The muscle of the lower back helps support the weight of the entire upper body, not only that but it helps with actions such as flexion and extension of the spine, lateral flexion, rotation along the axial skeleton and much more. On top of the long list of actions the lower back does and supports, it also is the junction for a lot of the lower body nerves that power the pelvis,legs and feet. Lower back pain, (also known as lumbago) often occurs from injury to the muscles ligaments, joints or the disks of the spine. Since the body heals injuries with inflammation, this is usually what causes the severe pain, along with trigger points and referred pain from different muscles of the body. If some muscles of the neck that keep the cervicals and upper spine erect become damaged by trauma or chronic overuse, it could affect back muscles by sending them into overdrive to make up for the loss of function in the neck muscles. This pain is usually a radiating pain right above the sacrum inside the erector spinae origin sites, and the lower fibers of the trapezius muscle. Herniated disks can also be the cause of pain in the lower back due to the same inflammatory process that takes place with injured muscles, the only difference being that a muscle has the ability to heal quickly, while a herniated disc will take longer or not heal at all. Symptoms of lower back pain are experienced differently when it comes to different people. Some people have mild or dull achy pains that might not surface until a long period of inactivity or after exercise. Some experience symptoms immediately, usually after lifting heavy objects incorrectly or after trauma such as falls. These more immediate symptoms can also cause long lasting symptoms due to sprains of muscles or strains on the ligaments. Long lasting symptoms usually include a burning/radiating pain from the low back going along the back of the thighs, which could also develop into chronic back pain which lasts over 3 months. There is also acute symptoms, lasting a few days or weeks that is a regular response to tissue damage as the body repairs itself. There are many types of low back pain the three most common types being Axial, referred and radicular pain. Axial pain, also known as mechanical pain, is described as sharp or dull, coming and going or constant. Axial pain is usually the caused by muscle strain due to chronic overuse of the muscle. Referred pain is characterized as dull and achy, mobile and varying in intensity, usually caused by referred pain from other conditions of the body. Lastly, radicular pain is a deep burning pain that follows nerve paths into arms and legs. This pain can also be accompanied by a weakness or numbness in the affected areas and is caused by a compression,inflammation or injury to a nerve root a common form being sciatica. Modalities for lower back pain are often differing depending on the type and symptoms of the client. Client’s with acute axial back pain can usually see improvements with general massage techniques such as effleurage and petrissage in the affected area, the flowing and tapping techniques help flush out the slight inflammation around the muscle and relieve some of the pain. For chronic axial lumbago more caution has to be taken when massaging the client. Chronic lumbago has more damage to the tissue itself, and more damage means more inflammation. If the target area is too inflamed cryotherapy can be applied to help reduce the swelling to the point where it can be safely flushed out without being too painful for the client. If swelling and inflammation does not go down the entire massage itself may be contraindicated. For cases of referred pain, massage may not be contraindicated if the origin of the referral pain isn’t too inflamed, even if the referral zone is. And in cases of radicular pain, the lower back may not be touched entirely in order to focus on the gluteal area in order to release the compressed nerve or flush out inflammation which would be the case for sciatica or piriformis syndrome. In cases where the pain radiates from the lower back into the arms and legs the client has to be at a safe inflammation level in order to work the lower back and help release the compression.
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