Finding Your Center (of Back Pain)

As previously discussed, radicular pain (shooting pain down the course of a nerve as it exits the spine) is pretty common when it comes to back pain.  Some common pathologies typically associated with radicular pain are herniated discs and spinal stenosis (narrowing of the gap where the nerve exits the spinal canal).

When it comes to improving these symptoms, it’s important to understand what positions bring your symptoms on.  Most people will have their symptoms irritated more by either bending forward like you’re going to touch your toes or bending backward like you’re doing the limbo.  What’s important is where those symptoms occur with these movements.

It probably isn’t surprising to hear that having pain that travels from your spine and down your leg is generally not considered good.  The idea is that there is more irritation to the nerve tissue the further the pain travels.  By contrast, if that same pain in the foot starts to move up the leg or even into the spine, this is a sign that the nerve is less irritated.  This concept is called centralization, and is commonly used as a guiding factor with certain types of back pain.

With centralization, treatment becomes based on the idea that you find a movement, usually bending forward or backward, and do it repeatedly to bring the symptoms towards the spine.  Here is a commonly used backbend progression that is performed starting on your stomach.  And here is a progression for forward bending performed starting on your back. The ultimate goal with either series is that your symptoms should centralize towards the spine.  You should also have improvements in your pain, range of motion, and ultimately your ability to do what you need to do on a day to day basis.

Let’s take an example.  Jim has a constant pain in his low back.  When he bends over to tie his shoes the pain travels from his low back down to the back of his knee, and then returns to his low back as he stands back up.  In this example, his pain peripheralized (went away from his spine) as he bent over and his pain centralized (moved toward his spine) as he stood back up (extended his spine).  After a more thorough examination from a clinician, Jim would likely be treated with repeated backbends based on findings in the exam.  For the majority of people with this kind of traveling pain, backbending is the most common successful treatment, but there are some people who benefit more from forward bending.

The book “Treat Your Own Back” by Robin McKenzie (the founder of this treatment approach) is a fairly cheap option (less than $15) for those of you who want some more information.  Here are links to Amazon and Barnes & Noble.

If you’re unable to find enough relief with these exercises, or they aggravate your symptoms, you should seek help from a physical therapist first.  Your primary care provider or chiropractor are good choices as well.

Got questions?  Feel limited in what you’re able to do?  The staff at Limitless Physical Therapy in Eugene, OR can show you how to be limitless. Contact us to connect with on of our PTs. Or follow us on Facebook.

***The above information, including text, images, and all other materials, is provided for educational purposes only, and not as a replacement or supplement to professional medical advice.  Please contact a certified healthcare professional or your primary physician for any personal concerns.

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