Lower back pain
Lower back and pelvis problems
Backache or lumbago is the collective name for all sorts of painful back problems. At least 80% of the population will suffer from lower back pain at least once in their lives, while 50% has backache more often. Most lower back problems are caused by poor posture, overweight, lack of exercise, a fall, or stress or tension. These triggers can result in dysfunctional movement of the inter-vertebral joints (facet joints). As soon as an improper movement occurs, the intervertebral disc is put under excessive strain, which in turn places strain on the surrounding structures. The result is an irritation of the pain nerves while the ‘good’ movement nerves are suppressed. This can lead to various types of pain: from a nagging, continuous pain to sharp pains in the back, to shooting pains in the legs.
Back pain can be felt during or shortly after the strain occurs, or after a few hours or days. A chiropractor is expert at treating problems of the lower back. Apart from treating the complaint, the chiropractor can also work to prevent. Regular check-ups and advice specific to the patient will prevent further damage to the spinal column and central nervous system.
Lumbago is the popular name for acute lower back pain. While this is often the diagnosis, in fact it is not a specific condition. A sudden wrong movement, often in combination with bending and twisting, can trigger this acute back pain. The pain is often coupled with cramping of the lower back muscles, comparable to cramp in the lower leg.
If lumbago is not treated properly, it can become a recurring problem. Even if the symptoms seem to have disappeared, the cause itself may not have disappeared. This makes it important to always be checked by a chiropractor after an attack of acute back pain. This will help prevent further problems.
The pelvis is the base on which the spinal column rests. It consists of three bones: the sacrum and the two pelvic, or hip, bones. These three bones are connected to each other at the back by the sacroiliac joints (SI joints). These joints are a common source of pain.
The SI joints can become too mobile, a condition known as hypermobility. This can arise after pregnancy and can lead to pelvic instability. The SI joints may be blocked, an underlying cause of a tilted pelvis. The result of this is a leaning to one side placing a burden on the rest of the spinal column. This can again lead to lower back problems, and in some cases even to complaints in the upper back and neck. Pain emanating from the SI joints can give rise to localized buttock pain, but also to pain around the area of a trousers belt, in the groin, the pubis or legs. Pain will be felt when sitting or standing for too long, bending or lifting. Exercise, and in particular walking, reduces the complaints. Pelvis problems and SI problems can be successfully treated by a chiropractor.
Sciatica is an inflammation of the sciatic nerve. This nerve runs from the lowest part of the spinal column along the buttocks to the foot. Sciatica is often caused by a dysfunction in the lower back and pelvis. A dull pain low in the back can signal the start of sciatica. If sciatica is allowed to develop, it can result in sharp or burning nerve pain in the buttocks and spreading to the legs. The pain usually spreads to the entire leg, but sometimes is only felt in the calf or the upper leg. Some sciatica patients never even have discomfort in the back.
Given that the symptoms of sciatica and hernia are so similar, the diagnosis is often wrong. A chiropractor has the expertise to trace the blockages in the spinal column and is thus able to make an accurate diagnosis.
A hernia – or hernia nucleus pulposus to give it its full name – is a common disorder of the lower back. Only about 50% of patients display any symptoms. A hernia is a tear in the outer ring of the intervertebral joints (anulus fibrosus), allowing the soft centre (nucleus pulposus) to protrude outwards. A hernia is usually caused by the improper functioning of the spinal column over a long period of time. The bulging of the hernia pressing against the nerve tissue is what causes the pain. The bulging of the intervertebral joint – the hernia – can occur when the soft centre puts pressure on the outside layer. In the early stage, the layer may bulge slightly outwards. At this stage it is called a protrusion. The pain associated with a protrusion can occur suddenly and often as a result of a bending or twisting movement. At a later stage, the “gel” pushes its way through the hard outside layer through ruptures or small tears. This is called a prolapse. These symptoms often arise gradually.
Hernias can also occur in the neck or the upper back, though this is less common than in the lower back. Many people automatically assume that pain in the legs is a hernia. In practice though, only 10% of patients with pain in the legs have a hernia, the other 90% suffer from something else. Hernias are not visible on an ordinary X-ray. A scan (MRI or CT) is required to make an accurate diagnosis. A scan will reveal whether the condition is indeed a hernia or direct pressure of a hernia on the root of the nerve.
In general, a conservative non-invasive treatment is undertaken. The chiropractor can play an important role in the treatment of hernias. Good results can be attained using specific treatment techniques and a special chiropractic table. An operation is only a consideration in cases of progressive loss of nerves and/or unbearable pain.
Many of our patients are from The Hague, Wassenaar, Delft, Rijswijk, Zoetermeer, Voorburg, Voorschoten, Randstad and Zuid-Holland