Back Pain Detective: Finding The Source Of Your Low Back Pain
Have you wondered how a chiropractor figures out the source of your low back pain? Check out the video and blog below to see how our chiropractors at Willowbrook Chiropractic in Langley figure out where your low back pain is coming from.
History:
History is important to get as much information as possible to get clues for the case. I'll ask a lot of questions. Patients bring in a lot of information about where they feel pain and where they don't. Thanks to the history, I'll have a good idea going into the exam of where I want to focus.
A patient might say that they first had their low back pain when they lifted their son up onto a play structure. They're not complaining of any pain in the leg. They're not complaining of any numbness or tingling or any weakness in the foot. This is good because it makes it likely that there isn’t any nerve involvement, but we want to look a little bit closer.
Exam:
I might ask them to walk on their heels and walk on their toes, which tests some specific nerves in those muscles that tell me if the nerve is involved.
Then, I look at their posture. Sometimes when the body is in a lot of pain and having spasms, the patient’s body might be pulled off to one side more than the other. There might be an imbalance in the hips based on your posture or the activities you get up to during your daily life.
Next, I'll ask them to bend forward. This patient has no pain bending forward, but bending backward causes some pain. This is a clue that the joints of the back could be involved. Now we can narrow it down a little bit. Twisting and leaning back are painful on the left side, but not on the right. Now we're thinking left-side low back pain possibly coming from the joints.
With the patient lying down, I do a few tests where I maneuver the legs to see how that impacts the low back. I might also want to test their reflexes. There is a knee jerk reflex and an ankle jerk reflex, and we want to make sure that those are normal to determine that the nerves aren't being affected. I might perform a straight leg raise, which is a nerve tension test. Someone who has nerve pain would likely only get about halfway up and it would cause pain. This patient can go a little bit further, and just a little bit of tension is in the muscles, but there is no back pain. This is good!
I'm particularly interested in the left side because that's the side that they said they had back pain on. We can check the hip motion to make sure that it's not actually a hip problem presenting as back pain. This also tells me if there's any muscle tension in this patient.
This patient has a bit of hip hiking, meaning that there's some tension in the front of the hip muscles. We want to consider how that impacts their back pain and make sure we address that in treatment. While the patient is lying face down, I might do more hip testing to see how the hip moves and how it impacts the low back.
We're going to feel the hip muscles to see if there's any tenderness or tension. This patient might present with low back tightness. The hardening of the muscles is showing me that there's a spasm on the left.
Now I move the spine from side to side to make sure there's good movement there. As I get lower, it seems like there's a bit of a jump response, a bit tender and painful on the left.
Conclusion:
In the video it wasn't a complete demonstration of all the tests I might do, but this exam shows me that this patient had pain in their low back on the left, most likely a sprain or strain of the joints, as well as a muscle spasm.
We'll come up with a plan to solve their problems, get them out of pain, and get them back to enjoying their life and lifting their son pain-free onto that play structure.
If you need help with your back pain, book an appointment online below or give us a call at 604.530.0530. We can usually see new patients within a few days, sometimes the same day.
