Today I want to discuss one of the most common injuries we see, low back pain. In the clinic I would say about 80-90% of patients experience some type of low back pain throughout their course of care. 

Low back pain is extremely common in all adults. More often than not, we can treat it and get people back doing the things they love. However, the truth is, low back pain is not “simple”. 

What is Mechanical Lower Back Pain?

The cause of most low back pain is from mechanical stress. Lower back pain caused by mechanical stress means that the source of the pain may be triggered through the wear and tear of the body, especially the movements of the spine. Mechanical back pain is triggered when a structure in the back, like an intervertebral disc, joint or a bone, is stressed, causing pain. 

There are no magic exercises that are going to help “fix” your low back pain! Every person that comes in with some type of low back pain symptoms can have significantly different presentations and root causes for influencing their pain.

First and foremost, if you are experiencing low back pain, go get yourself checked out by a skilled physical therapist. When you work with a physical therapist, they can identify the root cause of lower back pain and get you headed in the right direction. 

Common Causes of Low Back Pain

There are some common causes of low back pain that we see in clinic that you can keep an eye on to limit the amount of discomfort you may be in. Most common issues we see in clinic stem from mismanagement of what we call mechanical stressors. 

Mechanical stressors can be either load sensitivity, neural tension, or a positional sensitivity. So, let’s dive in…

Load Sensitivity 

A load sensitivity means that increased load on your spine is causing excess compression which could be leading to your low back pain. What this means is, any position in which you are leaning forward, sitting, or loading with physical weight can trigger your low back pain. 

Load sensitivities typically present with increased discomfort in the mornings, a period of improvement, and then increased symptoms at the end of the night. Avoiding positions that load the spine and good movement mechanics can minimize load and improve symptoms. Deloading the spine through techniques on the ground or in hanging positions can also decrease symptoms.

Neural Tension Sensitivity

Neural tension sensitivity means that one of the nerves of your back is irritated and sensitive to being stretched through different positions. A lot of times “L” shaped positions such as driving, lifting, sitting with feet up, etc. can lead to increased tension on the nerve leading to increased tension at the low back. Commonly described as dull achy pain in the back, hamstring or even the calf. 

Positions that put these areas on stretch or a combination of movements that elongate that nerve commonly trigger low back pain. Avoiding “L” shaped positions and being mindful of movement mechanics can help decrease symptoms from neural tension.

Positional Sensitivity

Positional sensitivity refers to pain at the low back caused by prolonged positioning or movement in a certain direction/position. For example, if every time you lean forward you experience pain, you could be experiencing a positional sensitivity. 

Prolonged sitting or standing that leads to low back pain can also be due to a positional sensitivity. This pain is very movement specific and does not present when not in that direction/position.

In Closing: Addressing Mechanical Lower Back Pain

As you can now see, low back pain is COMPLICATED! The categories above are just a glimpse into what COULD be contributing to your back pain. All of this and we haven’t even discussed the anatomy around the back, kinematics of surrounding joints, or the physiology occurring in the body.

So… what should you do if you're currently experiencing low back pain caused by mechanical stress?

Go get checked out by a physical therapist! Do not resort to medications, injections, or even possibly surgery. A skilled physical therapist can help solve the root cause of your problem and help guide you to a pain/restriction free lifestyle!

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Have you tried all these suggestions and you are still experiencing pain in your back? If you’re sick of getting the runaround and want to see if we might be a good fit, click here to schedule a free phone consultation with our team of West Springfield Physical Therapists.