When a patient comes in complaining of low back pain, I’ll start the exam by identifying exactly where it hurts. This entails my pressing on the spine to find the “ground zero” of the pain. Since the lowest lumbar vertebra of the spine is the most common area of pain I’ll begin there.
As soon as I press on that area, the patient will often exclaim “That’s it! That’s right where it hurts!” I’m always glad to find that key point. At the same time, I know well that the causes of the pain do not begin and end in that area.
Indeed, like a magician the body will inadvertently trick us by expressing the pain in one area while the actual cause lies in another area. In the case of low back pain coming from those lower lumbar vertebrae, the cause is very often directly below in the pelvis.
As we walk, the pelvis is designed to swivel and move. As we stand, it should provide a level base for the spine. As part of the exam, I will often feel the pelvis for motion. Very often one or both joints in the pelvis are fixated, that is “stuck”. As a result, when the person walks, the motion is no longer smooth and it begins to put stresses on the lumbar vertebrae above.
This area can also become misaligned such that the pelvis is no longer level. Eventually the ligaments fail, the vertebrae become misaligned and low back pain begins. Hopefully, the low back pain sufferer will go to a chiropractor right away. All too often, people try pain medication or just live with it until the pain gets too bad to stand (literally).
My job is to get the unlevel pelvis once again into level position, and in doing so, to mobilize the joints of the pelvis so that it begins to move normally again. This will take stress off the lumbar vertebrae above. Naturally I will also adjust any misaligned vertebrae above to quickly relieve the low back pain. But if I simply keep adjusting only the area of pain, the true cause is not being addressed.