We rely on the muscles that support and control the spine for all of our daily activities. Whether we are bending down to put on a pair of socks, shoveling, vacuuming, or carrying a bag of groceries, the health of the back depends on the complex interaction of muscular contraction to move and stabilize each joint in our spine. If any of the muscles that surround the spine become tight, weak, or uncoordinated, excessive strain will be placed on the other surrounding muscles and on the spine itself. Over time, if imbalance in the muscles and the resulting abnormal back motion is allowed to continue, more severe back conditions can develop.
A variety of situations can cause tightness, weakness, and abnormal function of the back. For example, repetitive use with certain sports or occupations, poor posture, lack of use, lack of stretching, muscle imbalance, or previous injury can all affect the normal function of the back and the surrounding muscles, resulting in excessive strain to the area.
Over time this strain can develop into what is known as micro-trauma. Simply stated, micro-trauma is very small-scale damage that occurs in the muscles, tendons, joint capsules, and ligaments in response to small levels of strain. Initially micro-trauma is not painful, but may be perceived as a mild ache or tightness in the muscles. Although small, this damage needs to be repaired. The body responds to micro-trauma in a predictable way: by laying down small amounts of scar tissue to repair the area. Unfortunately, over time this scar tissue builds up and accumulates into adhesions. As these adhesions form, they start to affect the normal health and function of the muscles and related joints. In fact, they will often lead to pain, tightness, stiffness, restricted joint motion, and diminished blood flow. This places even further strain on the back muscles, which in turn leads to even more micro-trauma. Essentially, a repetitive strain injury cycle is set up, causing continued adhesion formation and progressive spinal-column dysfunction. At this point pain and tightness will often start to become noticeable.
As the repetitive-strain-injury cycle continues, the ability of the back muscles to meet the demands placed on them diminishes. At this point it is not uncommon for the muscles to give way and a more severe and debilitating pain occurs. In fact, many patients come into our office saying they have back pain but they do not recall any specific incident that could have triggered the pain. When further questioned, these patients almost always describe some mild pain or tightness in their back that has been building over time. As you can see from the explanation of the repetitive injury cycle, these types of conditions can build up over time until they eventually develop into large-scale injuries.