My Back Is Sore Again…What The Heck Is Going On?

You bend forward to pick up that piece of paper on the floor and now your low back is in complete agony?  What happened?  Could one simple movement like that actually cause you to be in such pain or is it the accumulation of many things over a long period of time?

Option 2 is the correct answer.  Unless something traumatic happens, like falling down a staircase causing you to have low back pain, the pain is typically the result of having a less than efficient posture performing less than optimal movement patterns over a long period of time.  By the time you feel pain, changes in your tissues have been happening for a long time.  Your body has simply run out of compensations and is now letting you know there is a problem by causing you to feel pain.

I’ll summarize some pathoanatomical changes in both the zygapophyseal joints (Z Joints) and the intervertebral disc in your lumbar spine based on findings by Kirkaldy-Willis (1983).

First of all, to clarify, the Z joint (seen in picture 1 off to the sides of the centre of the spine) is a connection between 2 vertebrae (L4 on top of L5) where movement occurs.  So, when you are bending and twisting, the interaction between the vertebrae at these joints is one area that is allowing the movement to happen.  The disc (the cushion like piece seen in picture 2) is responsible for many things such as shock absorption between the bony pieces of your spine as well as aiding with movement and nutrition flow.   Lots of changes happen at these 2 areas as we go throughout our lives.

There are 3 stages of change:

Stage 1… Dysfunction

Stage 2… Instability

Stage 3… Stabilization

Stage 1 describes the initial changes that occur.  There is inflammation and softening of the cartilage around the joints and the discs experience microscopic tears, becoming larger causing the disc to herniate.  There is pain in this stage.

In Stage 2 the joints now experience laxity and continued cartilage degeneration.  The joints have too much movement in them because the ligaments are no longer as taut as they used to be.  The discs have herniated causing all sorts of problems followed by a process whereby your body starts to reabsorb the disc material and clean the area up for you.  People are still experiencing pain in this stage.

In Stage 3, your body is trying to deal with the extra laxity that has formed and is trying to make you more stable.  It lays down bone to do this which causes stiffening and possible stenosis, or narrowing of your spinal canal.  There is less and often no pain during this stage as everything has sealed up.

If the problems do not get attended to and this process repeats itself over and over again, the result is often an increased narrowing of the canal (stenosis) and spondylosis (a form of degenerative osteoarthritis).

The good news is there is alot of help for all of these stages.  Pain relief strategies, changing the biomechanics and movement patterns and educating someone as to what is going on and how to maintain as pain free a body as possible are essential.

Incorporating dynamic flexibility and stability exercises along with changing someone’s movement patterns is the best way to go.  Keep in mind this is not a quick fix as it has taken the body a long time to reach this particular stage.  The key is in how to empower yourself.  Once you have the knowledge of how to properly move your body, you can take this knowledge wherever you go!







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