SELF TESTS FOR LOW BACK PAIN
By Biagio Mazza
How can you tell if it's your back that's causing some of your problems?
Now, that may seem silly. You may think, "Well, it hurts in my back so it's coming from my back." That may be true, but going through some of these tests can give you an idea and a frame around what's going on with your back even a little bit farther. Let's take a look at these self tests.
1. Low Back Range of Motion Testing - There's really four directions that we're going to go through. The first is going to be bending forward. As you bend forward the knees don't have to be locked out, but without allowing the knees to bend like in a squat. So you're going to just bend forward as if you were going to touch your toes and you are going to look for three things. You're going to look for quality, for quantity, and for provocation. Quality is how clean it looks as you're bending forward, quantity is how far down you can reach, and provocation means does it create any symptoms.
When you bend forward, the thing that should stop you from continuing to bend forward is the back of the legs. If you feel that in your back as you bend forward, that is not cool and that is not okay. So if you're feeling it there that's giving you some indication that, hey, something's going on that might need to get looked at.
The second motion is backwards. You put hands on your hips, you lean backwards as far as you can comfortably. The thing we're looking at here is the same thing, quality, quantity, and provocation. But here we would expect the back maybe to feel a little tight as you get to the end ranges, and that's just the way the anatomy is set up -- that would possibly create a little bit of tightness and discomfort in that direction. That's semi-normal.
The third and fourth are side bending, side to side. You're going to lean off to one side, kind of bring your hand down your thigh on one side, same thing on the other. It should be symmetrical and neither direction should cause pain into the low back.
2. Nick Flexion, or Neck Bending Forward Test - So what you do is you bend forward, you get to your end range or where you start to feel any discomfort, then you bring your chin to your chest. Then you bring yourself back up. If the chin to the chest actually increases your symptoms more, that is giving you some information about what could potentially be causing your low back pain. Usually if that test is positive we're potentially thinking something related to the nerves, possibly the disc tissue.
Because of the connection from the brain all the way down to the low back, that as you bring your head down it pulls on that nerve tissue and it can reproduce back pain. So if that's positive that can be a nice test to indicate some different things in your back are going on.
3. Slump Test - What you do with a slump test is kind of like it sounds. You sit down and you slump down. You kind of sit with real poor posture -- just put your hands kind of in your lap or kind of at your side, you let your head come down to the chest. In that position there what you're going to do is point your toe up in the air and slowly kick out until you feel either a stretch or a reproduction of your pain.
Now, if you feel a reproduction of your pain in your back, that is significant for telling us what is going on with the symptoms because the same thing as that little chin tuck test, is it pulls the nerves. That can pull on the disc or it can pull on the nerve tissue and if it reproduces your symptoms that's a quality bit of information we would want to know.
You do the same thing on the other side. We're again looking for quality, quantity, and provocation. In this circumstance, we are looking more for the amount of motion that you have and if it provokes any of your symptoms.