The concept of a “pinched nerve” has become synonymous with the experience of acute lower back pain to the point that most patients diagnose themselves with a “pinched nerve” before they have even walked into my office. In fact, real pinched nerves are a fairly rare phenomenon and acute lower back pain or a “pinching feeling” in the lower back is not related to nerves at all. Rather, lower back pain is most commonly caused by irritated muscles and joints and in most cases can be easily managed by manual or movement therapy (i.e. your local Chiropractor).
So what actually causes lower back pain or a pinching feeling in the lower back?
These kinds of complaints are usually caused by small movements that we repeat over and over in our day to day lives that are actually causing damage to our spinal structures. Over time, this damage accumulates and causes an injury which then leads to the pain which most people experience.
If you are experiencing lower back pain or want to reduce your risk of developing lower back pain, the most important thing to do is to stop damaging your spinal structures in your everyday movement patterns.
Forward bending (known as flexion) and twisting (known as rotation) can be damaging to the spine if not done using the correct form. If you bend forward or twist with a rounded or hunched lower back then you could be causing small amounts of damage to your spine every time you bend over to brush your teeth, load the dishwasher, pick your socks up off the floor or pick up your baby or puppy. If you do this often enough and for long enough, you will eventually develop a lower back injury. In addition, hunching over a desk or computer is also considered a form of flexion which is damaging to the back. If you spend your whole life hunching over your desk, this too can cause an injury in the lower back.
Once you have this injury, bending over becomes painful and even intolerable. This pain also sometimes extends into the glute or leg.
How do we prevent and treat these types of lower back injuries?
Most of us can’t limit the number of times we need to bend over in a day, especially if forward bending is part of your occupation, child caring, housekeeping or fitness routine. But you can make sure that when you do bend forward, you do it well and avoid damage to the spine over time.
The key to forward bending well is to maintain a neutral lower back (not arched or hunched) and to bend in the hips (known as a Hip Hinge). The Hip Hinge protects the spine from damage by activating your abdominal’s (which keep your spine strong) and allowing your large glute muscles to do all of the hard work, instead of your back. If we consistently make sure to forward bend using a neutral lower back, we can successfully prevent lower back pain in the future.
What if you already have a lower back injury or already experience pain when bending or rotating?
Your natural response to this pain might be to avoid the movements that cause the pain i.e. bending over or rotating. In fact, forward bending is part of life and forward bending using a Hip Hinge will not only help to prevent future damage to your spine but will also allow a damaged spine the time to heal. Instead of avoiding the movement altogether (which isn’t really possible), it is better to continue to bend and rotate but to make sure to do it using a neutral lower back so that you don’t continue to damage your back. This will also help to teach your brain that this type of movement is “safe” and that it doesn’t need to avoid bending in order to reduce pain. Over time, repeating movements that were once pain-provoking can help to train your brain to no longer see them as painful.
Below is a comprehensive series of videos covering how to perform the hip hinge as a anti-dote to a “pinched” lower back.