low back pain

At our city of london based chiropractic and Sports Injuries Clinic, low back pain is the most common presenting complaint. Whether this be due to our patients working long hours with poor flexibility and faulty postures or from a sporting or overuse injury such as running. There are many dfferent causes of mechanical low back pain and to learn more about specific low back conditions, please click on the links below:

• Herniated/Prolapsed/Slipped Disc
• Sciatica
• Facet Sprain
• Piriformis Syndrome
• Sacroiliac Sprain
• Spondylolisthesis

(The list of diagnoses given above and subsequent explanations should not be considered a replacement for a full medical examination. Furthermore,we do not purport to treat all the Conditions listed. Should you wish to discuss any of these conditions with our chiropractors please do not hesitate to phone the clinic on 020 7374 2272 or email enquiries@body-motion.co.uk)

At Bodymotion Chiropractic and Sports Injuries Clinic, we take a proactive approach to treating back injuries. We offer a range of chiropractic care and Sports massage to reduce pain. However, once pain has reduced, our attention is directed to off-loading the area of pain and stabilising the spine. This aims to tackle the dysfunction at its root thus helping to prevent further malfunction and reccurrences.

How does rehabilitation help with back pain?

The musculoskeletal core is made up of the spine, pelvis, hips and abdominal structures.

The cores musculature is responsible for:

1. The maintenance of stability of the spine and pelvis,
2. Helping to transfer energy from large to small body parts during activity
3. Provide a solid base for our peripheral limbs to work from.1

If our core is weak, or our spine moves abnormally due to a dysfunction, then joints and tissues

will be stressed in a way they are not familiar with or not designed to cope with. This is one of the ways by which injuries can occur to the back and neck pain.

The easiest way to describe the core is to explain its function in relation to its design. Some authors have described it as the ‘abdominal box’. Our abdominals acts as the front (our 6 pack muscles) while our paraspinals and gluteals act as the back. The diaphragm is the roof and the pelvic floor as the base. An integral part of the core is a muscle called the transverses abdominis (TVA); it wraps around the abdomen and lies underneath our internal obliques. It is a deep muscle laying 4 layers deep in our abdominal tissue acting as a natural corset.3  

The ‘abdominal box’.5

Closely related to the TVA is the thoracolumbular fascia. This is an expanse of tissue incorporated into the maze of core muscular attachments. It acts as ‘natures back belt’ and plays a big role in core stabilisation. The TVA has large attachments to the middle and posterior portions of the thoracolumbular fascia creating a stability blanket across the entire midriff.2

Image from DeRosa C, Porterfield JA; 1998.

This concept is easier to understand when relating it to securing a tent against the wind. The tent itself (thoracolumbular fascia) is held up by the centre pole (spine), and without the support and tension provided by the guy ropes (abdominal musculature) the centre pole bares the full weight of the tent putting it under stress (back pain). In this state the tent is vulnerable to being blown over (injury). When the guy ropes are pulled tight (core contracts and stabilises) the tent (thoracolumbular fascia) is pulled tight, giving the pole (spine) even, bilateral stability and integrity against the elements (activity).

If you have any questions regarding Rehabilitation, please do not hesitate to conact Jack at jfishwick@body-motion.co.uk or if you would like to speak to one of our chiropractors with regard to your specific injury, please contact enquiries@body-motion.co.uk

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1. Kibler WB, Press J and Sciascia A. The Role of Core Stability in Athletic Function. Sports Med. 2006: 36; 189-198.
2. Hides J, Hodges P, Jull G, Richardson C. Therapeutic Exercise for Spinal Segmental Stabilization in Low Back Pain: Scientific Basis and Clinical Approach. Edinburgh (NY): Churchill Livingstone; 1999.
3. Nadler DO, Scott F, Venu Akuthota MD. Core Strength. Arch Phys Med Rehabil. 2004: 85; S86-92.
4. DeRosa C, Porterfield JA. Mechanical Low Back Pain: Perspectives in Functional Anatomy. 2nd ed. Philadelphia: WB Saunders; 1998.
5. Image from (http://www.nzihf.co.nz/media-resources-1/articles/core-training-as-a-personal-trainer-where-do-i-start) 7/12/2010.