those muscle spasms there. Ironically number two through six here many times will actually cause long standing muscle spasms.

So the first one we’re going to talk about is called the Facet Syndrome. Then we’re going to go into SI joint dysfunction. Then we’re going to talk about disk herniations. Then we’re going to talk about degeneration in the spine, or arthritis. Then we’re going to finally finish up with subluxation, or segmental joint dysfunction. Before we dive into two through six, again bear with me, let’s go through a little bit of spinal anatomy so you can better understand what we’re talking about as we look at the spine.

So an overview of the spine is if we look at the spine from the side, this is the back of the person’s head. They’re facing that direction right there. There should be a nice curve in the neck going forward, a nice curve in the lower back as well. As we look at the spine from the back we’ll notice these big dinosaur blades off the back here. Those are called the spinous processes. You can feel those along the back of your own spine, and even see those in the mirror if you take your shirt off. Along the back here, this is where the facet joints are at. So the facet joints are these joints down here that are set to glide back and forth right along there. So those are the facet joints that are supposed to move kind of like links on a bicycle chain.

Now the Si joints, which is the next thing we’re going to talk about, are these joints right along here, where the hip bones tie into the sacrum. We’re going to talk about that. So it’s these two bones right on the side there. Sometimes you can feel a little dimple in your lower back where those SI joints are at. Next thing we’re going to talk about are the disks. Now the disks, those are the shock absorbers that are between each of the vertebra. It’s actually like a jelly donut, with cartilage on the outside, with a jelly material on the inside. We’ll talk about the two things that happen with those. Usually it’s going to be bulged or torn, like this red spot right there, or they can actually dry up, become brittle, and begin to degenerate, which we’ll talk about here on number five. The last thing we’re going to talk about is subluxation. That’s just any time we injure any of these joints where the joints actually get stuck. So we’ll talk about each of these in more detail. I want to give you an overview before we get started.

So let’s dive into facet syndrome. So Facet Syndrome is where these joints in the back here, instead of being in a nice proper arc like this, they compress like this. So that curve in the lower back gets increased. That pressure itself, that constant pressure on the joints will create pain. Now the question is what causes the increased curvature? Remember we talked about the layers of it. So we said lower back pain can be caused from Facet Syndrome, where these get jammed up. What causes those to get jammed up? Well muscle imbalances can cause that to be jammed up. A condition called lower crossed syndrome can cause that. So we can have muscle imbalances where the hip flexors are too tight, the lower abdominals are too weak, etc., and some other muscle imbalances go along with that.

Also pregnancy can cause something like this for obvious reason, because there’s a lot of weight pulling the spine forward on the mom. Sometimes pendulous bellies, or being overweight can contribute to this. Sitting a lot can contribute to this, and cause this Facet Syndrome as well. So there’s a lot of different factors that can cause Facet Syndrome, one of which is actually having a neck problem. If you have a neck problem that causes your neck to go way far forward like this. You see a lot of people with this forward head syndrome like this. The first thing their body does is it compensates by shifting their thoracic spine back so they can stay balanced. Otherwise they would fall forward. Well just because of this neck problem compensation, that can actually cause Facet Syndrome in the lower back. So it’s important that we look at all these different areas so we can figure out why is the stress going to the lower back. Then we can fix that as well.

The next one is SI joint dysfunction. Again, that’s these joints, we see it on here in the lower part of the sacrum. Once again, pregnancy can cause that, because the ligament laxity, and all of the stress on the joint can cause SI joint dysfunction, either where the joint becomes loose because the ligaments have been damaged, or where the joint gets stuck from the joint being injured. If someone has a leg length inequality, where one leg is actually shorter than the other one to a significant degree, that can cause asymmetrical stress on this joint, and cause everyday activities to overload the joint to the point where it gets injured and irritated. Sometimes just trauma itself, falling down the stairs on your butt can cause damage to the SI joint. So really is comes down to is the SI joint stuck? Is it moving too much? Then what caused that? If you have one of these short legs, or some sort of muscle imbalance that’s putting more stress on that joint, we need to look at addressing that as well.

Moving right along. Disk herniation. Now the example, or analogy I like to use with the disk is that of a jelly donut. Where the outside of the disk is like a cartilage jelly donut. What happens in a herniation is where that cartilage gets weakened, where that jelly will push out in one of those sides there. Typically some signs that you have a disk herniation is if you’re bearing down, like you’re lifting something heavy, or maybe having a bowel movement, if that increases pain. If you’re coughing, and that increases lower back pain, or if you sneeze, and that causes lower back pain, that could indicate there is in face some bulging of the disk. But we need to look a level lower. If we have a bulging disk, why did that disk bulge? What biomechanical, or structural weakness was there that put extra stress on that disk to cause it to bulge? There can be a number of different things that need to be looked at to identify the cause of that disk herniation.

Let’s take a look at number five now, which is spinal degeneration and arthritis. So when we look at arthritis in the spine, there’s really two things that we’re going to look at. Number one is going to be what’s happening with the disk along here, and what’s happening with the bones along the joints there. In spinal arthritis we’ll notice that the disk is losing height, and we’ll also notice that there are bone spurs starting to develop along the edge of the bone. Any time we have those two things occurring, we have a higher likelihood of causing nerve and joint irritation, which for sure can cause pain.

What causes arthritis in the spine? Well in 2004 it was shown in a lab that what causes arthritis in the spine is in face number six, which is spinal subluxation, or spinal segmental dysfunction. Let me take a moment to explain that. Because in my experience this number six is a key player in a lot of these other issues that we talked about earlier there. If we look at this model here, this gives us an idea of how the spine should move. So each of these beads would represent a bone in the spine. So as we’re bending and moving, all these segments should be moving like links in a bicycle chain, if you will. Now the spinal joints are unique, compared to any other joint in the body, for one reason. If you sprain your ankle, and you injure that joint, the joint swells up, you lose range of motion in it, and it’s painful and sore. As the pain goes away, and you start using that joint again, you start forcing motion back into the joint, because it can’t really compensate. The spine is unique in the sense that when you injure the joint, the same thing happens. Like the ankle, you lose range of motion, it gets swollen and painful. But after the pain subsides, many times the segments above and below begin to compensate.

So you can be moving, bending, functioning fairly well, but inside those joints are not moving. Now this is important, because in between each bone in the spine, as we look at here on this model, that disk there needs intersegmental movement to pump nutrients into the disk, and squeeze the waste product out of the disk. So think of it like a disk sponge. As we squeeze the old water out of the sponge, we suck fresh water in. This exchange of fluid in and out is keeping it healthy. The same thing happens with our disk. So what happens to the disk if there’s no movement taking place? It will in fact begin to dry out and cause degeneration, and cause arthritis. These stuck joints in the body, in the spine, these compensations where the joints fail to move, those are the spinal subluxations. When the joints aren’t moving, then we get the pressure in the joints that can create pain.

So as we look at all of these different causes. We’ve talked about muscle imbalances. We’ve talked about posture. We’ve talked about compensation movements. We’ve talked about joints being stuck, or subluxated. There’s a lot of different factors that can go into lower back pain. I think where many people get frustrated is if they go to maybe a physical therapist, they really focus on the muscle imbalances. If they go to a chiropractor, they really focus on the joint dysfunction. If they go to their family doctor, they may be told it’s because you’re carrying 20 extra pounds of weight. Lose the weight and the pain will go away. People get frustrated because they do those things, and the pain is still there. We take a 360 approach. We consider everything. We consider body metrics. We consider postural alignment. We consider movement patterns, muscle imbalances, spinal mobility, and motion. We look at all of these factors. Then we put them cohesively into a plan of what is the biggest factor contributing to the lower back pain. What is the next factor, what is the next factor. Then create a strategy and a game plan of how do we resolve all those key issues involved.

So I know today’s video had a lot of information. Hopefully you stuck through to the end so we could answer all these questions for you. But if you like what you saw today, go ahead and give us a thumb’s up. Again, let us know we’re on the right track. If you have any suggestions for videos you would like to see, or questions that don’t make sense, or you need clarification for any of this, post them in the comment section and we will respond to you as well. Thank you for tuning in. Have an amazing day. Thank you.

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