Where lower back pain comes from
The lumbar spine transfers load from the trunk to the pelvis, so it reacts to everything happening above and below it. When the hips lose mobility and the thoracic spine stiffens up from sitting, the lower back starts making up for both. Add weak glutes and trunk muscles, and one careless movement is enough for pain to appear.
That is why therapy aimed only at the painful spot often works for a few days. Lasting improvement means changing whatever is overloading the area.
Is pain radiating into the leg always sciatica?
No. Pain can radiate into the buttock and thigh when the facet joints are irritated, or from trigger points in the gluteal muscles. We talk about sciatica when the pain runs along the sciatic nerve and usually travels below the knee – often, though not always, with altered sensation or loss of strength. Telling these situations apart is one of the basic jobs of the assessment at the first visit.
What to expect
At the first visit we take a history and carry out a functional assessment, and then move straight on to treatment – you do not pay separately for a consultation on its own. You leave knowing what is causing the problem, with specific advice for the days ahead.
Over the following weeks we gradually shift the emphasis from treatment to movement: from exercises that control position, through strengthening, to learning to lift safely and returning to full loads in training.
Desk work and back pain
Sitting itself does not wreck your spine – the problem is staying still. The body does not like holding one position for eight hours, however good the chair is. The simplest change you can make from tomorrow is to stand up every 30–40 minutes and do a few movements in the opposite direction to the one you hold at the computer. The rest – choosing exercises and setting up your workstation – we sort out at the visit.