Back pain is troubling and often mysterious, showing up without any traumatic incident. Fortunately, most back pain is not serious and can heal without injections or surgery. If perusing the latest selection of flower pots at City People’s leads to back pain, you should about its potential cause.

Back pain typically has three causes:

(1) Disc Herniation,

(2) Sacroiliac joint (SI) Dysfunction and

(3) Stenosis, or arthritis of the spine

A disc herniation, or “slipped disc”, is typically caused by bending, lifting, and/or twisting. An overly aggressive swing of the golf club may be a culprit of this. It can also crop up due to long term sitting or standing with bad posture. The number one sign of this is pain radiating into the buttocks and down the leg. This symptom is termed sciatica and can be accompanied by weakness, numbness, and tingling and usually occurs down only one side of the body at a time. It often gets worse with bending forward and sitting, and better with standing up and walking.

Most of the time, sciatic symptoms improve and dissipate over a period of months, but sometimes lasts longer. Conservative management consists of physical therapy to address, spinal alignment, muscle spasm, nerve tension, and weakness. It is important to note that in the state of Washington you can seek physical therapy care directly, without a referral from a physician.

The second most common cause of back pain is SI joint dysfunction. You have two SI joints, one on each side of the low back, located where the top, flat part of your tail bone. People often have little indentations, or dimples, over the area of the SI joint in the very low part of their back.

SI joint pain is often located right over the SI joint on one or both sides of the body, but can also radiate into the buttock, groin, and down the thigh, similar to sciatica. The development of SI joint dysfunction is most often associated with pregnancy, but can also develop after a fall onto the buttock, a misstep off a curb, or weakness in the pelvic and abdominal regions. People with SI joint issues may complain of difficulty performing movements that are one-sided, such as climbing stairs or stepping up onto a curb. Often these people feel imbalanced, as though one leg is longer than the other, or they may notice that one leg turns out or in further than the other when standing, walking, or lying down.

SI joint issues resolve readily with conservative management including physical therapy and strengthening. Physical Therapists are experts at regaining alignment in the pelvis and many people with SI joint pain feel great relief just after one physical therapy treatment. Some specific manual techniques can restore alignment to the pelvis almost immediately.

The third common cause of back pain is spinal stenosis, or arthritis of the spine.  Stenosis occurs when there is a narrowing of the holes through which the spinal cord and nerves pass, and this narrowing causes pressure on the nerves. Stenosis is a diagnosis associated with aging and general wear-and-tear of the spine versus bending or lifting trauma. Most people with stenosis are over the age of 50. A differentiating factor between stenosis and a disc bulge is that people with stenosis tend to feel better sitting or standing in a hunched forward position. This relieves the pressure that the bones themselves are putting on the nerves and, therefore, decreases symptoms.

Spinal stenosis is a little trickier to treat than the other two diagnoses. You can’t stop the aging process; it is a part of life and, unfortunately, some people have more of a propensity for osteoarthritis than others. What is possible, though, is regaining mobility in the spine and decreasing pain in the legs with mobilization, stretching, and functional movement. Physical therapists understand how to safely move the body of someone with stenosis, without causing an increase in pain and irritation.

If your back pain is cutting short your stroll through Madison Park Beach, then you should reach out to a physical therapist with expertise in treating back conditions.

Written by Dr. Ryan Simmons, Physical Therapist at MoveMend. MoveMend is located at 2818 E. Madison St. Contact the business at 206-641-7733 or