Back Pain Due To Tight Hamstrings

Each week I see a significant number of young, baby boomer, and elderly patients in my office with low back pain. As a chiropractor, I am very interested in figuring out what is causing the back problem rather than just relieving the symptoms. If there is an underlying problem with the patient that is making the person prone to becoming sore, I want to find out what it is. This article will focus on back pain due to tight hamstrings.

 

One common underlying cause of chronic low back pain is when you have tight hamstrings. These are the muscles at the back of your upper leg and they reach from the bottom and back of your pelvis down to the back of your leg just below the knee. When you bend forward, two areas of your body do most of the movement. First, the pelvis pivots at the hip joints and it tips forward. Secondly, the low back (or lumbar spine) flexes or bends forward. These two actions combined allow us to easily reach down to pick up an object off the ground. A problem arises when your body is not able to do one or both of these actions. Because the hamstrings attach to the back of the pelvis, they must stretch or lengthen as the pelvis tips. If your hamstrings are tight and will not stretch, the pelvis cannot tip. Then, the low back is forced to compensate for this and bend forward even further. You will still be able to reach the object on the ground but now the lower back is being stressed. If the object is heavy or you have to bend over repetitively, the low back will eventually become sore. If this repetitive stress on the lower back is maintained over a long period of time, arthritis will eventually occur.

 

A specific example that I saw in my office was a fifty-year-old logging truck driver who had strong muscles in his back and legs but their flexibility was very poor. He experienced several bouts of low back pain every year. We were able to eliminate his symptoms each time with treatment but he could not be bothered to stretch his muscles when he was not in pain. Finally, while frustrated from his most recent bout of back pain, we convinced him to follow a simple stretching routine. To his surprise, he did not experience any further bouts of pain as long as he was faithful to his stretching routine. He is a classic case of tight hamstrings making his low back compensate and work too hard. This inevitably caused his low back to become sore.

 

To allow you to bend and lift objects with less risk of injuring your low back, you should regularly do a few simple stretching exercises for the hamstrings.

With the Wrist, a Small Fracture Can Become a Serious Problem

The popularity of skate boarding, snow boarding, and rollerblading is increasing every year.  Unfortunately, as the participation in these sports grows, so do the number of wrist injuries.

One of the more common areas to be injured is the wrist. Our wrist is made up of eight small individual bones, called “carpal” bones.  When participating in the above-mentioned activities, falling forwards or backwards can be a common occurrence. When we fall forward, our first reaction is to put our hands out with our wrist bent backward in order to catch ourselves. When the wrist and hand hit the ground, they must absorb the entire weight of the upper body. When the force put through the wrist bones (called “carpal bones”) is excessive, one or more of them can fracture. Unfortunately, one of these carpal bones (the scaphoid) is the most common one to break. This “scaphoid” bone has a unique characteristic that the other carpal bones do not. Most bones in the body have a small artery entering them from each end. For example, the large bone in your thigh (femur) has blood supply entering it from both ends of the bone – near the hip and down by the knee. So, when you break that bone in half, each end of the bone has its own separate blood supply to keep it alive and healthy. The scaphoid bone is designed differently. Its primary blood supply enters the bone in middle instead of the ends (see diagram). Therefore, if you break off one end of the bone, the fragment may not get an adequate blood supply. This fragment of bone will then die and degenerate, causing severe arthritis in the wrist. I have had numerous patients come to the office who have broken their wrist before and have not had it treated properly. Their wrist is no longer able to bend backward or forward as it should and it is often suffers from moderate to severe arthritic pain.

 

scaphoid fracture xray scaphoid_fracture_diagram

To make matters even more difficult, a crack or break of this bone is very difficult to see on x-ray and can be easily missed by even the most trained medical or chiropractic doctors. With some patients, the swelling is minimal and no significant bruising is revealed. To be sure there is no fracture, the wrist should be x-rayed again 10 days later. After this period of time, a crack is easier to see as it is attempting to heal. If a fracture has occurred, the wrist must be immobilized with a cast.

 

If a fracture has been definitely ruled out and just a bad sprain has occurred, the wrist should still be immobilized for a short period of time. Once the pain and swelling has decreased, the wrist should receive conservative treatment. This includes mobilization of the eight bones in the wrist by a chiropractor. Stretching and strengthening exercises should also be prescribed to accelerate the recovery and prevent significant muscle wasting.

 

To prevent serious wrist injury, purchase wrist guards that are often sold with rollerblades. They protect the wrist from impact when falling forwards and prevent the excessive backward bending of the wrist joint. These simple and inexpensive pieces of equipment can prevent many of the wrist fractures from occurring.

Cutting Firewood Can Cause Back Pain

Over the past few years, people have been turning to other forms of fuel, such as wood, for heating their homes. But, in order to burn wood, one must go out and collect it. Surprisingly, this activity has caused a recent influx of low back injuries into my office. Read below to find out how cutting firewood can cause back pain.…..

Collecting firewood allows many a man to fulfill their primal urges of hunting and gathering. Like a caveman sharpening his spear, he sharpens his weapons (axe, chainsaw). This pre-hunt ritual occurs while the next generation of hunters, his son, watches in awe. After pleading ignorance about requiring a permit from the Ministry of Forests, he heads out looking for that perfect tree. Once found, the tree is butchered into pieces like a moose that was hunted and cut into quarters. While still under a natural adrenalin rush from the hunt, coupled with the need to demonstrate his Hercules-like strength to his son, he feels invincible. He proceeds to repetitively lift the massive pieces into his pick-up truck. The hunt proceeds just as planned, until….

 

I will use an example of a man who practically crawled into my office this month after attempting to collect some firewood. Just as he picked up the last piece, he felt a sharp pain in his lower back. It then shot from his back to his right hip and groin. While dropping to his hands and knees, the piece of wood he was holding fell and landed heavily on his big toe. Once the pain in the toe subsided, the pain from his right hip and groin began to spread into his right testicle and lower leg. Not only was his ability to hunt and gather suddenly disappearing before his eyes, but now his manlihood was also in jeopardy. Covered in sawdust and giving off a distinct odor of chainsaw oil with a hint of freshly cut pine, he crept into my office one hour later. He had sprained the joints in his lower back. The resulting inflammation then irritated the nerves that exit his spine and combine together to form the sciatic nerve. With chiropractic treatment and modifying his activities, he was back to normal within a week or two.

 

To prevent the rest of you men from having your hunting/gathering abilities decimated, as well as having your manlihood tested, I will review a few “back safety” tips when collecting firewood. First, find a tree that is accessible by your truck so that you will not have to carry the pieces over uneven ground. Second, cut the tree into shorter pieces. They will be lighter to lift and easier to split. When lifting each piece, keep your lower back straight and lift with your legs. Third, when tossing the pieces into the truck, do not twist your back. Fourth, do not try to collect the entire winter’s supply in one weekend. If you are like the average person, this is not an activity your body is used to doing. Last but not least, do not use an axe that is too heavy. You will not be able to control it properly that one time when your aim is a little off.

 

 

 

Which Jobs are the Worst for Your Back?

So which jobs are the worst for your back? When I have someone in my office that is suffering from severe low back pain, he or she will often claim that theirs is the worst.  However, in an informal survey, members of the American Chiropractic Association’s House of Delegates rated the jobs they consider to be the most “back breaking.” In their opinion, the following occupations (from 10th to 1st) cause the most stress and strains on the muscles of the back.

10. Auto mechanics. They work in physically awkward positions all day long, bending over cars, sliding under cars, etc. Having to look “up and back” at the underside of cars causes neck problems, as well.

9. Nursing home workers have to lift elderly people into and out of bed. The workers’ bodies can become twisted and off-center. Sometimes the seniors make sudden movements, which can result in workers’ unexpected injuries.

8. Delivery drivers are always running, often carrying heavy and awkward packages. Packages shipped via UPS, FedEx, etc., have increased in weight over the years. The job also involves a lot of driving, which is rough on the back.

7. Firefighters/EMTs. When they have a job to do, the conditions are extreme. They have to deal with fire and the water pressure from hoses and chop obstacles down with an axe to get closer to the fire. They often have to carry people to safety, which is particularly difficult if the victim is obese or incapacitated.

6. Shingle roofers. The worker’s body is always at angle, twisted, or in some other awkward position.

5. Farmers lift heavy equipment and bags of feed and grain. When doing fieldwork, they have to constantly turn backward to watch equipment that is pulled behind a tractor.

4. Police officers sit in their cars for long periods of time, which is rough on the lower back. When called into action, they have to make sudden movements. They often face resistance from those they are arresting or they can be attacked, which may harm the back. Police officers also wear belts that can weigh up to 40 pounds, which is a common cause of chronic back pain.

3. Landscapers. Landscaping may involve more heavy lifting than any other profession. Rocks, heavy dirt, sand, peat moss, and mulch are all extremely heavy. Wheelbarrows can twist and turn, wrenching the workers’ backs-particularly when they attempt to “catch” the slipping wheelbarrow.

2. Construction workers’ jobs can involve hammering, lifting, steelwork, or ironwork-all in very awkward positions. Moving steel beams can wreak havoc on the entire body.

1. Heavy truck and tractor-trailer drivers. The constant compression and vibration from such trucks can damage the back. Prolonged sitting puts pressure on the spine, which can result in disc degeneration. Liquid-carrying trucks are particularly bad. When this type of truck comes to a sudden stop, the fluid in the truck’s tank slams back and forth, and the driver feels the impact. Also, because professional truck drivers are always on the road, their diets are seldom what they should be, which can contribute to weight gain and eventual back problems.

 

For those of you involved in the above occupations, or anything else that results in significant stress on your low back, you need to be as proactive as possible. This should involve muscle stretching, consistent exercise, maintaining a healthy body weight, and seeing your chiropractor regularly. By seeing your chiropractor regularly, any minor problems in your low back will be identified and corrected before they become serious.  As well, proactive chiropractic treatment (when you are not in pain at all) will help maintain your spine’s full mobility and flexibility, making it less prone to injury in the first place.

When Is Back Pain an Emergency?

Surprisingly, severe back pain isn’t usually a medical emergency. Regardless, one of the most common reasons people go to the emergency room is severe back pain from a simple muscle strain and/or joint sprain. While these conditions can be extremely painful, it usually doesn’t indicate soft tissue or other structural joint/ligament damage to the back. However, there are some back-related problems that could very well indicate a medical emergency. You should seek medical help immediately if you experience any of the following symptoms.

 

1) Progressive weakness in the legs or loss of bladder or bowel control
The sudden onset of bladder and/or bowel incontinence and/or progressive weakness in the lower extremities can be an indication of a relatively rare but serious condition called Cauda equina syndrome. Anyone experiencing these symptoms should seek immediate medical attention. Typical symptoms of Cauda equina include:

  • Altered sensation, or severe or progressive weakness or numbness in the lower extremities – the legs and/or feet.
  • Loss of sensation or altered sensation in the “saddle” area (the area or your body that would sit on a saddle: inner thighs/between the legs, buttocks, back of legs, sacral region).
  • Loss of control of bladder or bowels (including retention or incontinence).
  • Pain, numbness or weakness in one or both legs that may cause difficulty walking.

Cauda equina syndrome is caused by the compression of nerves in the low back, which can happen from a trauma to the spine, any spinal condition that may compress the nerves (such as a disc herniation, spinal stenosis), or an infection. If left untreated, this syndrome can ultimately result in paralysis, as well as continued loss of sensation in areas below the lower spine.

 

2) Unexplained loss of appetite, weight loss, pain, or neurological problems
Weight loss from increased exercise or changes in diet can be healthy and can help reduce back pain. However, sudden weight loss and/or lack of appetite for no known reason can be indicative of a serious medical condition, such as cancer. Several symptoms of a tumor in the spine include:

  • Pain in the neck or back, followed by weakness or numbness of the arms or legs. As well, a change in normal bowel or bladder activity.
  • Back pain that does not diminish with rest, and pain that may be worse at night than during the day.
  • Nausea, vomiting, or fever, chills or shakes in conjuction with back pain.

 

3) Fever, some types of increased pain, and other symptoms of infection
Fever typically indicates some form of infection. An infection of the spine can either occur quickly (e.g., within 1-2 weeks following fusion surgery) or develop over time (e.g. in elderly persons or those with compromised immune systems). Spinal infections are rare, but can be quite dangerous if the infection moves into the spinal canal and causes an epidural abscess (a pus-filled cavity in the epidural space). Pressure from an abscess pressing on the nerve structures in the neck or back can result in paraplegia or quadriplegia.

 

4) Severe, unrelenting abdominal and lower back pain
The pain of an abdominal disorder can often extend to the back and be felt as acute, continuous low back pain. Acute lower back pain can be a symptom of an enlargement of the aorta (large artery) in the abdomen, called an abdominal aortic aneurysm. If the blood vessel ruptures or starts leaking blood this could become a serious medical emergency. The primary symptom of an abdominal aortic aneurysm is severe continuous abdominal and lower back pain. This is a life threatening condition. Anyone with these symptoms needs to seek immediate medical attention.

 

The above conditions are quite rare compared to the common causes of back pain, and most conditions that cause back pain do not require immediate medical care. Once your chiropractor or medical doctor rules out the above causes of low back pain, conservative treatment should commence. The most frequently used and successful treatment for mechanical low back pain is chiropractic treatment. Once the problem is corrected and the symptoms alleviated, then you should discuss with your chiropractor what lifestyle changes would help prevent it from occurring again.