Your spine is your integration center and your support system, where nerves, blood vessels, muscles, fascia, ligaments and tendons connect and communicate. Instability and misalignment in the back can lead to excess strain on the surrounding muscles, and stress on other joints as the body shifts to compensate.

Muscles
A careful balance of tension and tone keep the back aligned and supported. A common contributer to low back pain is muscle weakness and poor posture. If the abdominal wall muscles are poorly developed, then the muscles of the lower back have to do much more work to support the spinal column. Often back pain can be alleviated by a series of exercises to strengthen and tone the abdominal muscles.

Posture is also important, and muscle weakness can perpetuate poor posture when standing or seated. Posture alignment and exercises are essential, especially for those who work at a desk seated. The muscles that originate from the sacrum and lumbar spine and attach to the hip area can become tight and shortened after prolonged sitting. Stretching the piriformis, quadratus lumborum (QL) and psoas muscles will take unnecessary tension off the lower back.

Ligaments + Tendons
Ligaments are bands of tissue that connect one bone to another bone, and tendons connect a muscle to a bone. These structures are composed of poorly vascularized connective tissue. When a tissue has a low blood supply, it heals poorly after injury. As a result, ligaments and tendons can become over-stretched during an accident or injury, and never fully recover.

Loose or “lax” ligaments in the lumbar spine cause instability of the vertebrae and the bones of the pelvis, leading to chronic back pain. The job of the ligaments is to hold bones in place, and when ligaments are weak the surrounding muscles have to do the ligaments’ work. This results in excessive muscle tension in the back, back ache and chronic pain.

Conventional treatment for ligament instability is limited, with the end-option being back surgery to fuse unstable segments of vertebrae together to eliminate all movement within that section of the spine.

Prolotherapy is a less-invasive treatment for ligament and tendon instability that is very effective for chronic low back pain. Prolotherapy involves injections of dextrose and lidocaine into ligament and tendon attachments along the lumbar spine, sacrum and pelvis. The prolotherapy solution incites a controlled bout of inflammation to the damaged tissues, bringing healing cells to the poorly vascularized connective tissue. Prolotherapy strengthens and repairs damaged and torn connective tissue, and lays down new cells in an organized fashion, unlike the haphazard arrangement of scar tissue.