Case Study – chronic low back pain due to posture

This case involves a 40ish year old, very fit and active male. I know very few people that are in better shape than this guy. However, he still suffered from chronic low back pain.

We started with the usual treatments for this issue, including chiropractic adjustments, muscle therapy, and core stabilization exercises. However, after 3-4 visits, he wasn’t experiencing much of a change. I know to many chiropractors and physical therapists reading this, that’s not that many visits, but I’m accustomed to seeing some sort of improvement within the first few visits, or I begin looking for other causes.

Knowing that this guy was fit, I started to ask him about his exercise routine. Long story short, he was doing a ton of abdominal work. “After all, strong abs help with the back, right.” Usually, but the devil’s in the details. It turns out that he was trying to work out the abs, but the exercises he was doing targeted mainly the hip flexors. This lead to a condition known as “lower crossed syndrome”. The hip flexors became much too tight or overactive at the expense of the hip extensors and abs, allowing his pelvis to lean forward and the curve of his low back to increase. This caused the joints of his spine to “jam” together and give him his chronic low back pain.

Here’s a photo that helps illustrate this point.

Anterior Pelvic Tilt
Anterior pelvic tilt

So, how did we fix it? First, he had to stop overworking his hip flexors. This meant the roman chair exercises, sit-ups, and curl ups had to go. Next, the hip flexors needed to be stretched. Third, he had to work on exercises that isolated the abs like Janda sit ups and posterior pelvic tilt exercises. Last, we used myofascial/muscle therapy to loosed up his tight hip flexors and erector spinae.

Within a week of starting this regimen, the patient reported that his pain was gone. This was after many months of living in pain.

The scenario above is just one of many reasons a person can have back pain. As a chiropractor, it is my job to evaluate a person and find the cause of their pain. If you’re having an issue and live in Orwigsburg or the surrounding areas of Schuylkill County, give my office a call at 570-366-2613 to set up an appointment.

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