Question
Hi Dr Gillman,

I am 27 yrs old. I live a fairly active,healthy lifestyle and I usually lift weights and run.I

don't have a history of any diseases.

My problem:

My lower back (lumbar region L3-L4) hurts when I touch it with my thumb or when I get up from a  

sitting or sleeping position. It also hurts when I try to do the low cobra yoga pose or a superman

stretch and  when I try to bend my back backwards.It feels like a bruise from the inside.

The muscles surrounding the vertebrae don't hurt at all..rather I feel it is the vertebra L3-L4

itself which is hurting.

The pain is a bit sharp and localised and only occurs when I do some movements. I cant feel the

pain in my buttocks or legs.

The pain hasnt increased or reduced with time.I feels like the pain has been constant for some

time.However,I am able to get through the day without much trouble.

I apply ice everynow and then but I haven't applied heat as yet. Normal pain-killers haven't had

much effect on it. I do some daily stretches for the glutes and hip mobility and always maintain a

neutral spine e.g squatting while trying to pick things up.

I also don't have any lordisis of the spine or any similar condition.

Probable cause:

I was still trying to improve on my back squat form toward the end of January and early February

but I remember that I was leaning forward with the barbell on my trap area as I was squatting. I

guess this happened almost everytime I did squats due to lack of proper hip mobility.

The pain was subtle at first and wasn't caused as a result of sudden random jerking movement.

I have read most of the lower back sports injuries on the internet but I could not find any

description that would fit mine.Do you think it is just a minor lumbar sprain/strain?

At the moment I dont have health insurance and I cant afford treatment.

I'd be grateful if you can give me an opinion about my problem so that I can heal it on my own.

Thank you.

Nick

Answer
Hi Nick,

Yeah.  It sounds like you have a lumbar facet joint strain or you have a chronic irritation to the distal/insertion zone of what's called thoracolumbar fascia.   This is very common.   Often it is easily treated with the combination of manual joint manipulation, distractive manipulation (see my web site on distractive/decompressive manipulation), and Graston Technique or equivalent mechanically assisted soft tissue mobilization.   If you absolutely can't save up the dough to get some treatment, then have a friend vigorously massage the base of your lower back and over the sacrum using the edge of a soup bowl.  This will require you to have some sort of oily lotion on your back, and you would have to be in a position such as laying belly-down on an ottoman so your knees and hips are flexed.   The scrapping action of the bowl will help break up knots and crud (medical terms :D) in the fascia and underlying tendons that anchor themselves into the lumbar spine and pelvis.  If this works, then great.  If not, then you need to consider treatment.   It might only take a few treatment sessions to feel better, so don't get hooked into 3x/week for months on end and don't let yourself get x-rayed, etc.   If you are 27 and healthy, then you need basic examination, joint manipulation, and soft tissue mobilization.  I've seen similar cases and some athletes feel immediate relief in one session.  

'Hope this helps.

Dr. G'
www.drgillman.com