If you’ve ever experienced lower back pain, you’ll know that it can feel like a deep-seated pain that you just can’t put your finger on where exactly to treat.
It may feel worse after sitting down or driving for any length of time, or perhaps first thing in the morning when you get up and before you get going.
It may be something you’ve noticed happen, or get worse, since having children.
It may manifest on one side of your spine, or both sides.
And it may also stop you from exercising, as you don’t wish to make it worse.
If this sounds familiar, it may be that you’re suffering from a condition known as sacroiliac (SI) joint inflammation.
The science bit…
You have two SI joints in your back, one either side of your spine (ever wondered what those dimples in your lower back were?)
They connect your sacrum (spine) to your iliac bones (pelvis) and their job is to act as shock absorbers when transferring load from your upper body to your lower body when you stand up and move.
While the SI joint allows for a small amount of movement (around 2mm-4mm), generally speaking women’s ligaments are looser to allow the pelvis to accommodate childbirth. Therefore, SI joint pain tends to affect women more than men.
These findings correlate to the injuries clients present themselves with in my practice.
SI joint inflammation has a number of causes. The most common are:
– through high impact sports, such as jogging, which places excess load through the SI joints
– where the ligaments around your SI joints are loose, causing movement; and
– for pregnant women, where the body releases the hormone relaxin to prepare your body for birth, and again allows greater movement around the SI joints.
The problem is compounded by the fact that our bodies were not designed to spend great lengths of time seated (the modern malaise).
Sitting down so much means that glute muscles do not need to work as hard to support your hips and spine as the chair does the work instead. This means that glute muscles have a tendency to be relatively weak.
A seated position also means that with the legs fixed in a 90 degree angle, the tops of your legs remain closer to the body, causing your hip flexor muscles to be “locked” in a short position.
Add in weak abdominals too and your lower back must work even harder to keep you in an upright position, which in turn causes your lower back to tighten up.
Further, if your quadricep (thigh) muscles are also tight, particularly the outside quad muscles, vastus laterals, and you have tight illiotibial bands (ITBs), this is going to pull on the SI joints.
Treatment (How you can correct it and reduce the inflammation)
In the immediate term, the focus should be on reducing inflammation of the SI joints.
This may be achieved through icing the affected area for up to 20 minutes at a time several times a day (a pack of frozen veg wrapped in a tea towel will suffice), and also considering the use of anti-inflammatory tablets (always read the label before taking).
Depending on the severity of the SI joint inflammation, this may need to be done for the first 2-3 days or up to a week. Medical advice should be sought, where appropriate.
Once the immediate inflammation has settled, an exercise program as prescribed by your health practitioner should be followed.
The program will be specific to you and will be developed based upon a detailed posture analysis (both standing and how you move) and is designed to improve flexibility, stability and strength in the surrounding ligaments musculature to reduce or eliminate a recurrence.
However, like the rest of your body, the SI joints do not act in isolation, and the postural analysis may indicate other areas that need to also be addressed at the same time.
The flexibility component of your program will seek to reduce tightness in areas such as your hip flexors and quadriceps, as well as ITBs, in order to improve your range of motion. This can be achieved through stretching by yourself, or assisted stretching.
The stability component will seek to improve stability around your pelvis, such as your hip stabilisers, so that your body “knows” which muscles to activate to stabilise movement.
The strength component will improve strength in areas such as your glutes and core, which have been identified as being relatively weak. This will help relieve the tension on your lower back so it is not having to do more work than it should be keep you upright.
When these three components are combined you have a powerful prescription to improve and in many instances eliminate your lower back pain.
Although following the exercise program may initially cause some irritation to the SI joints and may lead to some further inflammation, this should not be as severe as your initial symptoms.
Your health practitioner will be able to assess you so that the exercises can be regressed or progressed as necessary to help you and report any further adverse symptoms you experience.
What to do next
In terms of ongoing advice, having completed a specific exercise program, care should be taken to when doing any weight- or heavy lifting, particularly over head height, to ensure proper form throughout.
Be observant of any drop in form when you tire: look out for your lower back arching to get into the lift and either drop the weight or discontinue. It is also advisable to ice the area after exercise and to do a few stretches during the day (see below)… and get up and move from your chair at regular intervals.
If you would like to connect for a complimentary consultation or just a brief chat about how to help you to reduce your lower back pain, then contact us.
About the author: Wendy Goldthorp is the Founder and Director of The FIT Movement and is a women’s health and wellness specialist based in Teignmouth, South Devon. She works with pregnant, post natal and midlife (peri- to menopausal) women to improve their wellbeing through exercise and nutrition.
This article is only intended to be general advice and proper medical advice should be sought by you in relation to your specific condition for proper diagnosis and treatment.