Common Causes of Low Back Pain in PT

Low back pain is one of the most common diagnoses I treat and over 80% of Americans will experience at some point in their life. While there are many causes of low back pain, I’m going to highlight the four general causes I see most commonly in clinic, but I don’t want to give the impression that there aren’t many other causes of back pain.  

1. Spondylosis

Spondylosis is a common, age-related change of the vertebrae and discs also known as osteoarthritis and degenerative disc disease. The discs will stiffen and may lose disc height and break down; the vertebrae may develop bone spurs and lose height as well. Patients can have spondylosis without symptoms, but it commonly presents as pain and stiffness which are usually worse in the morning. The degenerative changes of the disc and vertebrae can result in nerve root compression which may cause numbness, tingling, weakness, achy or shooting pain into buttock and leg.

2. Disc

The intervertebral disc is located between vertebral bodies and acts as a shock absorber. It’s composed of an inner nucleus pulposus, outer annulus fibrosus, and endplates which attach to the vertebrae. It’s important to remember you can have a disc herniation and not have symptoms which is why we don’t recommend patients rush out and get an MRI because you are not your imaging. Discs will naturally become lose their water content as we age and become less flexible which makes them more prone to injury. Most disc herniations aren’t exactly the result of a specific injury or trauma, but more the result of “the straw that broke the camel’s back” with bending over, twisting, or lifting a heavy object. Patients will commonly experience pain into their leg which can be sharp, shooting, burning, or electrical, weakness of lower extremity muscles, and numbness and tingling.

3. Segmental Dysfunction

This can be a pretty all-encompassing the pain is usually the result of too much or too little motion at a spinal segment. Patients will experience short, episodic pain that will be highly irritated for short duration. They will usually have movements into either flexion or extension that will provoke their pain. These patients usually respond well to early intervention including spinal mobilizations or manipulations followed by stabilization exercises.

4. Motor Dysfunction

This is also a broad category, but I find that patients lacking appropriate muscle control, primarily of their core musculature, fall into this final common group. Patients are usually younger and maintain full ROM and appropriate joint glide and mobility. They usually have little to no pain initially with an activity, but with repetition and fatigue, they will experience pain and functional limitations. The pain can result in inhibition and impairment of muscle control and they lack appropriate core stabilization.  On the opposite end of the spectrum, patients can have too much movement at a joint and that can be problematic because normal muscle control can’t maintain proper motor control in the increased joint motion.

If you are interested in learning more or about treatment options, don’t hesitate to call/text 701-318-4731 or email alison@pinnalcetherapywellness.com to learn how we can help. Don’t forget to follow on Facebook and Instagram to stay up to date on the happenings at Pinnacle Therapy & Wellness.