Nine times out of ten people diagnosing the cause of lower back pain miss the point.
People with lower back pain will be told that the cause of the pain is a herniated disc. Of course that may be right, but the question, 'What's the cause of the herniated disc?' It is rarely contemplated. The diagnosis is therefore inadequate. In fact it's well nigh useless.
And if the diagnosis is useless then so is the treatment. Would you put your car in the hands of a mechanic who did not know the cause of problem? Of course not. So why put your body in the hands of a therapist who did not know the cause of the problem? You're wasting your money.
The ultimate cause of most herniated discs is tight calf, hamstring and buttock muscles that drag the pelvis out of alignment. It gets tilted back, rotated around and one side will become lower than the other.
The problem is exacerbated by weak trunk muscles – front, back and core. (In fact strong trunk muscles may well save you from lower back problems by acting like a corset to support the bones of the back in their misaligned state; but tight calf, hamstring and buttock muscles continue their persistent march toward dysfunction.)
Once the pelvis moves out of alignment, the bones above it get taken out of alignment, putting pressure on muscles, tendons, ligaments and discs.
Gradually over the weeks, months, years and decades the nucleus of the disc gets squeezed out. You do not know this is happening. In fact you could be 99% of the way to having a herniated disc and think your back is in great shape.
Then one day you swivel around to pick up a phone book, or put a bag of fertilizer into the trunk of your car and BAMMO, you've got a herniated disc. The immediate incident gets the blame. If it happens at work, work will get the blame and the full responsibility for fixing you up. Hello!
With a badly herniated disc you can not sneeze or cough it hurts so much. You can not put on your socks, you can not bend over the basin to brush your teeth.
In a vapid and useless explanation, your doctor will tell you your back pain is caused by your herniated disc. Your radiologist will give you no advice whatever as to the cause. They are not allowed an opinion as to causation. Their job starts and finishes with a description of what they see on the X-ray.
WHAT'S REALLY GOING ON
You can read all about what's really going on at the Global Back Care and Egoscue websites.
You will not get much solace from the orthopods, chiros and physios. They get side-tracked by the pain; they continue to look at and rub, crunch, shock and heat up the point where it hurts – rather than teaching you to loosen the tight muscles that have caused the problem in the first place.
Two key principles:
1. Bones do what muscles tell them to do. This knocks chiropractic into a cocked hat. The physios are not looking too good either. They'll go for the quick fix; they'll go for the palliative palpitation, then stick you in a room with ten other people and hook you up to a machine.
The long term fix is a strength and flexibility training program, though, to be fair, even in the acute phase, a few hours doing some simple stretches will relieve a lot of pain.
Any therapist that does not send you away having taught you a dozen or so key strength and flexibility exercises is falling down on the job. They want you to come back.
2. The cause of the pain is rarely at the site of the pain.
So there you have it. Do not ask what your therapist can do for you, ask what you can do for yourself. You can not subcontract out your own strength and flexibility training program.
You do not have to spend a fortune at the therapists, just an hour or two each night for a couple of months, doing the exercises in front of TV.