Lower back pain?

Osteopathy and back pain

Back complaints are very common. Lower back pain in particular is something osteopaths see often in their practice.

Back pain is unpleasant and drains your energy. Sometimes the pain is so severe that the patient can no longer work. In most cases no clear cause for the back pain can be found. Yet the pain is very real. Osteopathy can bring about an improvement in back complaints.

In osteopathy we look at the causes of the back pain. Sometimes those causes lie outside the back itself, for example in its connection with organs such as the intestines or the kidneys. The osteopath always examines the whole body in order to treat and resolve the back pain.

Various studies have shown that osteopathy is effective in many cases in the treatment of (lower) back pain.

Types of back pain

There are many types of back pain:

• The pain can be nagging or sharp
• The pain can occur with certain postures or movements (e.g. bending over or turning over in bed)
• There may be pain radiating into one or both legs (sciatica)
• You may feel tingling in your legs or buttocks
• You may feel stiff after sitting for a while

Most back complaints go away on their own. When back pain lasts longer than three months, we call it chronic back pain.

Causes of back pain

In most patients with back complaints, the cause of their pain is hard to find. X-rays or scans show no abnormalities, even though there is pain. This common or non-specific back pain can have various causes:

• Heavy physical work (e.g. paving)
• A sedentary job (e.g. working at a computer or driving)
• Poor posture
• Prolonged stress
• Poor or reduced fitness and weak muscles due to lack of exercise
• Overload from too much sport
• Being overweight

In around 5% of cases the cause of the back pain is known and medical examination does reveal an abnormality. Examples include:

• A damaged intervertebral disc (herniated disc)
• Wear and tear (osteoarthritis)
• Ankylosing spondylitis (Bechterew’s disease)
• Arthritis
• Slipped vertebrae or displaced joints
• Pelvic instability
• Cancer

What does an osteopath do for back pain?

Treatment of lower or upper back pain always starts with an intake, in which the osteopath asks about the nature of the back complaints, the patient’s medical history, lifestyle and previous treatments. Often the patient has already been treated by a GP and physiotherapist, but the complaints have not gone away.

After the intake the osteopath will examine the back, but also the rest of the body, to see how the mobility of muscles, tissues and organs is affecting the complaints. Sometimes the cause of the back pain is not in the back but elsewhere. Lower back pain can, for example, be caused by adhesions after surgery, blockages in the bowel (IBS, constipation) or reduced mobility of the surrounding organs. Lower back pain can also be caused by restricted function of the hip or pelvis, or by reduced mobility in the upper or lower spine.

Once the osteopath has found the cause of the reduced mobility, treatment will focus on restoring that mobility. The body will then heal itself and the pain will usually ease.

To give a few examples:

• Restricted movement or hypermobility in the lower back itself and the SI joints, but also in the rest of the spine, can lead to overloading of the lower back.
• A blocked joint in the foot can lead to a faulty movement pattern in the back.
• Movement restrictions that develop after surgery, for example on the meniscus or anterior cruciate ligament in the knee, can eventually lead to overcompensation in the back.
• For athletes it is also very important to visit an osteopath after a physical trauma. If you ask a lot of your body, even the smallest disturbances can eventually lead to troublesome injuries.
• The organs can also play an important role: a kidney that does not move properly could explain pain in the flank. Adhesions in the abdomen, for example after removal of the appendix or uterus, can also cause back pain!

There are, of course, many other causes of lower back pain. It is important to know that you are generally not aware of movement restrictions in your body.