Back Pain – Causes
Causes and Results of Structural Misalignments
The following article is based on private research on around 3500 Patients between 2003 and 2005 using all common diagnostic tools (Hands, Eyes and also X-ray, CT, MRI, EEG etc.) and supervised by licensed medical doctors. It is not based on an independent scientific study but rather presents a new theory that developed out of tens of thousands of Back Pain patient protocols treated in Germany and elsewhere with a new form of Manual Therapy called the Dorn Method
Although there are many secondary causes possible like a slipped disc, certain diseases, toxins, psychological stress, stones in organs, cancer and other pathology, that all may require specific medical approaches, a Misalignment in the Sacrum (ISJ) seems to be the start of it all, at least a blockage in the ISJ can be diagnosed in almost all patients and is likely co-responsible.
Causes for Misalignments (subluxation*) include:
(*subluxation as I use this term here is a small (sometimes even minimal) discrepancy in the joint congruence or bone position relatively to each other that may not be seen on dianostic instruments like x-ray or MRI)
Wrong sitting positions
Trauma at birth (before, during or after)
Wrong lifting techniques
Chronically tensed Muscles
Accidents (Falling down etc.)
It is probably possible that most humans develop misalignments before, at or after birth due to a traumatic experience while giving birth like the squeezing of the baby through the birth channel and certain tests and positions done with the new born baby (holding it on the legs with head hanging down etc.)
Because of this the hip joint(s) and the sacrum very likely gets out of its ideal place and often does not go back into its proper position because unlike most animals who stand up soon after birth and by means of stretching wiggle their joints into a proper position, we humans are placed into a bed for the next 12 month or so and any existing misalignment goes not only undetected but also un-corrected!
A self re-alignment that is happening under normal circumstances (gravity (body weight), and movement that will normally guide and /or keep the joints (bones) in their proper position due to the design (shape) of the bones and ligaments, cannot take place because of one key element missing, i.e. gravity (weight), onto a body structure that is designed to stand upright because humans are not able to walk before 10 to 12 month into their life. (Maybe Human Evolution is still in development?)
During this time our body (Muscles, Ligaments, Bones and other tissues) adjusts to the given situation and therefore creates imbalances even before we start to walk on our own!
Later in life the wrong movements then aggravate this condition or if no misalignment existed then possibly produce them!
Modern life with all the bad sitting, lifting, competitive sports, stretching, all kinds of stress (also due to
unsolved inner issues), one-sided movements during work, unbalanced use of our hands (left/right
handed people!) etc., will then start its destructive work, because we violate so often the natural
movement range of our joints, especially in the hip!
Following movements could worsen and/or produce misalignments in our Hip-joint and/or Sacrum!
Sitting with crossed legs (probably the worst of all!)
Stretching the hip joint(s) less than 90° with the legs/knees straight (Stretching)
Lifting objects over the side (even light objects)
Turning in the hip with both feet firm on the floor while standing or the upper body flat and firm lying on the floor. (Stretching / Yoga)
Driving in a car (especially long driving without breaks, bad car seats and bad positioning in the seat and the wrong way of going in and out of the car)
and probably many more (I describe this more detailed in my book)
The pictures below show just a few of potentially harmful Movements for people with Back Pain and/or existing Misalignments. (At least during the first two month after a Dorn-Alignment-Therapy or Self-Help-Therapy with the Dorn-Method Exercises!, or any Therapy of your choice!)
» A balanced structure however can usualy handle these movements without problem!
See also: Prevention of Back Pain for more details on wrong movements and possible better alternatives or adjustments.
I know this is difficult to believe but I encourage everyone to try not to do these movements for a while (about 2 month at least) and see the difference!
» Do the Balance test to find out if you are in good alignment
This simple test using two similar weighing scales lets many people realize how obvious our structural balance can be influenced, read more...
Once your Joints are used to their natural position again, which can often be achieved by doing the Self Help Exercises, an immediate Misalignment by doing these potentially wrong movements is not very likely, however they should not become a habit again and better are substituted by similar yet more safe movements as described further in my book!
Mechanics of a Hip Subluxation and the following result:
The result of wrong movements etc. is a subluxation in the hip joint (although sometimes only for a very short moment) and a Misalignment of the Sacrum (ISJ) that leads to a difference in leg length .
The Femural head can bump against the roof / edge of the acetabulum and levers itself out of position and mostly stays then in that wrong position long enough (seconds are enough!) to produce an unbalanced tensioning of the attached muscles (which is most likely a simple reflex reaction).
This often existing Subluxation in the Hipjoint is mostly regulating itself thru the natural Self-Re-Alignment Mechanism (Mostly after a few Leg-Movements due to Bodyweight (Gravity) during Movement guided by the shape of the bones and the ligaments), but a small misalignment can still exist which can only be seen on x-ray pictures made from a special side position. (This Subluxation however is only in the Millimeter Range and Not in the Centimeter Range as often claimed!)
That in turn leads to an inclined and/or twisted pelvis aggravated by the now uneven tension of the strong Hip muscles and a subluxation of the sacrum follows, the foundation of our spine gets out of balance!
Although the misalignment in the hip joint might be very small and maybe is not always or easily seen on x-ray the resulting leg length difference can be quite large.
The joints of the knee and ankle can also subluxate and further contribute to a leg length discrepancy.
Misalingments in form of shifted vertebrae or curvatures like scoliosis are likely to develop.
That in turn is followed by a increasing tensioning of the muscles along the spine and often an unfavorable Muscular Tension already exists which of course is fixing the Joints in that subluxated position (blockage).
Further there is a possibility that an extremely tensed muscle is encouraging the joint to become misaligned.
» The classical what comes first discussion: Chicken or Egg - Muscles or Bones?
There may be more than only one specific answer because the human body is a functional unit made of different materials!
The nerves of these areas are also affected in an unfavorable way so the information exchange between the brain and the affected area is not as it should be which may lead to Pains and a weakening of the associated organs contributing to and even causing chronic inner conditions especially if co-factors like unhealthy lifestyle exists.
As long as the misalignments exists a real healing is quite unlikely because the main structural system of our body is not in a balance!
Anatomy of Misalignments
Normal Hip-Joint position with
critical point: The Roof-Edge
of the Acetabulum.
Subluxated (Misaligned) Hip-Joint position with
Femur-Head bumping against critical point:
The Roof-Edge of the Acetabulum.
A Leg-length Discrepancy due to Hip and Sacrum (SIJ) Misalignment and a twisted Hip-Blade:
(Click Research to read more about a study on this mechanics)
The Spine adjustmernt that follows the pelvis twist leads to the development or worsening of a scoliosis:
Scoliotic Spine – – Normal straight Spine
Look now at the Muscles along the Spine to undertstand that it is important to stay Balanced in this area!
The deepest group of muscles
And not to forget the muscles in the Pelvis:
With the irritated nerves involved:
Above Graphics courtesy from The Anatomy Lesson
Some More Anatomy:
In the below Graphic you can see that a pinching of the Sciatic nerve through the muscles piriformis and oburator internus is likely the main cause for sciatic pains and even other back pains as a result.
I believe the most important of all the irritated nerves in this process is the Rami communicans that leads to a disturbed Nerve Information Exchange between Brain and Organs.
(Psychological Connection here: Communication Problems!)
Read also: New science on Pain and Manual Therapy
Many people suffer unexplained back pains, meaning that no severe physical problem can be detected (despite x-ray, MRI etc.) but the Pain is there.
On the other side many people do have clear detectable physical disturbances like slipped discs, bone-fractures and deformations but they do not suffer from too much pain. Why?
I never found a single patient without the above mentioned facts (which is of course only anecdotal evidence for some), so I believe that nobody suffers only because of detectable disturbances or because of a Psychsomatic condition, a Misaligned sacrum is always involved and possibly the main cause!
(I challenge science to prove this statement as wrong!, or better help me to come up with recognizable evidence in clinical studies! As it can be demonstrated and proved on any actual patient!)
Beside the possible physical causes I believe the non-physical (Mental, Psychological and Spiritual or Higher Self) also play an important role in this complex system and Imbalances here may very well influence the development as well as the outcome and recovery process, that is why so often patients show a change in the non-physical side after a successful Dorn Therapy and that is why many people improve their physical condition simply by re-balancing their non-physical side.
More about this important connections at the page: Connections Table
What adjustment needs to be done to make potential harmful movements more safe?
As shown below make sure the Hip-joint stays in its proper position while sitting and stretching!
Left picture below: Hip-Joint in correct position while Leg (Knee) is tilted outwards, for example during a stretching of the Hip-Joint less than 90°!
Correct Alternative: (Picture left side)
All Stretching must be done with open legs!
The Knees must be tilted outwards while stretching the Hip-Joint less than 90°, only then the Hip-Joint stays in its proper position and is not levered out!
And: Use both Hands, Arms, Legs, Sides of the body more balanced and equally (Not easy in the beginning since we need to override old patterns and habits!, e.g. carry your shopping bad more often on the other side, brush you teeth with the other hand or when washing yourself)
AVOIDING all that is the 1. Step, not easy but after only two month you re-programed yourself and this work will bear its fruits.
Some more anatomy:
Picture above: Pelvis with Sacro-Iliac Joint and Hip-Joint, all stable but flexible areas that can suffer misalignments and out-of-balance positions if stressed too much.
If our sacrum gets out of balance then the whole foundation of our spinal column is no longer stable! It is then impossible for the Spine to stay straight and shifting of vertebrae can be seen as natural adjustments in order to equalize between the upper and lower part of the Spine. A simple but very important mechanical principle!
I believe the sacrum is the most important bone in our structural system! - The Key Stone in the Structure!
In the x-ray picture below you can see a sample of a sacrum misalignment, (subluxation):
The Hip-blades are not in Alignment with the Sacrum and the Femural Head.
This will cause some of the muscles of this area to be in an un-balanced state of tension and will therefore stabilize this twisted condition and produce a functional leg length discrepancy!
The picture below is from a patient with severe sciatica and who is diagnosed with a spondylolisthesis due to a fracture at vertebra L4 which he was told causes his problems.
The strange thing about this is that he does have this condition since years but the Pain he experiences is not been there before and in this present intensity appeared years later?
Side view of the same patient:
You can see here that the Sacrum is subluxated also towards the front! The dotted line represents the normal position of the sacrum as it should be, and the other line is the present, subluxated, position!
By the way: I never found a patient who's problems where only on the organ level or only on the mental level, so-called psychsomatic, all showed clear identifiable misalignments in the Sacrum, Hip-Joints and the Spine and other Joints. The fact that these structural disturbances are at least co-factors of basically all known health problems is clearly underestimated, ignored or even denied by most health pro's.
Take yourself, do you believe that a little discipline, awareness and caution and only a few minutes of exercises every day could really improve your health?
I want to use laymen's explanations to make it more easy understandable for everyone, and a more scientific selection of words can then be used at a personal meeting.
We are a living organism and therefore in a constant state of adjustment, if we ignore that we have to suffer the consequences.
Consider this: If you take the branch of a plant and fix a strong wire onto it that bends the branch to a specific direction then the two things will happen:
1. If you take away the wire soon then the branch will try to go back to its former position and all depends on how long the wire was attached.
2. If you leave the wire long enough (approx. two month) the branch will stay in this fixed positon even after the wire is gone because the cellular structure now adjusted to that new position.
A return to the old position is now difficult but not impossible.
The same principals apply to our body. If you break a bone you may need a fixture (like the wire on the plant) onto that area to allow the bones to grow together and heal.
At the same time the muscles less in use adjust also and get weaker.
Without that fixture however every wrong movement would probalbly cause further damage.
So in a sense that is what we want to achieve with the Dorn Method: The Avoidance of wrong movements together with the aligning Therapy and/or Self Help Exercises is the fixture that allows the fracture (misalignment in this case) to heal.
After a sufficient long time (minimum two month) the adjustment took place and stabilized in many cases.
However: This needs to be done by ourselfs! Nobody can do the whole process for us although outside help is often necessary in this process.
But believe me you can do miricals! Just believe and trust in yourself.
» Next: Pain Prevention