Low back pain hip flexor
When the facet joints or certain other structures in the spine become injured or inflamed, the large back muscles can spasm and cause low back pain and marked limitation in motion.
An episode of low back pain that lasts for more than two weeks can lead to muscle weakness (since using the muscles hurts, the tendency is to avoid using them). This process leads to disuse atrophy (muscle wasting), and subsequent weakening, which in turn causes more pain because the muscles are less able to help hold up the spine. Chronic stress can also lead to muscle weakness and back pain. Stress causes back muscles to tighten in a fight or flight response, depriving muscles of energy needed to support the spine. Another key structure in 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. An unhealthy posture results when the curve is overextended called lordosis or swayback. Proper posture corrects muscle imbalances that can lead to low back pain by evenly distributing weight throughout the spine. 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. The neutral alignment is important in helping to cushion the spine from too much stress and strain. Learning how to maintain a neutral spine position also helps you move safely 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. Without these supporting structures, the spine would collapse. They support the spine - much like guide wires support the mast of a ship. This guide wire system is made up mainly of the abdominal and back muscles. The abdominal muscles provide support by attaching to the ribs, pelvis, and indirectly to the lumbar spine. The muscles of the back are arranged in layers, with each layer playing an important role in balancing the spine. By using these muscles together, it is possible to change the curves of the spine. Controlling pelvic tilt is one way to begin helping to balance the spine. As certain muscles of the back and abdomen contract, the pelvis rotates. As the pelvis rotates forward, the lumbar curve increases. As the pelvis rotates backward, the curve of the low back straightens. Rotation of the pelvis is like a wheel centered at the hip joint. The muscles of the upper thighs also attach to the pelvis and contraction of these muscles can be used to change the curve of the spine. The abdominal muscles work alone, or with the hamstring muscles to produce a backward rotation of the pelvis. This causes the slight inward curve of the low back to straighten. If these muscles cause the curve of the low back to straighten too much, this may produce an unhealthy slouching posture. In the other direction, as the hip flexors contract and back extensors contract, the pelvis is rotated forward - increasing the curvature of the lower back. If this curve is increased too much, another unhealthy posture may result. This condition is called lordosis in medical terminology, or swayback in common terms. A balance of strength and flexibility is the key to maintaining the neutral spine position. This balance is the basis for optimal muscle function. Like a car, an imbalance may lead to wear and tear, eventually damaging the various parts of the car. 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 above. Another common problem results from tight hamstrings. As the hamstring muscles become tight, the pelvis is rotated backwards. This produces an abnormal slouching posture.
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