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Today you’re going to learn about lower back pain or back pain. It’s not just your spine’s problem. It’s not just your disc’s problem. It’s not just your sciatica problem. It’s not just your degenerative disc disease, or you lifted something wrong. There are many more other competence and solutions that can help you for your lower back pain.
I’m actually starting with a personal story I had with a client. I had this gentleman. His story is he came for the first time to see me for shockwave therapy for his lower back pain. And I was actually looking at his X-ray that was uploaded on our honour system before I saw that client, and I was going through the X-Ray. I saw this degenerative disease herniated this L four L five protrusion L three l four, and honestly fully loaded with labels diagnosis, and the X-ray looked very bad.
So, I was expecting to walk in the waiting area to see somebody that is perhaps in a wheelchair, or they’re using a walker or a cane, and they cannot even walk. But instead, I saw this tall, perfect posture gentleman that he just stood up from a sitting position like he had nothing wrong with him. And that’s when I said to myself and again, reconfirm because it’s not the first time that I’ve seen that. That what you see sometimes in X-ray and what this shows sometimes in an MRI, it doesn’t necessarily mean that that’s the cause of your pain.
Anytime when you take a picture of the internal body, obviously you’re going to see physical changes because that’s the goal at the end of the day of an MRI and X-ray to see if there is any physical damage, if there is any structural damage. But X-Rays, MRIs, and ultrasound do not show or cannot assess if there is a functional dysfunction in the area.
There’s no assessment yet to see or to do MRI in motion, or to do X-ray in motion or to do an ultrasound in motion. When you’re walking, what’s happening to that area, what is pinching, what is pulling. So, therefore, we take those into consideration, but we have to look at you as a functional mechanism – as a dynamic structure, not just the one little piece.
So, if you’re somebody that you have been diagnosed with protrusion or herniated disc, or like pretty much unique and you have tried everything. Then you’re still in pain. Perhaps your problem it’s not that – there’s something else.
So what I personally look for, and I have been forced to think this way because I deal with cases or people that have been in pain for a minimum of three months and have tried everything else. So when a client comes to Unpain Clinic, we have to sit and see okay, you have tried physiotherapy, you have tried acupuncture, you have tried massage therapy. You have tried chiropractic for lower back pain, and you have tried exercises, but nothing has solved the problem yet. So now we have to sit and try to put the puzzle together. Okay, what is the missing link here?
So the first criteria that I go and check is I ask if you ever had any surgery from a toddler to today. If I see a chart or some people think that that’s not relevant at all because they had an operation when they were five years old. And now they are 50 years old, and they’re complaining about lower back pain, and they have no clue why. In reality, that’s where the cause started. That’s where the dysfunction started. But when you’re younger, you can compensate much easier. As you get older, as you get more injuries, and please I want to correct myself here. Being older, it doesn’t mean that you have to be in more pain. It means that your biology is working properly. You’re actually ageing. You have good biology and dysfunction or compensation. It doesn’t matter how old you are. It’s a dysfunction, whether you’re making three or 20, you have the same muscle dysfunction.
So going back to the upper neck, to me, when that surgery is done, there is a physical cut of the skin, which damages the nerve endings. You probably still don’t have any feeling in that area. There is a physical copy of the fascia of the muscle. And imagine those muscles, those core muscles that stabilize pretty much your whole body’s whole trunk area, including your lower back. They become dysfunctional. Where does that impact of your sports, of jumping of sitting? It’s going to go to end up on your lower back. And obviously, when you’re 50. Now, yes, we’re going to see disc problems. We’re going to see changes in the structure because, normally, you’re further bruising your spine.
It’s a structure that protects one of your most valuable organs or tissue with a spinal cord. So, it cannot be a weak protection because it’s a vital system. So, for that reason, your body – like your spinal cord – it’s not superficial, but you can just like scratch it somewhere and cut it. It’s very deep. It’s protected by both muscle tissue and by structure. But what happens with time? You’re going to constantly put pressure on it, obviously. It’s going to wear out because your core muscles did not do the work.
Let’s say you are a person or you know somebody that never had any surgery on their body. But, they have chronic lower back, and they haven’t done anything. They don’t do sports. They don’t do any activities. So in terms of possibilities, you know, external factors, we’ll get into that. They’re very minimal, but they still have lower back pain. The next thing that we have to look into is your gut.
If you have ideas if you have any gut problem with digestion and inflammation that actually can cause lower back pain because your guts sit in front of your spine. And they go almost like that on the sacral area. So what happens is when you get constipated, and that inflammation actually builds up, and you already have some dysfunction on the SI joints or like lower back area, know that inflammation is going to irritate that spot and it’s going to give you more pain. So it’s not necessarily the cause – it’s something wrong in the lower back. Anything that is happening with your abdomen in the front can cause lower back pain. So as a tip, I tell people to make sure to have proper digestion.
Anything that is happening with your abdomen in the front can cause lower back pain.
I’ve read books and information about magnesium. It’s a good mineral that helps to release constipation because it lives in the bowels. So probably check or consult somebody in magnesium levels or your doctors and see if that’s the case.
And if none of them apply for you, but you are somebody that was using a snowmobile, or let’s say you were waterskiing. You just landed, or you were doing any kind of sport running. You’ve landed, but then you have injured your lower back, or you were lifting something, and I’m going to talk about the lifting. So later on, but more about physical injuries. That’s a different story. If you cause trauma in the whole lower back, it’s not just the spine. It’s pretty much the whole pelvis that is soft tissues that are traumatized because soft tissues are designed to move our body but also they absorb impact and energy.
So when the soft tissues are not doing the work first, they’re not moving through the joint properly. Second, if they’re super tight, they become more rigid. Then any impact that is involved is exposed, and it’s going to be transmitted to bones much easier. When muscles are a bit more relaxed, they can absorb more vibration and impact. If they’re super tight and rigid, that impact will be transmitted to the joint, and that’s how the joints are.
Now whether it’s your knee, whether it’s your head, your lower back, and then we have those joints in between each. Yes. So it’s the same mechanism. So that’s a completely different story. But if you’ve got lower back pain because you were just lifting something, that’s a completely different story. Why? Let’s say you do a deadlift. And if your core it’s responding properly, if all your big muscles are responding properly, that impact must go on the muscles must not end up in the job.
But when those muscles are not balanced – when those muscles are dysfunctional because you’ve had some kind of surgery or you rolled your ankle – and that ankle injury that you had years ago forced you to function differently. Even when you’re working out, I don’t care how big your muscles are because that doesn’t mean anything. But we all have our zero points. We all have our natural strength, and we are all meant to be functional without any pain.
We are all meant to be functional without any pain.
So being an athlete versus someone that doesn’t do anything when it comes to dysfunction doesn’t really matter. You can be a super athlete. You can lift all kinds of stuff, but you’re lifting – you are functioning in this functional mode. So that’s when I see bodybuilders injuring their lower back because the core muscle, the left muscle, the quadriceps, hamstring, all these large muscles of the body that are designed to handle that load. They’re not working in synchronicity. They’re not working together. Therefore all that impact goes and can enter your lower back.
So what are now the solutions, so the first thing whenever you have lower back pain? You can try to do some stretching gentle stretching. But regardless of what stage of lower back pain you are in and you’re looking for lower back pain relief, the first thing that you do, whether you’re in an acute phase or chronic phase, is breathing. You have to practice breathing exercises for lower back pain. Why? Typically, when the core becomes dysfunctional, now your back muscles, the QL muscles stabilize your lower back. But we call them the extensors muscles on the back.
So now, as soon as the big muscle becomes dysfunctional, the small muscles will take over, they will tighten up. The next big muscle that helps in the overall stability is your diaphragm for that front line. It’s this big muscle that separates your lungs from your abdomen.
And if you remember as a kid, if you were just running too fast and you got a deep pinching sensation on the right side or left side that shouldn’t have the diaphragm overworking, that kind of catches your breath and stops. So that’s the diaphragm. So the moment that body is asking for stability, it will go and contract the diaphragm. So the diaphragm has more tension, which means you’re not taking a very deep breath, which indirectly now causes more muscle tension – because less oxygen in the body means more muscle tightness in the body.
And you have to remember that if there’s less oxygen in the system, it’s not going to go to your muscles first. It’s going to go to the brain. It’s going to go to other organs. So therefore breathing is critical when you have lower back spasms or pain or whatever stage you are in. And the other thing from a muscle component or compensation is the diaphragms QR muscles.
Then your hip flexors, your source muscles, they all attach pretty much together. So, if one goes in spasm, it’s going to make others to go in spasm. And if you want to just research the psoas muscles, hip flexors muscles, you see these two big huge muscles that go from your pretty much P12, L1 to the L5. And touch there, and then they go behind the bowels, and they attach in front of your hip. So when you set those muscles get super short.
If one muscle goes into spasm, it’s going to make others to go into spasm.
And if you’ve seen other therapists for your lower back pain, then they’re going to blame those hip flexors. They’re going to give you stretching for the hip flexors because when they get short and contracted, then they’re going to compress all the lumbar spine area. So that’s the first thing that we see.
After you have improved your breathing and you have tried breathing exercises and techniques. Honestly, nowadays, you can check on YouTube for breathing exercises for lower back pain. There are a lot so if you still continue to have lower back pain, then look for a massage therapist. See if they can help you. They can give you guidance, and as a massage therapist and massage therapy for lower back pain specifically does not help your pain still, then you have to console pretty much with your doctor or look at a physiotherapist that specializes in lower back pain or most chiropractors. They are really good when it comes to lower back pain. So you can try those, and if they help you great, that’s amazing. It was just almost like a glitch in the system. They help you. That’s awesome.
But if you’re somebody that you already have tried all those modalities and nothing has helped them, you have to look at you kind of think yourself, okay, do I have gut issues? Do I have IBS? Do you have constipation like to look at that? That aspect of your body?
Check your stress level because when you’re stressed, you’re not going to breathe as well. You’re going to breathe very shallow, and then it’s going to affect you from that perspective that I just explained that for psoas hip flexor muscles. And that could be one reason is if those are all good and you still have a problem, it means that the problem could be now, or the compensation could be more within deeper structures.
So those are cases where we come in or wherever you’re around the world, look for shockwave therapy, sort of lower back treatment. And what shockwave therapy would do with this case? It would shoot with sound waves, so it would break down scar tissues or adhesions that have been built up. You know, probably from sitting, from different factors. And then it will reach 12.5 centimetres deep in your body. So, it will go to places where normally we cannot reach by hand or with IMS needles or dry needling. No other modality would be able to go that deep in the body to break down physically the scar tissues adhesions and to stimulate regeneration.
So typically, we’ll start with three to five sessions as more than enough to get things going. And how we do shockwave for lower back is we have to go and treat both sides both of your hips – the whole lower back. We cannot just go and treat the area where you’re experiencing the pain. Because now when you want to influence changes have to reach balance in the whole lower back region. You have to treat your hip muscles because on the hip muscle or the glute muscle, there’s a small muscle called the piriformis. That muscle when it gets super tight, it compresses the sciatic nerve. So sometimes, when you have sciatic nerve pain, it’s not necessarily that it’s only coming from the nerve root from the spine, from the vertebra or from the disc. It could be pinched from the piriformis muscle. So therefore, we must release that muscle and by releasing that muscle because if it touches on the end of your sacrum and on the hip, it actually adjusts your sacrum. So your sacrum is the foundation – is the base for the lumbar spine.
Sometimes, when you have sciatic nerve pain, it’s not necessarily that it’s only coming from the nerve root from the spine, the vertebra, or the disc. It could be pinched from the piriformis muscle.
Imagine if we can look at the body from the top. We have a very small spine because we need more foreign movements on the neck as it goes lower. Because again now forces of the body are higher as the body has adapted and created those strong structures. The lumbar spine is bigger, but then the big don’t move as much as on the top bar. And then the sacrum is more fixated – because that’s the base that’s the foundation. So if the foundation is off because those glute muscles that attach to the sacrum, they’re pulling in different directions, then the problem stems there.
So, therefore, it doesn’t matter what kind of treatment you have. Look for therapists that treat your dysfunction. They don’t really focus on labelling. I know as humans, we like to have a label we like to get diagnosed. Then once you get diagnosed, you’re happy. But then you realize we bother to diagnose, but there’s no solution. So, therefore, don’t focus much on the names. Focus and feel what is working for you. Which therapist is helping you the most? Which modality is helping you the most? And keep looking at that in that direction. And that’s how you end up with a solution of lower back pain or especially chronic lower back pain.
Okay, so the next thing is where you go in and work closer to the spine area. I’m personally not fond of cortisone shots – injections that block pain for chronic lower back pain because they’re just treating the symptom. They’re just trying to stop your pain, but they’re not treating that dysfunction. And you have to remember that your body is one single system.
If you stop the alarm, the signal in the lower back region, you force that, and your doctor is able to do that. That’s great, but then that pain, that dysfunction, is going to move elsewhere. Your body’s not going to stop telling you that something is wrong in the system, and I need help until you correct.
Okay, so it’s hard. It’s hard to find therapists like that, but you have to if you want to feel better – if you want to get better – you have to take things into your hands. If you expect the medical system to help you, it’s never going to happen. And the main reason is that our medical system doesn’t matter where in the world, is designed more to look for structural damage. So, we see a problem here, “Okay, let’s try to fix that.” But when it comes to the dysfunction, it means in this function, it is your life, you know, your mindset, your activities, your food, your habits, and all of that, plus aggravating factors and physical changes that happen. So, therefore, I say the best doctor to help yourself is you. I truly hope that this happens.
Help you in a way just to have a different perspective and mindset towards lower back pains. If you’re in need wherever you’re in the world, it doesn’t matter that you’re not from Canada. Or you’re not from Edmonton. We truly want to help you at UnPain Clinic. We have a free telehealth session – 15 minutes, so just get into that. Let’s see if we can help you, and we have a big network of people that we know of practitioners who are like-minded.
So, we can at least guide you to go to the proper place and have the proper technique. But if you’re lucky, if you’re familiar with and you have UnPain, or from Alberta, we also get people that drive six, eight hours just for one session. Then they go back, and typically was shockwave therapy is only three sessions, three to five sessions. And then hopefully we never see you again.
So, I want you to be at the next podcast episode to listen to the next condition that we are going to cover. I don’t know yet which one will be but thank you for your time, and I truly hope that this helped you or somebody that you know that is experiencing lower back pain to look into those things. Thank you. Have a great day.
