Clinical Massage and Back Pain
Causes:There are many causes for back pain – too many for this to be a complete list.
Low Back Pain Causes : Herniated discs, kidney stones, strains, sprains, misalignment of the spine, muscle spasms, muscle tightness, overdeveloped muscles, nerve impingement, spinal stenosis, spinal degeneration, disc compression, fibromyalgia, scoliosis, piriformis sydrome or false sciatica.
Upper Back Pain : Muscle spasms, spinal misalignments, heart attacks, indigestion, heart burn,
Signs/Symptoms: back stiffness, back pain, back tightness, hip pain, sciatica, pain down legs into feet, numbness in legs – to feet, limited range of motion.
Most Back injuries result from stresses due to poor posture, joint dysfunction, degeneration of the joints and psychological stress.
Bolstering: Many people will not be able to lie supine very long without back discomfort. Use bolsters to prop knees up and reduce the lumbar lordosis. Prone position may require a pillow under abdomen. Side Lying position may be the most comfortable.
Specific Muscle treatments:
Erectors may be too long or short depending on lumbar lordosis and anterior/posterior rotation of the pelvis.
Deep paraspinals used in sidebending and rotation of lumbar spine.
Psoas/iliacus- compress lumbar spine when tight. These muscles should lift and separate the vertebrae and support the spine. One side is usually tighter than the other meaning that the opposite side will not be working properly. Tight psoas muscles are also weak.
Quadratus Lumborum contributes to lumbar compression
Rectus femoris/tensor fascia lata pulls ASIS down and forward contriuting to anterior pelvic tilt.
Hamstrings when overly contracted pulls ischial tuberosity down contributing to posterior pelvic rotation
Abdominals when too tight or over developed compress spine and reduce effectiveness of the psoas muscle which supports the vertebrae
Gluteals and deep rotators tightness adds to hyperlordosis and anterior pelvic rotation.