At Lahore Chiropractor Spine Care, we treat lower back pain. Our methods include spinal adjustments, manual therapy, and rehabilitation for lumbar spine problems. Dr Asra Imtiaz is an ICA-certified chiropractor. She treats both acute and chronic lower back pain. Her approach is evidence-based and takes place in Lahore, Punjab, Pakistan.
What Is Lower Back Pain?
Lower back pain is discomfort in the lumbar spine. It happens between the ribcage and pelvis. The lumbar spine consists of five vertebrae (L1-L5) supporting body weight and enabling movement. Lower back pain impacts many parts of the body. It affects the vertebrae. It also affects the intervertebral discs. It also impacts the facet joints, paraspinal muscles, ligaments, and spinal nerves.
According to the World Health Organisation, lower back pain is the leading cause of disability globally.
The condition shows up as:
- Acute pain (less than 6 weeks)
- Subacute pain (6-12 weeks)
- Chronic pain (more than 12 weeks)
What Causes Lower Back Pain?
Lower back pain happens due to mechanical issues, structural damage, or nerve problems in the lumbar spine.
1. Mechanical Causes:
Muscle strain occurs when paraspinal muscles or erector spinae undergo overstretching or tearing. Ligament sprain affects the anterior longitudinal ligament, posterior longitudinal ligament, or iliolumbar ligament. Poor posture places excessive load on the lumbar vertebrae and intervertebral discs.
2. Structural Causes:
Lumbar disc herniation occurs when the nucleus pulposus pushes through the annulus fibrosus. This can compress spinal nerve roots. Degenerative disc disease involves loss of disc height and hydration in intervertebral discs. Facet joint arthritis causes cartilage deterioration in zygapophyseal joints. Spinal stenosis happens when the spinal canal narrows. Result: Squeeze the spinal cord or nerve roots.
3. Neurological Causes:
Sciatica occurs when the sciatic nerve undergoes compression at the L4, L5, or S1 nerve root level. Radiculopathy involves inflammation of the nerve roots, causing pain radiating into the lower extremities.
4. Contributing Factors:
A sedentary lifestyle weakens the core muscles that support the lumbar spine. Obesity increases mechanical stress on lumbar vertebrae and intervertebral discs. Repetitive lifting with improper technique strains lumbar structures. Age-related degeneration reduces disc hydration and vertebral bone density.
What Are the Symptoms of Lower Back Pain?
- Lower back pain has four main symptoms:
- Localized lumbar discomfort
- Reduced range of motion
- Muscle spasm
- Radiating pain
Localised Pain: Pain intensity ranges from mild aching to severe, sharp sensations in the lumbar region. Pain worsens with prolonged sitting, standing, or physical activity. Morning stiffness affects lumbar flexibility upon waking.
Movement Limitations: Reduced lumbar flexion restricts forward bending. Limited extension decreases backward bending capacity. Lateral flexion impairment affects side-to-side movement. Rotational restriction reduces twisting ability.
Muscle Involvement: Paraspinal muscle spasm results in an involuntary contraction, protecting injured tissues. Muscle guarding creates stiffness and restricted movement patterns. Trigger points in the quadratus lumborum, multifidus, or iliopsoas muscles produce referred pain.
Neurological Symptoms: Radicular pain moves from the lower back to the buttock, thigh, leg, or foot. It follows certain dermatome patterns. Numbness or tingling indicates nerve compression. Muscle weakness in the lower extremity suggests nerve root involvement. Foot drop occurs with L5 nerve root compression.
How Does Chiropractic Treatment Help Lower Back Pain?
Chiropractic treatment helps lower back pain. It uses spinal manipulation, manual therapy, and rehab. These methods focus on fixing biomechanical issues in the lumbar spine.
Spinal Manipulation: Spinal adjustment uses controlled force on stiff lumbar vertebrae. This helps restore normal joint movement. High-velocity low-amplitude (HVLA) thrust technique corrects vertebral misalignment. Manipulation releases entrapped synovial folds in facet joints. Joint cavitation produces an audible release during adjustment.
Research in the Journal of Manipulative and Physiological Therapeutics shows that spinal manipulation helps reduce pain and improve function for both acute and chronic lower back pain. A study in the Spine journal found spinal manipulation superior to medication for subacute lower back pain.
Manual Therapy: Mobilisation uses gentle oscillatory movements to improve the lumbar joint range of motion. Myofascial release targets restrictions in the fascia of paraspinal tissues. Soft tissue therapy reduces muscle tension in the erector spinae, quadratus lumborum, and psoas major. Trigger point therapy deactivates hyperactive muscle nodules that produce referred pain.
Therapeutic Exercise: Core stabilisation boosts the transversus abdominis, multifidus, and pelvic floor muscles. These muscles help stabilise the lumbar spine. Flexion exercises improve intervertebral disc nutrition through fluid exchange. Extension exercises strengthen erector spinae and reduce posterior disc pressure. Stretching increases flexibility in the hip flexors, hamstrings, and piriformis.
What Conditions Does Lower Back Pain Treatment Address?
Lahore Chiropractor Spine Care treats 8 main lumbar spine issues causing lower back pain:
- Disc herniation
- Sciatica
- Facet joint syndrome
- Muscle strain
- Degenerative disc disease
- Spinal stenosis
- Spondylolisthesis
- Sacroiliac joint dysfunction
Lumbar Disc Herniation: Treatment reduces nucleus pulposus protrusion through the flexion-distraction technique. Spinal decompression decreases intradiscal pressure, allowing herniated material retraction. Manual therapy improves annulus fibrosus healing.
Sciatica: Spinal adjustment reduces nerve root compression at the L4, L5, or S1 levels. Neural mobilisation techniques improve the gliding of the sciatic nerve. Piriformis muscle release decreases sciatic nerve entrapment.
Facet Joint Syndrome:
Manipulation restores normal facet joint mechanics at the L4-L5 or L5-S1 levels. Joint mobilisation reduces capsular adhesions. Anti-inflammatory modalities decrease synovial inflammation.
Muscle Strain: Soft-tissue therapy promotes the healing of strained paraspinal muscles. Therapeutic exercise prevents recurrent strain through strengthening. Postural correction reduces mechanical stress on lumbar musculature.
Degenerative Disc Disease:
Spinal manipulation maintains joint mobility, preventing further degeneration. Core strengthening reduces loading on degenerative discs. Traction therapy creates negative pressure, promoting disc rehydration.
Spinal Stenosis: Flexion-based exercises increase spinal canal diameter. Manual therapy improves facet joint mobility. Postural training reduces stenotic symptoms.
Spondylolisthesis: Stabilization exercises strengthen muscles, preventing progression of vertebral slippage. Spinal manipulation maintains joint function in adjacent segments. Core training improves lumbopelvic stability.
Sacroiliac Joint Dysfunction: Sacroiliac joint manipulation corrects joint hypomobility or hypermobility. Muscle energy techniques restore pelvic alignment. Stabilisation exercises strengthen gluteal muscles and core musculature.
How Is Lower Back Pain Diagnosed?
Diagnosing lower back pain includes four methods:
- Clinical history
- Physical examination
- Orthopedic testing
- Neurological evaluation
Clinical History: Pain location identifies the affected lumbar segments. Pain quality distinguishes mechanical pain (dull, aching) from neuropathic pain (burning, tingling). Aggravating factors reveal the movement patterns that cause symptoms. Relieving factors indicate beneficial positions or activities.
Physical Examination: Postural analysis evaluates lumbar lordosis, pelvic tilt, and spinal alignment. Palpation identifies muscle tension, trigger points, and vertebral tenderness.
- Range of motion testing checks:
- Flexion: 80-90 degrees
- Extension: 20-30 degrees
- Lateral Flexion: 25-30 degrees
- Rotation: 30-40 degrees
Orthopaedic Testing: The straight leg raise test detects sciatic nerve tension or a disc herniation. Patrick’s test (FABER) identifies sacroiliac joint or hip dysfunction. Kemp’s test reproduces facet joint pain through extension and rotation. The slump test evaluates neural tension in the sciatic nerve.
Neurological Evaluation: Dermatome testing maps sensory changes corresponding to specific nerve roots.
Myotome testing checks muscle strength at specific levels:
- L2 for hip flexion
- L3 for knee extension
- L4 for ankle dorsiflexion
- L5 for great toe extension
- S1 for ankle plantarflexion
- Reflex testing examines the patellar reflex (L4) and the Achilles reflex (S1).