Low Back Pain

It has been stated that back pain is the most common cause of disability in adults under age 45. Older individuals also suffer chronic and sometimes function altering back pain. Most workplace or medical service designed programs have made little progress in reducing low back pain causes and consequences. Kulp Physical Therapy and Massage is uniquely suited in treating low back pain causes and consequences. We take an approach of evaluation and treatment, which looks at the why's, and how's that create low back pain. Back pain can be categorized into upper back pain and lower back pain. This article will concentrate on lower back pain. Most medical practitioners agree that back pain can come from multiple sources. Some of the sources include lumbar discs, vertebral and facet joints, organs, nerves and most importantly, the muscles. Most disc, joint, nerve and muscle disorders are influenced by posture; work, household and recreational activities; nutritional and hormonal imbalances, as well as psychological factor(s). Kulp Physical Therapy and Massage will look at each of these factors in determining how they are influencing individuals pain and how each factor overlaps with each other.


Myofascial treatment of low back pain is an effective modality for reducing low back pain. Kulp Physical Therapy and Massage utilizes the Travell Trigger Point Treatment approach to the treatment of myofascial pain. Our approach utilizing up to six different steps, thoroughly reduces the myofascial pain symptom. (See article labeled myofascial pain and treatment) There are 15 different muscles or groups of muscles that are primary in causing symptoms of low back pain. They include the quadratus lumborum, iliopsoas, abdominals, longissimus lumborum and thoracis, iliocostalis lumborum and thoracis, multifidi, the gluteal muscle complex, piriformis and obturator muscles, tensor fascia lata, quadriceps, hamstring and soleus muscles. These muscles will all cause local or referred low back pain. (Note the attached pictures) It is important in the treatment of these muscles that the trigger point is effectively reduced. It's also important that defining the perpetuating factor or factors that makes the trigger point continue, and reduce these factors. These muscles are influenced greatly by the discs, joints and ligaments that they support. Kulp Physical Therapy and Massage utilizes a variety of joint mobilization treatment techniques including the Maitland approach, strain-counterstrain approach, and the muscle energy approach.


Each approach is specifically utilized in the treatment of joint disorders and takes into account the individuals input, comfort and past experiences. A significantly overlooked treatment for low back is the Neurodynamic Stretching approach. This approach takes into account how nerves can be a site of pain generation. Nerve symptoms can be in both the local low back and referred into the lower extremity. Kulp Physical Therapy and Massage has been uniquely trained in this treatment method. Most individuals are unaware how organs can create low back pain. A term coined Viscero-Somatic pain describes symptoms referred from the organs to the body wall. Myofascial trigger point treatment has been utilized in the treatment of Viscero-Somatic referred pain. Fibromyalgia is a term currently used with disorders of multiple muscle and joint involvement. Fibromyalgia can result in low back pain, and is a subject of vast study and importance and will not be addressed in this current article. Myofascial trigger point treatment is effective in the reduction of myofascial pain.

Quadratus Lumborum