Treatment for Lower Back Pain - The Body as a Tensegrity Unit
Low back pain causes 40% of absence from sickness in the NHS (1*) and it’s the most common reported musculoskeletal presentation worldwide.
Knowing this figures one would think that we humans, intelligent beings, have a solid and widely accepted treatment solution for it. Fact is we don’t. Our health system is quite naked when presented with this condition, lacking the right tools and the time to treat it effectively. This is not without reason…
Lower back pain is usually a symptom of underlying weaknesses and imbalances within the whole structure of that person’s body. Every individual has a unique presentation of this condition. Affected by lifestyle, trauma, diet, stress levels… This makes it a difficult condition to treat. That together with the fact that it is not life threatening results in a health system that can’t or won’t care enough to take solid action.
Here is the question thought, could we treat it effectively if we wanted to with the Health system we have?
The answer is clear, not with the conventional current model our health system is based on.
This model needs to be updated if we want to see effective results in dealing with presentations like lower back pain or other musculoskeletal presentations.
Why?
Because the conventional treatment methods are based on an outdated model of the body. What we call Newtonian concept. The current system still looks at the human body in a linear way like we did many years ago. Each muscle and structure is looked at and treated isolated from the whole system in a simplistic way.
The body has other plans. Our body is not a linear system but a quantum system. The physical manifestation that we experience as lower back pain (in this case) is a result of bio-psycho-socioeconomic factors and the body is ultimately an energy entity that encompasses our physical, emotional, mental, spiritual, and soul aspects combined together with our ancestry, experiences, stories, personality, and character.
An effective treatment method needs to have these aspects into consideration.
The body is a complex interrelated unit and it’s a far more sensitive system than the linear system we once thought. Our Health system desperately needs an update.
Something else to have into consideration when treating a musculoskeletal condition is the fact that the physical body behaves as a whole interconnected unit, a tensegrity structure.
Tensegrity: is a structural principle based on a system of isolated components under compression inside a network of continuous tension.
This means (in a simplistic way) that our bones are held suspended by tensional forces. These tensional forces are the muscles and particularly the fascia.
Let’s talk about the fascia…
The scientific discovery that changed the way we look and treat our body
The Fascia or Myofascial tissue has revolutionised the way we look at the body in the past couple of decades.
The Myofascial tissue is a connective tissue in our body, a spider web-like tissue, a single piece of fabric that it’s found in the body in different compositions and in different levels.
This tissue allows the transmission of force generated by the muscles through the whole system allowing the muscles to work together as a unit rather than as isolated individual entities.
We’ve always known that the fascial existed, what we didn’t know it’s how important its role is within our body. The old model in which our health system and all the professions within it still needs to be updated to accommodate these new findings.
It’s in the dissection room where we get a chance to study the body in detail. We’ve been doing this for a long time but we missed something!
We were cutting through the fascia to isolate and study the muscles (which we thought were the important ones). The body was cut and studied in isolated pieces and in such way we missed the global view of the body, which works in fact as a unit.
The fascia is one of the most fascinating fields of study in science as we try to understand its role fully.
What we do know already is that it’s an extremely sensitive organ, it has more sensory receptors than the skin itself. We also know that it reacts and adapts to pressure changes within our body and to chemical changes within the environment in which it lives, which makes it sensitive to psychological stress.
This is in itself a paradigm shift in the way we look at the body now.
How new evidence shapes an effective treatment method for the musculoskeletal system
In order to achieve the most effective possible treatment we must include the scientific new evidence in our treatment methods.
We must look at the body as a whole interconnected system where the fascia plays a major role and muscles work functionally in chains of action.
We must look at the body as a result of multiple bio-psycho-socioeconomical factors.
When treating low back pain, we must look at the whole body, assess any imbalances in the musculoskeletal system and how these might be contributing or causing the resulting symptoms or pain. We must have into consideration the person’s lifestyle and stress levels as well as their socieconomical background.
We can then create a treatment plan focused on correcting the imbalances that might be contributing to the presentation.
A good treatment plan usually includes a combination of different techniques that address different aspects of the person. Usually it means:
- Addressing the nervous system with techniques focused on increasing the activity of the parasympathetic nervous system. It’s important to guide the client’s body into a self-healing place. It’s ultimately our own body that heals itself.
- Addressing the myofascial restrictions that are causing or contributing to the imbalance directly working the myofascial tissue. Either with direct myofascial techniques (the tissues are physically guided into the direction desired by the therapist) or with indirect techniques (the tissues are held and invited to release, the therapist will follow-guide the release to facilitate it).
- Addressing the muscular system with strengthening exercises with the purpose of, one activating the muscles that are not engaging when they should and/or secondly to strengthen those muscles which weakness is causing or contributing to the imbalance. Re-training the body to work functionally.
Gluteus medius weakness in lower back pain
Research shows evidence of gluteus muscle weakness, in particular gluteus medius weakness in people presenting with Low back pain, or in the side where the pain is localised.
Research also shows that exercises targeting the gluteal muscles in combination with exercises targeting lumbar stabilisation are more effective than just lumbar stabilisation exercises alone in pain levels and functional disability levels.
This is a clear example of how interconnected the musculoskeletal system is, how all structures are working together to keep the balance within the system and how we ought to look at the body as a whole unit when seeking an effective treatment method.
References:
- Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls, European spine journal, volume 25, pages 1258–1265, (2016). https://bit.ly/3OGXheb
- The global burden of low back pain [website]. International association for the study of pain. 9 of July 2021 http://bit.ly/3GLJpdw
- The Effects of Gluteal Muscle Exercises Combined Lumbar Stabilization on Lumbar Stability in Chronic Low Back Pain Patients with Lumbar Instability, J Korean Soc Phys Med 2013;8(1):29-39 https://bit.ly/494lfrP
About the author
Rocio Santiago
MA in Nursing, Dip. Soft Tissue Therapy
Ro initially began her career as a nurse. Following this and after a difficult time in her life that resulted in a career change, Ro went on to train at one of the leading soft tissue therapy schools in Europe, completing a 3 year degree level course and specialising in effective soft tissue manipulation for the treatment of musculoskeletal pain.
The treatment method Ro uses consists of a combined approach using different specialised techniques, myofascial release and trigger point work among others, with the intention and focus on providing effective results in the least possible amount of time.
Combining her training, science background and life experience, her treatment method is based in science and built using a whole body approach, where mind and body are addressed as one.
Ro has been seeing clients as a soft tissue therapist for 8 years, successfully treating a wide range of conditions.