What is it?
Often referred to as the ‘long muscles’ of the back, Erector Spinae are a group of muscles that stabilise the spine and also produce motion. They run vertically in a groove on each side of the spine.
What do they do?
They are the chief extensor muscles (leaning back) of the spine, and also allow you to straighten your body from a flexed (bent forward) position.
Why have we chosen Erector Spinae?
At the Good Health Centre, lower back pain is one of the most common conditions we treat; and the culprit most regularly responsible is Erector Spinae in the lumbar region (lower back).
Lower back pain
Erector Spinae can be injured due to chronic spine flexion (stooped posture and bending from the waist), lifting, twisting, carrying heavy objects, or falling.
We see a lot of patients who have lifted something heavy and have ‘felt their back go’. This is often because using the back as a lever when lifting puts an enormous strain on the back muscles, ligaments and vertebral column.
For protection, the back muscles go into a spasm after injury, or in response to inflammation of ligaments. Spasm is a sudden involuntary contraction of one or more muscle groups. You will feel cramps, pain, interference with function, producing involuntary movement and distortion.
When lifting heavy objects, you can minimise injury by crouching, holding the back as straight as possible, and using the buttock muscles and lower limbs to assist with lifting.
How do we treat lower back pain?
Our philosophy has always been to treat all patients and all conditions individually. We may see two patients with what appears to be the same problem, but the journey to recovery will always differ, as no two people are the same. Our treatment is specifically tailored towards the individual.
Let’s take a look at three different cases …
Three patients have lifted a heavy weight, and felt their ‘back go’ as they did so. They have presented to our osteopath with the same right-hand side lower back pain.
1) Josh: A 25 year old male, usually fit, a healthy body weight, never experienced any previous lower back pain.
On examination, our practitioner discovers that there is an obvious joint sprain, causing a lot of muscle spasm, and subsequent aches and pains.
2) Linda: A 40 year old female, with intermittent episodes of back pain.
On examination, our osteopath discovers a fixed forward posture with a reversed lumbar spine. Linda has had two children, both delivered by caesarean section which subsequently weakened the muscles in her abdominal wall.
3) Lee: A 30 year old male, fit and healthy, with occasional stiffness in his lower back.
On examination, our osteopath discovers Lee has one leg shorter than the other which causes a tilted pelvis when stood. Due to this, Lee bends to one side (away from the shorter leg) while walking. This has led to back compression on the opposite side to the shorter leg.
As he has lifted the heavy object, he has stretched an already shortened muscle that caused the lower back to strain, evoking the spasm.
How would our osteopaths form a tailored treatment plan?
If our practitioner were to employ the same treatment plan for each patient, it is unlikely to be successful due to the extremely varied factors which must be considered.
Different approaches …
1) Josh: As Josh doesn’t have any additional complications, our osteopath predicts he will need two sessions. He is young, fit and healthy, therefore firm mechanical techniques are applied, including soft tissue mobilisation and manipulation. Immediately after treatment, Josh finds that full range of movement has been restored, and reports he is in much less pain.
2) Linda: If this same firm technique was used on Linda, she would find it too traumatic as her underlying cause for her problems have not been addressed properly. Instead, our osteopath employs a very gentle approach, supporting the tissues allowing them to unravel and relax. Our practitioner then shows Linda breathing techniques and abdominal exercises to strengthen the muscles that were weakened by caesarean section. This coupled approach gives her the quickest benefit with the least trauma.
3) Lee: Our osteopaths approach Lee’s problem in two phases – short-term and long-term. In the short-term the aim is to reduce pain, improve joint mobility and reduce inflammation; to which Lee responds very well. However, the presence of a shorter leg would be regarded as a possible maintaining factor to his complaint. Careful consideration and appropriate treatment to his unique presentation (such as heel lift or pelvic tilt) will hopefully prevent a reoccurrence of his acute back.