Low Back Pain

There are  a number of causes of low back pain including disk problems in the lower back, a rotated pelvis, impingement of the sciatic nerve and walking on the outside of your feet.

Knee, ankle, and foot problems can also cause low back pain as the injured side is favored and the extra weight is put on the “good” side.  This will often cause contraction and pain in the hip and buttock on the uninjured side.  This is seen frequently after surgery on the hip, knee, ankle or foot. Once the person is walking on crutches a good deal of the pain they feel is in the opposite hip and buttock.

Walking on the outside of your feet can also cause low back pain.   You can determine this by looking at the sole of a well worn pair of shoes, notice if the outside of the shoe is worn away much more than any other part of the sole of the shoe.  In an ideal gait the heel touches first, the outside of the foot is lifted slightly by the muscles on the outside of the calf and the weight is transferred to the big toe and the ball joint behind it.  When the weight instead is put on the outside of the foot and no transfer takes place the muscles on the outside of the leg become overworked.   Muscles that are meant to lift up the outside portion of the foot to transfer weight are instead used to support the weight of the body.  This causes connective tissue to be laid down to deal with the extra weight, the ability to lift the outside of the foot is compromised as well as the ability to walk safely on uneven surfaces.  If you have trouble lifting up the outside of the foot (bones of the side of the foot lift toward the outside of the knee) you are much more at risk for an ankle sprain.  In addition, the entire outside of the leg becomes tight, fibrous and with a decreased blood supply.  This tension is transferred up the side of the leg and into the SI joint (sacroiliac joint) causing muscle contraction above and below the hip in the back and also across the buttock on that side.

Sciatica can be caused by impingement of the nerve root caused by disk problems or by impingement of the sciatic nerve as it exits from the side of the sacrum.  This is commonly caused by contraction of the piriformis muscle which runs from the side of the sacrum to the top of the thigh bone.  Often times symptoms can be drastically reduced or eliminated by techniques to relax this muscle.  Once the nerve is no longer impinged, the tingling, pain and numbness down the leg will disappear.

Rotation of the pelvis can also cause low back pain.  The most common rotation is towards the right.  This causes the left hip to be higher in the back and all the muscles on that side to be shortened and tense.  A common cause of this rotation is sleeping on your left side with the right hip rotated forward so your knee and lower leg can rest on the mattress.  This can be avoided by simply sleeping with your knees stacked one on top of the other and a small pillow between your knees.  Avoid sitting with one knee crossed over the other as this also rotates the pelvis.  Often people will sleep with their pelvis rotated and then sit at a desk all day with their legs cross, rotating the pelvis in the same direction.
With a rotated pelvis there is often a misalignment of the sacral iliac joint, this is where the hip bone meets the sacrum in the back of the body.  This joint is meant to move slightly with each step.  When this movement is prevented due to the rotation, the muscles splint around the joint and there is often a significant knot just below the hip bone at the top of the buttock.  This tension often affects the muscles of the low back and sometimes as far up as the lower ribs.