Understanding Chronic Low Back Pain

by Gord Grant, Ph.D., R.Ac.

Understanding Chronic Low Back Pain:  This article will help explain the nature of chronic back pain, and show how acupuncture can help get you back on track. Although  many cases of lower back pain are self-limiting and get better on their
 own, they often develop into a chronic problem.  These account for a  huge proportion of healthcare expenditures and reduced productivity and  quality of life.

Sometimes  back pain can be related to a specific injury, but more often than not,  the actual moment of injury is trivial, such as in bending over,  twisting, or otherwise putting a rather “normal” strain on your back.   From this perspective, the majority of times when you “put your back  out”, it is “the last straw on the camel’s back” that makes it yield to the load.  It is the result of the myriad little traumas and subsequent postural distortions accumulated over the years in your low back, pelvis and hips.

The  pelvis represents an amazing centre for forces to be transmitted  between the head and torso above to the legs below.  The curvature of  the low back (and neck) is unique to bipedal species like us humans.   This design serves as a great shock absorber allowing us to walk  vertically with a relatively smooth, non-jarring motion.  The drawback  to a curved spine is that it is particularly vulnerable to damage, especially when wear and tear of joints, muscles and sinews  put the spine, pelvis and hips out of whack.

A sedentary lifestyle can create weaknesses in muscles and loss of flexibility causing postural quirks and imbalances.  Even for those who do get exercise routinely, in can be in the context of unhealthy extremes of being relatively inactive for most of the day and then trying to get exercise in all at once at the end of the day or on weekends. The low back/hip postural  problems that build up over time make  us vulnerable to tightening and  weakening of key postural back and hip muscles.  This sets the stage for soft tissue  strains in associated muscles, sinews and ligaments when you do a workout, and ultimately  intervertebral disc degeneration in the spine and significant pathologies  in pelvic structure.

How Acupuncture Can Help?  To  treat lower back pain, the extent, location, and quality of the pain is  determined.  Aside from acknowledging all medical history and  diagnoses provided, I perform a physical assessment to measure any  misalignment of the spine, pelvis, and hips.  I then do specific muscle  strength, range of motion, and orthopedic assessments to account for muscle-sinew abnormalities  that could  be related to the pain directly or indirectly.  Often many  of the low back and  hip muscles are contracted or weakened to protect  the actual area of damage or  inflammation, and the acupuncturist can  identify patterns of holding that need  to be released before healing can  commence.

Although  it is understood that acupuncture needles cause a remote release  of endorphins in the spinal cord and brain to reduce pain, the  ultimate significance of the needles is something more fundamental.   When a needle is inserted into a tight muscle or sinew at special  locations called motor points, the whole associated tissue train can be  relaxed.  When properly used, acupuncture can break the vicious cycle  of spasmed muscles and tight tissues associated with low back pain.  Over-contracted, strained, tight muscles relax to restore both blood  flow and a more natural posture that requires less compensatory “holding and protecting” from other muscle groups.

This sets the stage for a return to  more efficient movement and the possibility of the patient restructuring  the tissue during recovery through proper rehabilitative exercises.  Continuing life or training without addressing the postural imbalances can in effect “fix” even further the postural distortions which predispose the patient to further injury.