Lower Back Pain and Medical Massage Therapy: The Motion Segment of the Lumbar Spine



Lower Back pain is a common ailment for many massage clients. This issue can be highly complicated and difficult to deal with on your own. More often than not, lower back pain can require the help of professionals, massage therapists, chiropractors, or other medical professionals. It is caused by many different things and can occur as a result of driving or getting in an accident, sitting at a computer, lifting too heavy, falling, walking, standing, or sitting incorrectly, being on your feet too much, and so many others.


There are so many ways to injure your lower back because there are so many components to injure in that particular area, and because we get a lot of use out of it as well. The lower back is responsible for quite a bit of our regular movement, our stability, transferring weight from the upper half of our body to the lower half, and the list goes on and on.



There are many ways to help your lower back, and we will try to cover some here. Some things, you are able to do at home or on your own to maintain proper care of your lumbar region of the spine. If medical intervention is needed, you may need to see a doctor or a chiropractor. It is helpful to see a massage therapist regularly, to assist you with preventative care. At Healing Solutions Inc, we have a wellness program that gives our members a discount for coming in regularly. To learn more about our packages, visit us here!


In the future, after an injury has already happened, it may be necessary to get medical massage therapy. Did you know that medical massage therapy is often covered by insurance? We can help you with that as well. To contact us, visit our website at www.HealingSolutionsInc.com, or call us at (720) 768-3381. To read more about medical massage therapy, you can check out our blog here.


To understand the inner workings of the motion section of the lumbar spine, it is important to get a feel for the anatomy of the region. This is what your medical workers and massage therapists know, and why they are able to help you so much. Knowing how you were injured and what part of you is injured allows them to give you proper treatment. It is also important to know how massage therapy may help you before or after an injury to your lower back has occurred.


Motion Segment of the Lumbar Spine



Movement between two bones is what constitutes as joint movement. That basic definition is good enough to describe almost all of the joint movement in the human body. The spine, however, is a complicated thing. Spinal motion involves quite a lot of soft tissues, more so than other joints. Here, we will focus on the lumbar spine and the neck to showcase the complexity of these areas of the body. Movement of the neck and lumbar spine are a necessity, and use of proper mechanics in order to move correctly is highly important. Dysfunctional mechanics will cause pain and possible injury to these joints.


The ‘motion segment’ or ‘functional unit’ of the spine is integral in proper body motion and mechanics. The bones and tissue involved in this structure are the vertebrae, the intervertebral disks in between them. There are many other soft tissues involved as well, here. Exploring the motion segment of the spine, we can look at two parts, the anterior and the posterior.


Anterior Portion of the Motion Segment of the Lumbar Spine


The anterior portion of the motion segment is made up of the vertebral body, the intervertebral disk, and the anterior longitudinal ligament. Heavy weight bearing is the burden of the intervertebral disk and surrounding soft tissues. When you lift heavy weight with your upper body, the weight distribution makes it to your lower body by way of the spine, and the lumbar spine, this motion segment, takes a large amount of that load. Due to this, the largest disks in your spine can be found in the lumbar area.



This part of the spine is uniquely built to be able to carry a heavy compression load while still remaining mobile. Have you ever moved from one house to another? Do you remember bending to pick up then carry those heavy boxes? Weight lifters can also be grateful that these spinal processes are at work. That is the miracle of the lumbar spine at work. The intervertebral disks are cushions, shock-absorbers. They sit between the vertebrae and stop the bones from hitting each other.


The inside of the disk is made up of a gel-like material called the nucleus pulposus. The outside is a container for the gel-like material and is called the annulus fibrosus. Much like the name suggests, it is made up of firm fibrocartilage. The vertebral end plate is where the disk gets its nutritional supply. Disks don’t have a supply of blood that comes to them from the body, unlike most of our anatomical parts.



The vertebral end plate is a very strong cartilage (hyaline cartilage) that is in between the bone and the disk. It is important to note this because highly compressive lifting causes a lack of nutrient diffusion from the vertebral end plate to the disk. This could be a factor leading to degenerative disk disease. This long term injury/disease is extremely painful, and it causes debilitating effects as the disease worsens.



The anterior longitudinal ligament is extremely important here, because it is what allows your spine to handle this type of workload while still maintaining structural integrity. The ligament helps hold everything together and assists by allowing the lumbar spine to move, but not too far. Spinal extension can be a very dangerous injury, and the anterior longitudinal ligament assists in stopping it.


Posterior Portion of the Motion Segment of the Lumbar Spine


The parts of the posterior portion of the motion segment of the lumbar spine include the vertebral arches, the facet joints between the adjacent vertebra transverse and spinous processes of the vertebrae, and the supporting ligaments that span between adjacent vertebrae. There are quite a few ligaments, but we will discuss some as a group. There are the intertransverse ligament, the interspinous, and the posterior longitudinal ligaments. There is one main function of the posterior portion of the motion segment of the lumbar spine. The purpose is to guide specific movements of the spine and to stop or slow down other movements of the spine. This is often the case when you see that many ligaments in one place.


The facet joints are also important in the guiding of the lumbar spine’s movement. They allow for maximum flexibility due to the way they are built. Spinal flexion and extension are possible at the large range they are because of the facet joints. There is also some lateral flexion and rotation in the lumbar spine, but the most flexibility is definitely in the flexion and extension. It is the section of spine above the lumbar region, the thoracic region, that is responsible for rotation, but it is responsible for minimal flexion and extension due to the rib cage connections.



The ligaments that are present in the posterior portion of the motion segment of the lumbar spine are primarily there to provide stability. The intertransverse and interspinous ligaments support vertical spine stability. There is a constant back and forth at this point in the spine between maximum extension/flexion motion and stability. When you think about what is really going on at this level, it is incredible.


Understanding what makes up the body we have can help us to understand what all goes into making us stable, and also helps us understand why we are so easily injured in this area. Professionals who understand the inner makeup of the lower back can zone in on trouble areas and assist in finding and aiding us in a recovery that is specific to the actual injured area.


There are too many pieces that can be injured here, and it isn’t easy to tell what injury you may have. At Healing Solutions Inc, we are trained heavily in Medical Massage Therapy, and we are able to help you understand if you need regular massage (Sports Massage, Sports Injury Massage, Massage for Chronic Pain) or other medical intervention to help you recover from your injury. If you have questions or would like to book a massage with us, visit us here, and we will contact you as soon as possible. Our mission is to relieve pain and restore lives. We would love to help you.


Dysfunctional and Improper Mechanics of the Spine and How they can Cause Injury

There a large amount of soft tissue injuries that are prevalent in this area of the spine, and many of them are due to improper mechanics or dysfunctional mechanics. As you can see from the explanations above, spinal movement is a fully coordinated effort. All of the pieces need to move properly together in order for your full movement to be productive and healthy. Although we are discussing the movement portion of the lumbar spine here, it is equally important for the adjacent movement sections to be practicing proper mechanics as well. The body all works together to create a perfect movement harmony.


If movement is lost in one segment of the spine, movement can also be lost in areas that connect to that segment. This can be very detrimental to the overall health of a person who is experiencing movement loss. It can cause impaired movement, of course, but can also cause injury to other parts of the body. Many people who experience limited movement in the lumbar spine are eventually faced with hamstring and thoracic spine injuries due to the strain caused by that loss of movement.



Issues can also be caused when the facet joints are forced to bear weight. They are not meant to do so, but poor posture and body mechanics can cause undue stress on the joints. Normal spine mechanics allow for the facet joints to bear barely any weight. Improper posture in the form of lordosis, when the back is curved in at the hip, commonly seen during pregnancy, etc., causes weight to move to the posterior motion segment. The weight being placed there can cause arthritis, degenerative issues or lumbar facet syndrome along with muscle tension and strain.


Issues can be caused in the anterior portion as well, but as stated earlier, the anterior portion of the movement portion of the lumbar spine is built to withstand heavy weight bearing pressure. Muscle tension will accompany any anterior issues. Intervertebral disk pathology can also occur, which is a huge problem. Although the disks are resistant to compressive loads, they can be seriously injured due to improper mechanics or lifting things that are too heavy over periods of time.



Prolonged overuse of the spine by way of heavy weight loading can cause disk deformities. Herniated disks and ruptured disks occur as a result of this type of overuse. This happens when the nucleus pushes out into the annulus or ruptures all the way out. Severe pain along with degenerative changes accompany these injuries to the disk. Disks are so resistant to injury from compressive loads that when proper mechanics are used, proper posture and lifting technique, most times the vertebral end plates will fracture due to compression before the disks are herniated or ruptured. This illustrates just how important it is to take care of your back with proper stretching, exercise, healthcare, self-care, and body mechanics.


Without proper back care, fusion of the spine may be necessary, which in turn, can cause more back pain. Fusing joints in the back causes immobility of the joint, permanently. We discussed above that immobility in one area causes the areas above and below that area to also be less mobile. This overall lack of mobility in the back will cause ongoing back pain. Nobody wants irreversible, permanent back pain. Don’t let it get this far. Take care of yourself.


Take care of yourself in every way that you are able. Stretching, exercise, and proper self-care are great ways to keep your back healthy. Practicing proper ergonomic techniques while sitting, walking, and standing are also very important. We have a blog on self-care that may help you decide how to best assist your body in its overall health here. At Healing Solutions Inc, we offer a variety of ways to help you with consistent spinal care, spinal injury recovery, and maintenance of your healthy back. We offer Cupping, Healing Touch, Yoga, and many Massage Therapy Techniques that will help you.


How Massage Therapy Can Help


There are an incredible amount of benefits to regular Massage Therapy and Medical Massage Therapy. Massage Therapy is particularly useful in manipulating muscle in a way that allows the body to loosen and use proper mechanics. All of the issues we discussed above are worsened by tight muscles. Tight muscles cause immobility, pain, and often, improper posture and body mechanics. This is the root cause of most back pain. This also results in pain all over the body due to improper mechanics of the motion of the back.



Massage Therapy is a leading treatment for tight muscles, and, as a result, is a huge help in reducing back pain. Regular massage therapy can be extremely beneficial to your overall spine health because it allows you to move properly, thereby, allowing your proper body mechanics to be even throughout the entirety of your body.


Increasing mobility in the spine is great for your body mechanics and reducing back pain. It has a ripple effect as well. Loosening muscles around the spinal area will allow for proper self-care techniques to be fully realized. Less pain will allow for a deep and therapeutic yoga session, a run that flows more freely, and a more receptive overall body. Massage Therapy relaxes the region first, then addresses deeper issues in key muscles within the region that have a direct effect on the motion segment of the spine.



The latissimus dorsi is a large muscle that lays over the entire back. Massage therapists will know that to reach the lower muscles, they will have to loosen the latissimus dorsi first. After that, the therapist will be able to work on deeper muscle layers that may include the erector spinae group, for instance. There are three divisions of this muscle group, the spinalis, the iliocostalis, and the longissimus. This muscle group is a common issue for people who come to massage therapists with lower back pain.


Massage therapy brings immediate relief to people who have tight muscles in the erector spinae group. They are superficial compared to many other muscle groups, and are relatively easy to loosen for a trained professional. These muscles, when tight, cause severe lack of motion in the lumbar spine. They also alter the ability of the muscles around them to work properly if they are tight or injured. Loosening these muscles allows the trained massage therapist to alleviate back pain immediately, and also allows them to go one layer deeper as well.



There are layers upon layers of muscle in the back because they are responsible for the stability of the body’s core. If even one of them is injured or tightened up, it can throw off the way we move. Benefits can certainly be had in combining chiropractic care and massage therapy. It is also beneficial to have this duo on hand in case you are injured. Many insurance companies will now cover massage therapy if it is prescribed by a chiropractor or doctor. To read more about Auto Accidents or Workers Comp and Medical Massage, check out our blog here.


Lower back pain is a primary reason for people to seek out massage therapy and medical massage therapy. Understanding the mechanics of the spine can help you to make a decision on what you may need done and where. Massage therapy can help you with any of the spinal issues you may be having in so many ways. To read about the benefits of Therapeutic Massage Therapy and Relaxation Massage Therapy, read more here. All of the benefits may help you when dealing with a lower back injury by restoring optimal spinal mechanics and mobility. We can apply techniques and strategies in our treatment rooms that will absolutely help you. Our goal at Healing Solutions Inc is to relieve your pain and restore your life. Consider booking with us today at www.HealingSolutionsInc.com




Source:

Massage and Bodywork Magazine, Issue January/February 2020, pages 100-103

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