Sketch Low Back Pain
Low Back Pain


I’m going to presume in this case that we are dealing with pain in the lumbar area, which often manifests more on one side than the other, or may switch from side to side or can be felt diffusely all across the low back and into the buttock and hip area.

Take Care

If you have suddenly become aware of numbness between the legs (The saddle area} or a dramatic change in bowel movement or bladder function. You should seek urgent medical attention.

Also I am presuming that serious pathology has been ruled out such as cancer or osteoporosis etc. and that you are in reasonably good health otherwise.

Swelling and Inflammation

The underlying cause will be inflammation and swelling of the soft tissues in the area. It will be a matter of degree from slight swelling and nerve root irritation up to herniation of the vertebral disc’

What is going on?.

Most people who are suffering don’t really know what is happening back there. You soon find out that every other person you meet is an expert and will tell you exactly what to do. People say “ It’s the muscle or it’s the nerve”

The fact is it is often both and the vertebral joint also.


Sketch of Pelvis to help Diagnose Low Back Pain
Sketch of Pelvis for Diagnosis


Let’s look at what is most probably going on.

For various reasons the vertebral joint becomes irritated. There are many possible causes some mentioned on my page “About Low Back Pain.”

Nerve Root Irritation

The nerve root which branches off the spine exits through a space between two vertebral joints. This space is dependent on the intervertebral disc and can be affected by any inflammation in the joints attached to the spinous processes.

Nerves are tricky things, the spinal nerves are usually doing their thing without any help from you, but if they are continually being stimulated by some extra pressure after a while they fire off and stimulate the muscle they are supplying. This is the sudden spasm that is often experienced. Now if this muscle is part of a large group it can cause a massive contraction.

The contraction then causes the vertebrae to be constricted thus further pinching the nerve. So now we have a vicious cycle involving the joint, the nerve and the muscle

Leg Length

The first thing to check is leg length.

Lying on your back get someone to check the inside ankle joints (see illustration) then check the levels of the iliac crests (See illustration)

According to the following results you can proceed as indicated.


Ankle levels equal( Medial Malleoli), Iliac crests equal — (1)

Diagram Legs and Iliac Crests Equal
Ankle Level Iliac Crest Equal


Ankle levels (Medial Malleoli )unequal, e.g. Right Side up, Iliac Crest right side up . or vice versa i.e Left ankle up left iliac crest up

Probable muscle spasm on that side…….(2)

Diagram Ankle and Crests Raised on the same side
Fig 2


Ankle levels unequal Medial Malleoli e.g. Right side down Iliac Crest right side up (A), or vice versa Left ankle down Left Iliac Crest up(B)

Possible Anatomical Long Right Leg (A)

Possible Anatomical Long Left Leg     (B)     (3)

Diagram Anatomical Long Leg
Fig 3 Anatomical Long Leg

Fig 3

In all cases lie on your stomach and feel along your spine for tender spots see diagram,

Diagram of tender spots on spine
Possible Tender Spots


Any questions Please feel free to ask below.


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