Lower Back Pain

Lower Back Pain

Fabio Abrate D.O.Osteopathy   Sport Massage therapist

Pain in the spine is a fairly common disorder. The lumbar curve is highly adaptive due to the considerable capacity to move. Its function is precisely to compensate rigidity of 3 volumes between which is interposed: pelvis, skull and thoracic. Composed of thirty-three vertebrae, the spine supports the whole body. The vertebrae are connected to ligaments and muscles that enable us to perform all the movements and postures to assume the most articulate

The spine is divided into: cervical (seven vertebrae), thoracic (twelve vertebrae), lumbar (five vertebrae), sacral (five vertebrae), and coccyx. On the inside, ie in the "vertebral canal"flows the spinal cord. The vertebrae are separated from each other by intervertebral discs, real bearings which avoid the friction of these bones between them and amortize the movements absorbing the mechanical shocks that affect the vertebral column. The intervertebral disc consists of a nucleus pulposus (format for the 90% water) and an outer annulus fibrosus that contains it.

The most famous of back pain is the famous "lumbago" which arrives intense and sudden in the lower part while you are moving a weight. As the weight of the body is discharged mainly on the lumbar area, the state of suffering and the pain thereof, are defined as "low back pain", a 'largely benign clinical entity that improves spontaneously in a few weeks, reserving the most problems (chronic back pain ) to a restricted number of subjects.
In English, the pain is more appropriately called "low back pain" (pain in the lower part of the column). The pain is "
barrier", that transversal in the lower back with possible radiation to the sciatic nerve (sciatic pain ). When low back pain is chronically may be exacerbated by specific posture (eg, staying too long standing in the same position while driving or sitting in the car for long journeys).

This pathology affects at least 80% of the population at least once in their lifetime. Suffer the most are the people aged between 30 and 50 years, but there are cases of young people who are less than 20 years. The conditions that can determine the cause and the persistence of low back pain are numerous, sometimes not localized in the spine. The causes of this disorder, produce the phenomena of degeneration of the disc, that is, more or less premature aging of the intervertebral discs.

Analysis  from the  point of view osteopathic

Personally I think that lower back pain is caused in most cases by an underlying problem, and specifically from the point CARDINE( transition area) T11-T12/L1. Since T11 vertebra has most 6 ° rotation while T12 has a rotating almost anything and   side.
When this area loses its mobility, often painless (and 80% of the population suffer this loss of mobility), the spine is forced to overcompensate this loss of mobility, demanding more work especially to the lumbar vertebrae. Imagine this situation as a football team playing without two players, these will run more and very faint, just like our lumbar vertebrae, which at some point will lock ... and from there “ low back pain “

Are the muscles, deepest spine, especially the multifidi, toned muscles (muscles tireless) that go into spasm and hyper tonicity, and when this tonicity rises due a period of stress, fatigue or for attack of fever you can have a block CARDINE (Transition area)T11/t12/l1.

The lumbar vertebrae which will tend to "work" more will be especially L5 and L3.
A problematic of L5 will result in a reflex pain down the leg (
sciatic pain ), posteriorly and laterally to the knee and foot.

Important to know that the pain in the area of the buttocks and upper leg caused by the piriformis muscle spasm due to a dysfunction of motion of the ankle / knee and / or the sacroiliac joint and not as you think of a problem Lumbar (except in very rare cases).
The so-called "
lumbago" may be due to a lifting of a weight, when the position of flexion, we move into a position of extension of the column; pain is intense and immediate, verifiable at the lumbar level low, but always due to a loss of mobility, and in this specific case to a real  "distortion" vertebral level T12/L1.Less frequently, but not rare is the "lumbago" due to a sudden and abrupt movement from a position of flexion to an extension of the column, where however was already present a loss of partial mobility of the area Cardine T12/L1.

Analyzing the technical movements of the modern bowling, if done properly and the bowlers with an athletic body and prepared, I do not think that this movement is the primary cause of lower back pain or block of the cardo T12/L1, although for some subjects a particular movement particularly challenging

More likely that a loss of mobility at the level of T12/L1 (80% of the population), associated with a movement that requires particular lateral inclination, can cause an excessive work of the lumbar vertebrae and long term a block of the same, but this loss of mobility, in these individuals would happen anyway. These people are programmed to have a herniated lower back or a  discopathy (L4-L5 the most frequent) irrespective from work or physical activity. Clearly an intense stressful working (mason, carpenter, joiner, driver) or a sport that combines flexion / extension movements of tilt / rotation favors the appearance of these problems.