Lower Back Pain

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If you’re suffering from chronic back pain, Hands On Healing in Montgomery, Alabama offers an alternative, hands-on approach to help avoid the need for invasive surgical procedures.

Treating Back Pain – An Alternative Approach

Estimates indicate that over 300,000 surgeries are performed each year for lower back pain.

The same body of growing evidence also suggests that 10% – 39% of patients continue to suffer from pain or worsen. The majority of these surgeries primarily focus on the treatment of herniated disc conditions and symptoms.

The focus of this article is not back surgery, but an understanding of disc pathologies and why healthy posture can be the leading method for preventing invasive surgical procedures.

The Role of Vertebral Discs

Vertebral discs are a dual-layered design consisting of 20 concentric rings known as the annulus fibrosis, which surrounds a soft gel-like substance known as the nucleus pulposus. (See Figure 1, click to enlarge)

Each disc is designed to absorb the force and pressure created through movement/action that travels through the vertebral column.

When vertebral discs are healthy, e.g., good blood supply, no previous injuries, etc. with a well-maintained posture, the downward force exerted on the discs should ideally land as close to the center of the nucleus pulposus as possible.

This gel-like center then spreads equally in all directions against the more robust rings of the annulus fibrosis, thus absorbing the pressure.

Disc Herniation & Lower Back Pain

However, the story changes in an imbalanced body.

When downward pressure on the disc suddenly lands off to one side of the center of the gel, this causes the gel to exert its strength in the opposite direction of the force.

As time passes, this focused pressure begins to progressively overwhelm the rings that comprise the outer layers of the disc, thus allowing a portion of the gel-like center to move away from the middle of the disc.

Depending on the number of rings that are damaged, the disc will begin to bulge, as there are fewer layers to resist the outward moving pressure, and when completely broken and the gel center leaks out of the disc, a full herniation occurs.

Improving Posture is the Key

There are many methods used to treat these types of conditions in current medical practice.

At Hands On Healing, treatment approach is quite simple and elegant: we try to change the direction that the body exerts on the discs by improving posture.

Since the primary complaints with disc conditions are the symptoms of pain and discomfort, changing the direction of pressure on the disc back towards the center draws the force away from the nerves, thus helping to alleviate the pain.

Also, as a bonus, correcting postural alignment can help improve overall blood circulation, which allows for faster rates of healing to the discs.

No one should forego treatment by a medical doctor for any health condition, but bodywork is always an excellent choice for the non-invasive treatment that can help decrease pain and discomfort.

Psoas Muscle & Back Pain

When discussing many of the primary factors that contribute to lower back pain, no topic is more important than releasing the psoas muscle (pronounced “SO – as”).

And no, that’s not a typo. It’s spelled psoas (with a “p”).

These muscles (right side and left side) are unique and carry numerous responsibilities such as:

• Balancing the spine and upper body
• Protecting the lumbar nerve plexus
• Walking (a primary task of this muscle)

Like any other muscle in the body, everything from daily demands to injury can create a marked level of dysfunction in the tissue; however, this group of muscles requires particular attention because its effects are far reaching throughout the entire body.

In Figure 2 (click to enlarge), the psoas major is shaded green, showing its direct attachment to the lumbar spine (the muscle sits underneath the intestines), traveling right through the pelvis and attaching to the lesser trochanter of the femur (not visible in image).

This attachment from the spinal column directly to the leg is unique to the psoas, as every other muscle of the trunk and limbs attaches to the pelvis.

What Causes the Psoas Muscle to Tighten?

In previous posts, we’ve discussed how the hips can often time become restricted in their movements, thus forcing a shift to occur in areas of the body not created for that purpose.

When the psoas tries to move a restricted hip, the force is then applied directly to the lumbar spine, adding pressure to the vertebral discs and bone structures.

Tightness in the psoas most often radiates into the lower back, and at times into the groin and hip.

Simply put, the psoas is the most overlooked structure in the entire human body, creating resistance against the diaphragm through their shared attachment, creating breathing problems, and invading the nerves of the lumbar plexus (visible in the photo, penetrating right through the muscle) which impede normal function in the quadriceps.

Psoas Muscle Release

Much of this discussion here makes the psoas sound almost villainous.

In truth we would suffer immensely if the psoas did not provide the lumbar support that it does, and we would damage some of the most delicate parts of our body if it did not resist unhealthy movement.

Like any structure in the body, the psoas being loose and free to adjust to our daily environment allows the abuse we put ourselves through to move “out” of our bodies, instead of “in” against the bones and nerves.

The treatment of the psoas is sometimes tricky, requiring pressure to be applied through the abdomen to reach the front of the lumbar spine; but any person familiar with the work will endorse it as one of the most freeing experiences of his or her life.

Chronic Psoas Tightness

There are far-reaching complications related to chronic psoas tightness.

Lower back pain is quite possibly the most common complaint we receive as therapists, often followed by upper-back, neck, shoulder, and hip pain, all tied for second.

The most common discussion we have with our clients about their pain is that they’re all related. More often than not, each pain is a sign of compensation for some portion of the body that is otherwise not doing its fair share.

To give you an idea of why so many conditions are related, I want you to imagine looking at someone’s lower back, and I want you to try to see only the vertebral column (just the bones).

No muscles, no skin, just the bones.

Now when you look up to the shoulders, you see that the upper body is quite broad to be balancing on such a small structure like the spine, but that’s how we are built. With that image in mind, I now want to show what happens when the psoas major becomes too tight.

Figure 3 (click to enlarge) illustrates the torque exerted on the pelvis and spine by the psoas major previously described.

At this point, we imagine you have a whole new idea of how difficult this type of pressure can be on the spine, and how something like this can limit the entire support structure of the back.

Back Problems Caused by Psoas Dysfunction

The lack of function in the lower back translates over time to the recruitment of the hips or upper-back to keep us upright.

In the end, we must deal with a compensatory pain. It’s also common that psoas tightness is stronger on one side than the other, leading to spinal rotations.

Other influences from this exertion of force on the spine include:

• Disc degeneration
• Nerve impingement
• Radiating hip and leg pain
• Scoliosis
• Breathing difficulties

All of these are clear signs that the vertebral column has become highly disorganized and is beginning to apply pressure to spinal nerve roots.

Bodywork Therapy for Back Pain Relief

There’s no doubt that conditions related to psoas tightness range quite dramatically.

Much could be written about the numerous reasons to receive regular bodywork and treatment for this deceptively simple looking structure.

But, instead of using our hands for writing, we’ll put them to work getting your psoas back on track!