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“Why does my lower back hurt?”

By Dr. Michael Lian, PT, DPT


It’s a simple question with a complicated answer. There are a lot of reasons your back can hurt but I’m going to discuss two of the most common causes I see in our clinics. To better understand why low back pain happens, let’s look at basic anatomy that is most likely to be involved in the problem.



 

(1)  The Spine: Comprised of spinal segments (vertebra), each separated by a squishy flat disk.


(2)  The Spinal Cord: Coming down from your brain, going down the back of the spinal segments, with little branches coming out that turn into your nerves (which then branch out to your whole body).


(3)  The Natural Curve of Your Spine: Should curve forward a bit in your stomach area, and then curve back a little bit in your chest area.






In the simplest terms possible, if your lower back hurts (for physical therapy related reasons), it is probably due to something in your back being pushed too far. The most common reason I see for lower back pain is if the curve (#3) in your lower back is curving a little too far forward. This can lead to those nerves (#2) in your back getting squished by the spinal segments. This can present as general lower back pain, or potentially be involved in your classic signs of sciatica if it affects some of your lower extremities.


Another common reason is the instability of your spinal segments (#1). If the segments lack support and move too easily, this can lead to them putting strain on the spinal cord and nerves (#2) every time a little bit of force goes through the spine. This can lead to back pain with activities like pushing and pulling, or anything that might involve needing your body to be stable. Everyday activities such as pulling groceries from the car or reaching up to grab something in the closet can trigger a terribly painful episode.


Back pain isn’t always due to one cause. Fixing your posture and strengthening your abdominal muscles are easy ways to deal with both issues above, but you’ll want to make sure you do it correctly and carefully, especially if you already have lower back pain. You don’t need a six-pack to protect your back, but if you notice yourself slouching forward while sitting or needing to bend your knees while lying down, a little bit of core strengthening could go a long way.


If you feel like your back pain is stopping you from enjoying life or completing your work, talk to a medical doctor or a physical therapist and see if there’s something you can do to decrease the pain. Stay tuned for our next articles covering easy to do stretches and exercises that can help reduce lower back pain or keep your back strong for years to come.

 

About our CTS Therapist: Dr. Michael Lian’s goal is to provide care, therapy, and teaching, all guided by the latest research and best practices. He earned his Doctorate in Physical Therapy at Chapman University and is a Licensed PT in the state of California. Fun Facts about Michael are that he is an avid baker, computer enthusiast, and hiker.

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