Low Back Pain

Paul Townley, Physiotherapist, Shows Some Techniques for Treating Back Pain

There are a number of muscles that may be implicated in low back pain:

• Deep spinal muscles (small) - multifidus
• Lumbar erector spinae
• Gluteus medius
• Hamstrings
• Rectus abdominis
• Quadratus lumborum
• Iliopsoas 

Added to this hardware is the software that the brain uses to coordinate and sequence movement.

The above-mentioned structures feed information to the brain in a constant stream, providing orientation (proprioception) as well as force and direction (velocity).  The brain then responds by organizing movement sequences in functional units.

These functional units mainly consist of a prime mover (agonist), an opposing muscle force (antagonist), and other muscles that either fix the local joint (fixators) or help the prime mover (synergists).  Eighty-six percent of low back pain is mechanical and may come from any one of the following structures:  bones, discs, facet joints, ligaments, and/or muscles.

Treating Low Back Pain with Dry Needling - Paul Townley 

To summarize, the anatomy and structures of the lumbar spine consist of various elements:

1) The spinal column of the axial skeleton is made up of vertebrae consisting of, for simplicity, three joints:  two facet joints on each side and posterior to the vertebral body, and the joint between the vertebral bodies, consisting of the disc and cartilage end plate.  These joints have their various ligaments.

2) The neural structures—such as spinal cord, nerve roots at the various segmental levels, and the cauda equina (the collection of nerves at the end of the spinal cord).

3) The muscles and fascia or myofascia surrounding the spine.  Obviously, there are blood vessels in the area, but we are more involved in addressing the joints, myofascia, and nerves.

Erector Spinae with Trigger Points

Iliopsoas with Trigger Points

Quadratus Lumborum with Trigger Points