I hear it all of the time from patients-“My back is out,” My SI is out,” “My pelvis is out of alignment,” “My L5 (or any other numbered vertebra) is out,” “My vertebra is rotated.” I don’t blame my patients for saying these things-this is what they have learned to be the cause of low back pain. Maybe it was from a friend, or they read about it online, or maybe they were told this by another health care provider. Something being “out of place” can definitely seem like a plausible reason for the pain that a person may be feeling or the difficulty that they may be experiencing while trying to move. But....is this really true?
I hear it all of the time from patients-“My back is out,” My SI is out,” “My pelvis is out of alignment,” “My L5 (or any other numbered vertebra) is out,” “My vertebra is rotated.” I don’t blame my patients for saying these things-this is what they have learned to be the cause of low back pain. Maybe it was from a friend, or they read about it online, or maybe they were told this by another health care provider. Something being “out of place” can definitely seem like a plausible reason for the pain that a person may be feeling or the difficulty that they may be experiencing while trying to move. In fact, there was a time when I believed that people had low back pain because something was out of place, rotated, or not moving correctly. The problem with this explanation is that it is actually not true and believing that something goes “out” in our backs and needs to be “put back into place” can make us view our spine as fragile and vulnerable.
What we have come to realize through recent research is that the spine and pelvis region is in fact very stable and strong. They do not “go out of place” while bending forward, picking something up, sleeping, slouching, twisting, running, lifting weights, etc. You can definitely experience low back pain with some of these activities, but evidence shows that pain onset is likely related to other factors and there is no evidence that our spine or pelvis region gets out of alignment. See picture to the right showing the extensive ligamentous support for our pelvis. In order to damage this area, you would realistically have to be in a high speed car accident or fall.
Now, you may have had x-rays by someone who told you there was a vertebra out of place and that you needed a certain treatment (likely an adjustment) to put it back in place. Again, this is “old school” thinking that is not supported by any research to show that this is the case. You may have been “adjusted” and felt better, but it was not because something was put back in-our spines are stronger than that. In fact, if you are seeing someone for your back pain who is taking x-rays and telling you that you need to be treated because you are “out of alignment,” I strongly suggest that you look for a different person to treat your back pain. Here is a link to a short video discussing this type of care. Let me just preface this video by saying that showing this video is not meant to apply to all chiropractors as there are some very good ones that do good things and practice in an evidence-based way. However, there are also still a lot of others who continue to use x rays and tell people something is out of place and needs to be put back in alignment. These are the chiropractors to avoid.
There are other health care practitioners who, instead of using x-rays, place their hands on certain regions of your spine or pelvis and state that they are able to see or feel that something is out of place. This was me a number of years ago before I began questioning what I was doing and started delving into the research related to this way of treating back pain. Again, this type of framework for explaining and treating back pain is just not supported in the research and anyone still treating this way is not staying up to date on what is now known about low back pain or pain anywhere in the spine for that matter.
Now, you may be thinking, so what? I had adjustments, manipulations, muscle energy techniques done to correct my problem and it helped so that’s all that matters. Well, it is great that it helped, but in the long term you need to know that your back is strong and resilient and not prone to just “going out of place” and in need of being put “back in” by someone else to get better. There is no doubt that our backs can become painful and sensitive to certain motions or positions. However, the cause of this can at times be complex and being told information that is not true and does not reinforce the innate resiliency and robustness of our body, may not help you recover and regain your ability to live your life to its fullest capability.
The idea of back pain being caused by a joint being stuck, twisted, rotated, out of alignment, etc is just one of the many long-held beliefs that have been proven to not be true. Follow along in my future Blogs as I address some of the other false beliefs still being held by other health care practitioners in regard to the causes and treatments for low back pain.
If you are or have been treated by someone telling you your spine and/or pelvis is out of alignment and you need extensive treatment for things to be put back into place, let's talk! Click on the link below and we can set up a time to talk about your problem and discuss some other reasons why you may be having pain and what can be done about it.