As we investigate the patterns of low back pain simply through understanding the history of how patients experience pain, we start coming to a working diagnosis of what the cause of pain is. So far we have evaluated two components. Firstly, we want to know if the pain is present more in the low back or felt more in the leg. Next, we want to determine if the pain is constant or intermittent. To understand more as to why these things are important, read our previous two blog posts.
We are moving on to a very valuable question that helps narrow down the pain generating structures in our spine that can elicit pain. If you take a moment to evaluate your pain, you will find that it will either be worse when bending forward or when extending & arching your back. You may likely feel that you have pain in every position. However, pay close attention and determine which position is even marginally worse. This is an important criteria to start to determine not only what structure is primarily causing the pain but also in which direction your treatment should start.
Majority of worsening pain in extension of the low back can be related to posterior boney elements of the spine with some secondary association with soft-tissues. Worsening pain in the low back with forward bending is typically a sign of pain emanating from a disc, nerve or other soft-tissues of the spine with secondary involvement of boney structures.
These positional questions along with others we are investigating start to give us a bigger picture as to the length of time your pain will typically last, what hands-on treatment is appropriate as well as the stretches & exercises that are recommended specifically for you.