It shouldn’t be at all surprising that in a chiropractic office setting that we often see patients with neck and back pain. After being in practice for 25 years I’ve noticed patterns and common traits as to where people will feel their pain.
Very often, where the patient reports she is hurting is Not where the problem is.
A good example is someone will say she has neck pain and her upper back hurts just between the shoulder blade and the spine. She will say she has pain on the right upper Traps and her right forearm or maybe even the hand feels a little tingly or numb.
I will test her by palpating her spine, checking for joint movement between individual vertebrae and checking her ranges of motion in different areas of her back and neck. I’ll typically find that the C1 (top vertebra in the neck), is stuck or "fixed" with the right side turned to the back. Even though she reports no lower back pain, when I check her lower back I’ll find that her sacrum is fixed and turned to the back on the right side also. When I start to push on and palpate her left hip area I’ll find that the left pelvis is fixed and tipped back...but no noticeable lower back pain.
On x-ray I’ll see that C1 and the sacrum is in fact turned back on the right side and the left pelvis is tipped back.
What is the connection between her upper back pain and her lower back?
The pelvis is the foundation of the spine. If it is twisted or rotated, the spine which is attached to and standing on the sacrum will also rotate. One of the attributes or characteristics of being alive is that living beings adapt to their environment. A non-living structure such as a chair does not adapt. If you push on a chair enough it will fall over. If I push on you (at least initially), you will subconsciously push back - your muscles will automatically tighten on the same side to prevent me from pushing you over...That’s you adapting to the force of my hand on your shoulder. Were I to push hard enough I might over-come your ability to adapt and you will fall over.
When the pelvis tips back on one side, the other side adapts - it counter-rotates and tips forward. This causes the sacrum ( in between the two pelvis bones), to twist. One side rotates forward and upward and the other side goes back and downward. The lumbar spine (L5 specifically), which is attached to the sacrum must also twist and tip with the sacrum (they’re attached - just as if I twist your hand your wrist must twist with it...), as all of the vertebrae are similarly attached in line, the entire spine must become twisted to some degree all the way up to your head.
All this twisting of the spine is also making your spine bend because bending and twisting are coupled and always go together - you can’t bend the spine without twisting it and vice versa.
Try this: throw a quarter on the table so that it turns / wobbles around it’s edge. Now watch it as it continuously turns and lifts its edge. What is happening is that as it leans to one side it turns to that side and as long as it continues to turn and lean...it will continue to lean and turn.
This is a physical phenomenon seen with any circular object. The weight-bearing portion of your vertebrae are essentially round just like the quarter - but much thicker. Same laws apply.
So, as our patient’s back is twisting (and leaning), it is also attempting to "adapt" to this changing shape. The end result is muscles that are not ordinarily all that tight - get tight. A lot tighter... And this explains why she is hurting in between her shoulder blade and her spine.
There was no problem there before but because her low back was twisted out of alignment and not even hurting (yet), the end result is that her upper back is taking the heat for this.
This explains why when your low back "goes out" you can feel it elsewhere - in your upper back, your neck or maybe even get headaches, carpal tunnel pain, TMJ, PMS, reflux, feel stressed, have insomnia. It also explains why it pays to check and examine the entire spine instead of only the part that hurts. Treating the point of pain...you might just miss what is causing the whole entire problem.
When you step on the dog’s tail the other end might just bite you ...
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