Chronic low back pain. Why does some back pain not go away, even when you have had treatment? Probably the most common reasons are incorrect diagnosis, or treatment aimed at the wrong area. There are a few key things that are typically overlooked when it comes to low back pain.
Low back pain is sometimes on one side, both sides, or can even swap sides. There may be pain into the buttock area, and/or down the front, side, or back of either leg. Most times, it will resolve on its own within one to two weeks, but when it persists the correct diagnosis and course of treatment is essential.
Commonly overlooked mechanical dysfunction:
1. One hip becomes dysfunctional, placing more stress on the lumbar spine. This is typically a glute minimus muscle dysfunction, and is generally quickly resolved with dry needling, and exercises that target the muscle. Pain is often felt at the side of the hip and down the back or side of the leg.
2. QL or quadratus lumborum muscle dysfunction. Quite a varied pain distribution, but very one sided, with pain from the lower rib area, into the small of the back and often a sciatica style presentation. Treatment is often required at the lower ribs, the lumbar spine and the hip and may include dry needling, spinal manipulation and of course exercises.
3. SIJ or sacro-iliac joint dysfunction. Very one sided, hard to place weight on the affected side, and pain may radiate from the back in a sciatic presentation, and even cause lower abdominal and groin pain. Dry needling and SIJ manipulation are very effective. This is often as a result of a fall, or going down a step heavily on one leg, and can last for many months until it is correctly treated.