Low back pain hip flexor
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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When the facet joints or certain other structures in the spine become injured or inflamed, the back muscles can spasm and cause low back pain and limitation in motion.
Another key structure in the production of low back pain is the hamstring muscles, the large muscles in the back of the thighs. Patients with tight hamstrings tend to develop low back pain, and those with low back pain tend to develop tight hamstrings. The theory is that tight hamstrings limit motion in the pelvis, so the motion gets transferred to the bottom lumbar motion segments and increases the stress in the low back. Rehabilitation focuses on strengthening the muscles and stretching the hamstring muscles.
Muscle strength and flexibility are essential to maintaining the neutral spine position. Weak abdominal muscles cause hip flexor muscles to tighten causing an increase in the curve of the low back. A poor posture results when the curve is hyperextended. This is called excessive lordosis or swayback.
Management and prevention of back pain begin by understanding the neutral spine position. Three natural curves are present in a healthy spine. The neck, or the cervical spine, curves slightly inward. The mid back, or the thoracic spine, is curved outward. The low back, or the lumbar spine, curves inward again. Learning how to maintain a neutral spine position also helps during activities like sitting, walking, and lifting.
The natural curves of the spine are the result of the muscles, ligaments, and tendons that attach to the vertebrae of the spine.
A balance of strength and flexibility is the key to maintaining the neutral spine position.
Muscle imbalances that affect the spine have many causes. One common cause of muscle imbalance is weak abdominal muscles. As the abdominal muscles sag, the hip flexors become tight, causing an increase in the curve of the low back. This leads to the swayback posture mentioned earlier. Another common problem results from tight hamstrings. As the hamstring muscles become tight, the pelvis is rotated backwards. This produces a slouching posture.
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