I have been a bodywork therapist for more than fifteen years. My expertise includes Shiatsu, Thai Massage. I am also a registered acupuncturist with additional training in sports medicine acupuncture for orthopaedic disorders. One of the most prevalent and debilitating conditions I treat is lower back pain.

Acute vs chronic back pain

When addressing lower back pain, it’s important to differentiate between acute and chronic conditions. An acute condition may be an injury that happened a few days or weeks ago or a sudden pain that started recently. A chronic condition is pain that is recurrent or constant and has been present for more than three months.

As a rule, acute issues are easier to treat because the body is still strong and hasn’t been debilitated by ongoing pain. A body with chronic pain is weakened both by pain and by compensatory abnormalities or restrictions in movement. Chronic lower back pain may be the result of an old injury, bad posture, improper diet, stress, lack of exercise, or digestive or menstrual problems. All applicable causes must be addressed to correct the condition.

Once we assess and identify the type of pain, we can decide what kind of treatment is appropriate.

The assessment

Assessment starts with diagnostic questions then moves on to orthopaedic and muscle imbalance testing. Diagnostic questions explore the history of the pain and identify symptoms and lifestyle considerations. The orthopaedic assessment addresses the alignment of the hipbones and sacrum. In 90% of cases where lower back pain is present, there is a structural misalignment that needs to be addressed.

We first check the position of the hipbones. They may be tilted to the front (figure 1), which causes constriction of the lower back, or to the back (figure 2), which causes weakness and poor stability in the lower back.

We then test the sacroiliac joint for movement. The sacroiliac joint connects the sacrum bone to both hipbones or iliac bones (figure 3). It is often locked on one or both sides when lower back problems are present. Finally, we conduct muscle testing to reveal which muscles are weak or not firing well, and which muscles are working harder to compensate, causing fatigue, weakness, pain, and misalignment. Muscle malfunction can be either the cause of the problem or the result of an alignment issue. For example, if the gluteal muscles are weak, the hip will tilt forward because they cannot hold it in the correct position.

 

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