Therapy for Low Back Pain
By Stan Andrzejewski • February 17th, 2006 • 11714 Views
Hatha Yoga as Physical Therapy for Low Back Pain.
Another cause of low back pain is lumbar facet and sacro-ilial joint compression in extension. This mechanical stress to the joints inflames the surrounding tissue, including the nerve roots. When one stands unskillfully with increased lordosis, pelvis in tilt and forward shift, lumbar facets can be compressed unevenly. If there is no grounding or lift, this uneven compression can be quite excessive. If one is asymmetrical, collapsing on one leg, the mechanical stress can be injurious to that side?s joint structures. As well, spondylolisthesis is exaggerated as the lumbar vertebrae are translated anteriorly due to the mechanical stresses of this unskillful stance.
People report low back pain upon prolonged standing. Maybe even slow walking brings on pain, but brisk walking can be relieving. In brisk walks, they have enough skill of spine lengthening to stay out of compression. They might even report S/I pain in weight bearing of one sit bone when sitting upright.
In this scenario, forward bending is relieving and extension is provocative. One issue is that standing and sitting upright is extension, and therefore, provoking inflammation from joint compression. One cannot, of course, avoid upright postures in one?s daily activities, unless in the most extreme of restrictions of movements, bed rest. One needs to learn the motor skills of standing and sitting upright without injurious joint compression.
Lumbar facet joints will compress on a neighboring facet and the sacrum will compress on the ilium with too much nutation/ extension. An ilium will compress on a sacrum with femur in extension, as the ilium anteriorly rotates. With the femur in external rotation, the ilium outflares to compress against the sacrum. The sacrum can compress into the ilium as the spine rotates the sacrum into the ilium. If the thoracic spine sits too heavily on the lumbar spine, injurious compression may result. If the thoracic spine is hypomobile, then spinal movement has to come from too few joints of the lumbar and sacro-ilial area. The thoracic and cervical spine needs to have the skill of lengthening in order not to excessively compress above or below the stiffer thoracic spine.
Skillful standing in yoga is Tadasana. One needs to learn the inner actions of grounding, centering, and lifting with keen attention to breath, body sensation, and imagery. ...