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What is the cause and solution for Low Back Pain and Disc Disease

Low back pain comes with a variety of different names of diagnosis as below.

Low back pain, low back stiffness/achiness, Degenerative disc disease, herniated disc, bulging disc, sciatica, lumbar radiculopathy, stenosis, spondylolysis, spondylolisthesis, ankylosing spondylitis

The most common causes of low back pain are Myofascial origin and Disc related pathology in physical therapy.

Myofascial Release Therapy ➡️

Trigger Point Therapy ➡️

Myofascial origin low back pain is connective tissue dysfunction. Muscle, tendon and surrounding fascia get tight and develop trigger points. This poor quality of tissues limits smooth gliding movement of muscles. It also increases compression force in your spine and decreases circulation. The most common structures are as below.

  1. Hip flexors (iliacus, psoas muscle group)
  2. Quadratus Lumborum (Back and side muscle)
  3. Paraspinals (muscle groups supporting your spine)
  4. Abdominal myofascial tightness & tension (this tension compresses your spine)
  5. Gluteus Medius & Maximus
  6. Hip external rotators including Piriformis
  7. Oblique muscle group

Treatment solution: Releasing the adhesion/ scar tissue/ trigger point/ myofascial restriction by manual therapy including therapy tools is crucial in myofascial origin low back pain.

Manual Therapy to break up myofascial tightness (myofascial release, trigger point therapy, Glaston therapy, Therapy Gun, Spine Adjustment, Assistive stretching), Exercise program (stretching, strengthening), Education for self-release technique (patient can perform self-release using a tennis/ lacrosse ball, form roller), Home exercise program for prevention

Radiating pain towards buttocks, leg and foot can happen from herniated disc or hip external rotator muscle tightness entrapping sciatic nerve. Diagnosis can include Herniated disc, Bulging disc, degenerative disc disease, and sciatica. Important points in low back radicular pain are as below.

  1. Most Disc herniation gets better naturally with proper rehab treatment without any medication. Flexion movement will make symptom worse, so it should be avoided if you feel radiating symptom. Acute disc pain gets better with extension movement (bending backward) and applying ice.
  2. People who are inflexible and stiff with tight muscles have much more chance having disc disease since it increases compression force in your spine then disc will be bulging easily from stress.
  3. If Sciatica is from hip external rotators (piriformis syndrome), we need to release trigger point in the muscle and apply stretching. Patient will be educated to perform self-release skills and stretching.
  4. To prevent disc disease, the most important thing is to make core muscle group strong as well as maintain good flexibility. However, we need to be careful of too much weight training and high intensity exercise as it can make your body very stiff resulting in muscle weakness in a long term.
  5. Regular stretching and core exercise, Cobra exercise (lumbar extension), and proper sitting posture with lumbar support will decrease a chance of disc disease significantly.

Treatment solution: Knowing proper exercise movement and learning healing mechanism of disc are crucial in disc disease treatment.

Mckenzie exercise program, Manual Therapy (myofascial release, trigger point therapy, joint mobilization, spine adjustment), Home exercise prescription for proper disc healing mechanism, exercise program (stretching, strengthening, core exercise)

Other things to consider

  1. If low back pain reoccurs easily, we need to check their foot, ankle, knee, legs
  2. Unstable foot and ankle can cause stress in your knee, hip and spine
  3. Proper shoes should be recommended for carrying over treatment effect in daily life

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