Back pain is one of the most common pain conditions which affect people today. Because there are many different causes of low back pain, it is important to identify the pain generator(s) of the condition. Unfortunately, whatever type of practitioner you see will try to fit you into their way of thinking. When you visit The Pain Treatment & Wellness Center, we will be as comprehensive as possible in your evaluation and will look for the many different causes of pain, particularly muscular tension and myofascial trigger points.

"...a surgery cannot be undone"

Let us first look at how the muscles of the body can cause pain and dysfunction. According to specialists in the field of myofascial pain, there are 4 major causes of pain from the muscular system.¹

Muscle tension comes from not working off the stresses of life and is one of the most common reason for chronic pain. Because the muscles are staying tighter than normal the muscles actually begin to cut off their own circulation and place additional pressure on surrounding nerves and eventually irritating them.

Muscle Deficiency (weakness and stiffness) is a part of both muscular tension and spasm. Under exercised muscles may contribute to much, if not all, pain supposedly caused by arthritis.

Muscle spasm is when a muscle contracts strongly and won’t let go. This is what is usually responsible when a person says their “back went out”.

Muscle trigger points are small tender nodes of degenerated muscle tissue which develop as a result of prolonged spasm or tension and have the ability to send pain to areas distant to their location. These trigger points need to be addressed first as any type of strengthening tends to make pain from trigger points worse.

Trigger points located in the long muscles which run up and down the back can many times cause pain in the low back and buttock. However, it is the abdominal muscles which tend to create even more problems by referring pain directly across the low back. Also, a muscle called the psoas, which is a flexor of the hip (brings the knee up to the chest) can cause pain which runs vertically beside the lumbar spine and into the upper portion of the hip and even into the crease of the thigh on the front side of the body.

Aside from trigger points, low back pain may be caused by the muscular system by muscle tension (one of the most common pain generators), muscle spasm (what usually happens when someone says their back has “gone out”) and muscle weakness in the muscles of the abdomen and low back, sometimes referred to as “core muscles”.

Many people who have findings of bulged or herniated discs from MRI studies should be aware that an anomaly, or abnormal finding, does not necessarily indicate the finding as a pain generator. As a matter of fact, a 1994 study proved that many people walk around all day and sleep all night – never knowing they have a bulge or herniation of one or more spinal discs.²

Surgery is not the first step. A conservative surgeon will be certain he has exhausted all other forms of conservative care before placing a patient on the operating table. This is because the good surgeon knows that a lot of pain may be well managed if not eliminated by conservative care. Besides, a surgery cannot be undone.

When people come to The Pain Treatment & Wellness Center, they generally experience significant relief within 4 to 6 routinely scheduled appointments. If no change is seen in that time, we will help them find a medical practitioner who can better suit their needs, if they do not already have one.

Reference:

1. Marcus NJ, Arbeiter JS. Freedom from Pain. New York: Fireside; 1994

2. Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, et al: Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331(2):69-73.