Low Back Pain Case Study: Flexion vs Extension

Person A is a 65 year old male, retired and non-active

• Lower back pain and leg discomfort

• Heaviness in the legs often makes standing or walking for long periods of time very difficult

• Slow onset over several months

• Sitting is a relieving position

Person B is a 45 year old male, works a desk job, active weekend warrior

• Lower back pain and leg discomfort

• Mild numbness and tingling in his leg

• Leaning forward while sitting or standing worsens symptoms

• Quick onset over a few days, after moving a couch

• Arching backwards is a somewhat relieving position

Both of these people are experiencing low back pain and leg discomfort… but for different reasons. Person A’s symptoms are being caused from lumbar spinal stenosis. This is when there is narrowing of the spinal canal which compresses the nerves where they exit between the lumbar vertebrae. Person B’s symptoms are coming from a lumbar disc herniation which commonly presses against, or inflames, a nearby nerve causing discomfort down the leg. This can often be caused from a lifting and twisting movement.

Both of these conditions are treatable, but the treatment approaches are quite different. In essence, Person A will benefit from mobilization/manipulation and exercise that promotes flexion of the lumbar spine which will widen the spinal canal. Person B will benefit from therapy that emphasizes extension in the lower back which relieves pressure on the overloaded disc. It is important for both these individuals to become more aware of their body as they sit/stand/walk/move through their daily tasks.

Sometimes it is difficult to determine the source of your back pain and what to do about it. Depending on the cause of your low back pain, your chiropractor can determine the most appropriate type of treatment for the problem. A thorough history and examination are used to choose the treatment intervention that you would most likely benefit from.