CAPOW Series – Lower Back Pain

Lower Back Pain – It is something that most, if not all of us have had a massage treatment for – So how does our office job contribute towards it?

I know I’ve gone on saying a few times now, how the body is complex, well Lower Back Pain (LBP) is probably one of the most complex.  This is because there can be many different causes and to be honest there is no one real answer.

In fact, a meta-analysis of Lower Back pain treatments found that 90% of patients with LBP were diagnosed with ‘Non-specific lower back pain’ (NSLBP).

What does that even mean?

Well it just means that the diagnosis it not due to a recognized pathology. LBP is described as self-limiting, so that means overtime it generally will ‘heal’ itself.  However, I don’t know about you, but I do not want to spend weeks dealing with something that can have that much of an effect, that it accounts for almost 25% of absences from work.

So why mention it if the cause can’t always be found? I think because it highlights an important trait of quality massage therapists. We treat the person, not the condition. I always consider a lot of variables before discussing the treatment plan with my clients.  I ask a lot of questions, use testing and physical assessments to determine the best approach for that session based on the information that is provided.

That folks is what we call clinical reasoning!

The Culprits:

Hamstrings Group: Biceps Femoris, Semimembranosus & Semitendinosus which are responsible for Knee Flexion (Bending the Knee)

Commonly in office workers LBP is usually due to (you guessed it) postural strain.

When you are sitting at your desk unless you have ultimate control of your core and actively engage the muscles you need to keep you in a neutral spine, you will more than likely ‘slump’.

My clients comment so many times “I know I have a weak core” or “I need to do more back stretches or yoga” and those a great, I also need to do them.  Today however I am going to talk about your hamstrings.

In the ‘slump’ picture above you can see how the curve in our lumber spine (lower back) flattens out and this directly affects the pelvis by putting it in an Anterior Pelvic Tilt.

Also when you are sitting in your office chair, your knees are bent and if we look at where the hamstrings attach, we can see that that hamstring group is in a ‘shortened’ position.  After a long time of sitting, like we tend to do, that Anterior Pelvic tilt can contribute to the Lower Back Muscles being in a ‘lengthened’ and ‘taught’ position and then voila, LBP!

Of course, there could be many other contributing factors like a scoliosis, but hopefully I was able to highlight why most times I tend to target the hamstrings as part of my treatment.

Stretches / Strengthening:

First and foremost, if you are in a corporate setting, you will most likely have access to an Ergonomic Assessment.  Get one!  You will have an Occupational Therapist come in and assess your work station and make it function efficiently for your body and reduce those postural strains.

In addition the stretch that I commonly tell my clients to do is a seated hamstring stretch below.  The only things i would add are:

– Rather than moving back and forth, hold the stretch for 30-45 secs for at least 3 sets.

– Do not round your lower back any further.  Place your hands on your hips, squeeze your shoulder blades together and lean your trunk forward feeling a deep hamstring stretch but encouraging the natural lordotic curve.