Lower Back Pain – It could be your legs?
If you are unfortunate enough to be one of the large percentage of the population experiencing lower back pain (LBP) then you will know that it can often times make your thigh, calf or foot feel numb or tingle. Many patients experience a tugging/pulling sensation in the leg while the back pain is more subdued. Others may just experience an uncomfortableness in the back of the thigh or a distinct pain in the lower back.
Your Dr may take a MRI or an X-ray and diagnose you as having a problem with your disc which lies between the vertebrae or perhaps a nerve compression. There are a few diagnoses that can be made and just as many treatments can be offered. Often times this leads to what we call revolving door practice. The patient comes in for treatment and leaves feeling better only to show up again to repeat the whole process. This happens with surgical and non-surgical treatments. WHY?
The answer to that lies in the research that has been conducted over recent years on the link between the lower limbs and your spine. For treatments to be effective we need to find the root cause of the problem. Just knowing whats wrong is not enough. We have to answer why did the problem occur. We say this because the diagnosis that you are given is the manifestation of the root cause.
So what could the root cause of persistent lower back pain be?
Lets consider Angela’s (fictional character) case study. She goes to work Monday to Friday where she spends an average of 3 hours in total standing and walking. The rest of the time she is seated. For 2 years now she has had this dull lower back pain and goes for a massage to relieve the back and the tight leg muscles on her left side once a week. She noticed that it was always worse after a day of shopping having walked for hours. One day she decided to finally mention it to her general practitioner who gave her an anti-inflammatory drug. It felt good but as soon as she stopped the drugs the irritating pain returned. She then turned to chiropractic which helped. An orthopeadic surgeon referred her to their physiotherapy department and that helped too, but the discomfort returned as soon as she would stop treatment. One day her aunt jokingly said to her: “Why do you walk with your feet turning out like that?” Her aunt later insisted that she should see her podiatrist. It was on this visit where we discovered not just the diagnosis but most importantly the root of the problem. Angela had a limb length discrepancy, that is to say, one leg was shorter than the other by 8mm.
Leg Length Difference
This made Angela’s pelvis tilt (as shown in the picture) causing the spine to curve. Biomechanical data proves that any difference greater than 3mm can wreak havoc with your alignment and course persistent lower back pain. After addressing the difference the lower back pain and its associated leg discomfort resolved within 3 weeks.
There are many other biomechanical anomalies such as flat feet, incorrect leg bone rotational alignment, knee position, pelvis rotation and weakened buttock muscles that can be the underlying cause. It can be discovered by having a biomechanical examination.
A typical biomechanical examination can last 10-20 minutes and may include X-rays and video gait analyses depending on the problem. Expect to have your walking and alignment scrutinized. Lower limb alignment is not the only thing that causes back pain but it is certainly the most commonly overlooked problem.