Low Back Pain

Low Back, Sacral & Coccyx Pain

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01

Causes

Find out what I've noticed causes most problems within these areas
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02

Symptoms

Find out what sort of symptoms accompany problems within these areas
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03

Treatment

Find out what types of techniques I use in order to alleviate and begin to resolve problems within these areas
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04

Management

Find out how I try to manage my patients so that they can maintain the treatment benefits in the long-term
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01 Causes of Low Back, Sacral & Coccyx Pain

Pain in the lower region of the back is one of the most common locations to experience pain in a person’s life.
Pains can range from stiffness, dull aches and lack of mobility all the way through to debilitating pain.
 
Low back pain generally falls into two categories:
 
Acute low back pain includes sharp, intense and debilitating pain that may be accompanied by shooting pain into the legs. Many patients find the likes of walking up/down stairs, putting on shoes or socks, getting in and out of chairs or cars and picking objects up from the floor incredibly painful and difficult.
 
Chronic low back pain includes stiffness sensations, dull achy pain that may come and go or remain constantly in one location. In some cases nothing changes this sensation, it may be constant no matter what position they are in. Other patients feel this sensation first thing every morning after waking up or only when leaning forward or backward.
 
In the majority of cases low back pain is a result of long term irritation to muscles and joints in the back. This includes build up of pressure from poor sitting postures (desk bound or delivery jobs) or lifting techniques in manual jobs (stacking shelves, assembling furniture, gardening etc). Intense sporting history is also a factor, whether major injuries were picked up in early sport careers or if intense sports were continued over many, many years. Even hobbies such as reading in bed or slouched over a chair, or gaming whilst sitting on the edge of bed can provoke low back pain.
 
Sacral pain is more common in patients who have fallen directly on to it during accidents or sporting injuries. These include falling backward directly onto your ‘buttocks’, sitting down too fast onto a hard chair or tripping during hurdles, falling during gymnastic based movements or falling backward in tennis, squash or racquetball. The pain is usually a dull ache that is aggravated by direct pressure onto the area of the fall/injury with little pain when standing or walking.
 
Coccyx, aka ‘the tail bone’ is usually irritated from direct pressure, whether be any or all of the same causes as sacral pain. Direct pressure, especially prolonged or sudden impact, will cause small amounts of inflammation or bruising on the bone and so can feel constantly painful especially when sitting down.
 
Low back pain can also be referred from other areas such as stomach and bowel issues, bladder problems, ovarian/menstrual issues or genital issues. These will be screened through detailed case history and if there is suspicion then referral to your doctor for tests will be advised.

02 Symptoms

Symptoms of Low Back, Sacrum and Coccyx Pain
 
Constant pain, whether dull or strong, in the low back region
Pain bending forward to pick up objects or put on shoes and socks
Pain leaning backward or manoeuvring in and out of cars
Pain getting out of bed or from the floor to standing
Pain coughing, sneezing or initiating bowel movements
Pain walking, sitting or during sports
Weakness sensation in the legs or back
Pins and needles or numbness down the front, side or back of the leg
Sharp pain when sitting on hard stools or wooden chairs

03 Treatment

As always, assessment of the upper back and rib function, along with the pelvis, hips, knees and ankles is essential to identify the root cause of the problem.
 
Management of low back pain falls will depend on which category it falls into:
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Acute low back pain: often more gentle and slow techniques will ease the body out of the pain rather than longer and intense sessions. The body appears to favour the ‘less is more’ approach at least when beginning the treatment plan. Once the body has let go of most of the pain and healed a lot of the damaged tissue treatments can be longer and involve more work.
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Chronic low back pain: often the pain becomes long term because the body has suffered for so long it tries to bury and ignore the back pain. Treatments will ‘dig up’ the buried injury and try to resolve the root cause of the problem. In many cases only a handful of treatments are needed to resolve decades worth of backache.
 
Treatment of acute and low back pain include osteopathic mobilisation techniques of the spine and pelvic joints both rhythmically and also some stronger pressure to release off tight joints. Spinal manipulation, if indicated, may also be employed to release particularly irritated joints. Soft tissue techniques to ease off of muscle tension and deep tissue techniques to really release spasms in gluteal and low back related muscles. Muscle techniques that involve a series of specific contractions and relaxations also unwind the tension throughout spinal muscles.
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In many cases temporary adjustments in walking, sitting, standing and sport postures may need to be employed to encourage the body back to normal.
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Hydrotherapy techniques can make huge improvements to symptoms and significantly improve the bodies’ ability to heal the injury.
Nutritional interventions can play a big role in reducing the inflammation, which may prevent resolution of the pain.
Specific exercises may be advised to improve spinal function and improve the patients’ control over the pain.
 
If appropriate treatment is deemed necessary to treat to other areas see more in upper-mid back pain, hip pain, knee pain and ankle pain.
 
Sacral and coccyx pain will incorporate many of the techniques mentioned above, however, may require more ligament tension release. This allows the joint to ‘let go’ of the injury sustained and return to a pain free state.

04 Management

Treatment plans for low back, sacral and coccyx pain depend entirely on what is found during the consultation and follow up sessions. This is why, as osteopaths, we will design a treatment which is as accurate and efficient for each patient as possible.
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