We have a new protocol that we are using clinically that I think is rather common for a lot of back pain that is slow to heal and more severe in presentation.

The presentation is typically:

1) Moderate to severe low back pain, especially with changes in position.

Example: it hurts when getting up after being in a seated position, especially after a drive of more than an hour and/or getting up out of bed. In the clinic, I asked clients do you have the “old man walk” when you get up out of bed?

2) muscle spasms or cramping.

A lot of times it will happen into the calves and feet but can easily present through the lower back and upper back.

3) sciatica

“Tight” pain in the glutes typically one-sided, but it can be bilateral. This happens through the area of the upper butt and wraps through the Glute muscles. Often the pain “shoots” down the leg along the side following the IT band, and at other times, running directly down the back of the leg.

The combination and presentation of these three issues are why I have named this the low back triad.

It is typically three different things that are all happening at the same time. Most often this results in the patient getting poor results, assuming the issue is much worse than it is, trying to treat one thing at a time or more classically -treating each of these issues incorrectly.

Each of these issues by themselves hurt. A lack of understanding and treating each of these issues incorrectly isn’t going to help your problem go away..

Here’s the problem.

There are multiple reasons to have tight muscles and you have three of them! At once. Yet, None of these issues respond well to heat or stretching.

Yet that is the most common self treatment protocol I hear in my clinic. It makes sense, if you were doing your treatment wrong, you aren’t going to get the results you are looking for.

Almost everyone I see in my clinic comes to me and says they have been trying to stretch and use heat in an effort to decrease the muscle spasm.

The problem is you have a muscle spasm in your lower back that is a protection for the disc strain.

The treatment for this is to take care of the inflammation (the threat) and the spasm typically goes away when the threat is gone. Ice works better than heat for nearly all of these low-grade disc strains.

The second thing you have going on, is tight muscles due to an electrolyte deficiency. Stretching and using heat won’t work for this either as the issue is primarily an electrolyte ratio problem. You need to get electrolytes back in your system..

And lastly, you have tight muscles through the glutes most often because they are elongated and your hips are rotated in. Contraction, not stretching will work better for this.

Understanding of this common lower back triad will help you treat this properly and speed up rather than hamper your recovery!

In recap, here’s what you need to do:

Treat the disc strain. The best thing you can do at home is an ice pack for about 8 to 10 minutes. Treatment and use of anti-inflammatories is a personal preference and should be made based on a professional assessment. Understand the issue is primary inflammatory in nature so adding heat/stretch and even massage can be counterproductive at this stage.

Get some electrolytes in your system because if your levels are sub optimal, you will constantly battle spasms and cramping.

Get the biggest, strongest muscles of your body up to speed and working for you. You need to get those glutes turned on. If the glutes are not doing their job, extra pressure is put into the lower back as the muscles of your lumbar spine are now being asked to do their job and the job of another muscle.

Although it is easy to get frustrated when the combination of pain, change, the position and nervous sensation are all happening at once. This try it is not typically a very difficult issue to work on when it is understood, and properly treated.

Each aspect of the triad typically is quick responding and I would expect great changes within one week. Just remember, you need to treat this as a combination issue and not one separate issue at a time. Treating one aspect of a three pronged problem isn’t going to give you the results you’re needing.

The low back triad is something I am starting to recognize and diagnose more often in my clinic. It takes a three fix approach and a good understanding to get optimal results.

This article is built for information purposes and understanding only. It is not to be used as a treatment nor exam by itself.