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  • JH Backcountry Health

Creating a Healthy Back

Almost a fifth of US adults experience back pain in a given year and up to 80% in their lifetime.

People have long been going to chiropractors for low-back pain and there is plenty of research to substantiate the practice. Systematic reviews show that chiropractic care decreases pain and disability both in the short-term and the long-term.

What type of back pain can we help alleviate?

  • That jarring pain you get when bending over.

  • That pinching hitch-in-your-giddyup as you walk.

  • The sharp zinger down the back of your leg.

Whether it is low back muscle spasm, sacroiliac joint dysfunction, or a disc-related sciatica, the majority of low-back pain is mechanical, a result of an aberrant movement while shoveling heavy snow or from chronic posture or gait patterns. Addressing the muscles and other soft tissue as well as the joint mechanics gets to the root of the problem, as opposed to masking it with painkillers.

Often back pain is related to sacroiliac joint dysfunction; this is where the sacrum, the end of the spine, attaches to the ilium, the pelvis. Hours sitting puts excess pressure through the joint. Our favorite activities of hiking, biking, running, and skinning result in tight hip flexors- especially when we work them and then sit for hours leaving them in the shortened position. When we stand up, the pull on our low back where the psoas attaches and on the pelvis where the iliacus attaches leads to anterior pelvic tilt. This is even more the case when we have weak gluteal muscles (since we sit on them all day) and abdominal muscles. As a result of our lack of core stability, the low back is subject to excess motion which can irritate the SI joint or facet joints of the vertebrae in the low back. In addition, some of the muscles that are trying to stabilize the low back get overworked and go into angry spasms. Those knots in your buttocks are often an irate glute medius. The tight low back keeping you from touching your toes- the quadratus lumborum or QL which is tired of getting yanked around.

Perhaps the most feared low back condition is sciatica. Shooting pain down your leg. So often we have patients with radiating pain from their low back or buttocks, and they are afraid they are destined for surgery. Most often, they don’t need surgery; chiropractic and other conservative care can fully address the pain and radiation.

What is true Sciatica?

According to the Mayo Clinic, “Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.”

Causes of sciatica include

  • herniated discs (most common)

  • bone spurs

  • spinal stenosis

  • abnormalities in the lumbar vertebrae

Sciatic Nerve Pain that isn’t Sciatica

The sciatic nerve can get trapped in other locations, and impingement and nerve irritation can lead to radiating pain, numbness or tingling that isn’t technically sciatica. The most common spot is where the sciatic nerve pierces the piriformis muscle (causing Piriformis Syndrome). Other areas of entrapment are other hip rotators (such as gemellus superior), between the hamstrings, and on top of adductor magnus deep in the back of your thigh. This can cause radiating pain down the back of your leg right along the path of the sciatic. As chiropractors, sciatic pain is something we treat all the time.

Chiropractic Care for Sciatic Nerve Pain

Adjusting the low back and pelvis can help greatly with the nerve root impingement that causes sciatica. Addressing the muscles and fascia using Active Release Techniques and other muscle work can free up the sciatic nerve as it travels down the leg. As sports chiropractors, we also look at your posture and movement patterns to find out what caused the irritation and give you exercises and stretches so you can avoid having it occur again.

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