This type of pain can strike suddenly and without warning, leaving people crippled in pain, the pain is often described as sharp and stabbing. Any movement is painful, sometimes the pain is so bad the only way to get around is by crawling on their hands and knees It’s usually the most trivial or mundane things that set it off, whether it’s emptying the dishwasher, or picking something off the floor. Another common time to get this is when you’ve been in bed for an extended period with the flu or illness and have been sneezing and coughing excessively, causing the muscle(s) to spasm. Typically there is one particular muscle that is the main culprit with this type of back pain, the quadratus lumborum, It attaches to the bottom rib, to the top of the pelvis, and to each of the vertebrae of the lower back, when there is spasm or complete contracture it can irritate the structures of the low back, it’s like having a calf cramp, but instead of the leg its of the lower back and unfortunately can’t be stretched out like most calf cramps.
Although the pain may be excruciating, in the absence of leg numbness, weakness, or changes to bowel or bladder (cauda equina syndrome) It’s important to realise the level of pain you’re experiencing is not a reflection of how much damage or injury to your spine. Part of successfully treating this type of pain is doing an assessment ruling out any potential medical reasons (which are very rare), releasing the QL spasms and the compensatory spasms around the lower spine, and receiving reassurance that the “bark is much worse than the bite” and how to best manage the first 48 hours and begin the process of recovery so you can get back being pain-free and reintroduce movement and exercise without pain.
On a side note, when getting treated make sure the therapist doesn’t have you laying face down for more than 20-30 minutes at one time, as this may make it extremely difficult when trying to get off the table due to pain, I typically have my clients do some cat/camel and stretches throughout the treatment, many are often surprised how much easier it is to move in a short amount if time.
