Why does my back hurt?

Back pain can be debilitating. It is the leading cause of missed work in the U.S. It is annoying and can keep you from doing the things you love. As a Doctor of Physical Therapy, I see clients with back pain everyday. They are often frustrated and sometimes even feel helpless because no amount of massages, medication, or posture improvements seem to help. Some have been to countless appointments and tried every medication possible, but the pain does not subside. Although spines are complicated, it is very possible to find a solution for your pain if you pinpoint exactly what is going wrong. The Core The core plays a huge role in keeping your spine stable. Some of your most important abdominal muscles wrap around your torso like a corset and provide stability while you lift, bend, twist, work, and play. Without strength and stability in this area, you can lose stability of your spine or start using compensations for the lack of strength in other areas which can lead to pain and dysfunction. The Hips The hips attach to the pelvis which you can think of as an extension of your spine. Because of the close proximity of the hips to the spine, along with many muscle attachments at the hips that attach at or close to the spine, the hips can be a source of back pain. When your hips are stiff or weak, compensations happen in the low back that can lead to pain. The Upper Back Upper back stiffness is a common impairment in my low back patients (maybe because of our increased use of cellphones and computers?). Stiffness in the upper back can cause low back pain. Also, tight knots in the lower part of your upper back can cause referred pain right down into your lower back. The Pelvic Floor The pelvic floor muscles (your “bicycle seat muscles”) can be thought of as the bottom portion of your core. If these muscles are weak or have poor motor control, it can compromise the stability in your spine similar to abdominal muscles. Problems in this area can occur in men and women, but are common in women after childbirth. So what do I do? These are a few of the areas which can lead to low back pain. Not to mention neural involvement, disc and other structural issues, and the actual joints within the spine, plus more! If you have back pain, have you been to a healthcare provider who takes the time to evaluate each of these areas? MRI and x-ray imaging only goes so far and is being shown more and more in research to not correlate well with actual symptoms. To fully evaluate back pain, it is necessary to watch the way a person moves and bends, as well as check the strength, stability, and muscle/joint mobility in each area. If you have had MRI’s and been prescribed medications and other procedures, I urge you to have your back checked by a physical therapist. At Dr. Holly Physical Therapy, I work as a physical therapist and pride myself on taking the necessary time to check each possible cause of pain and narrow your diagnosis down to the real cause. If you do not find the true cause, how do you know the solution? Please check out my website at www.drhollypt.com or Instagram @drhollypt for more information on my practice.