Self-Care Module for Low Back Pain

Myofascial Pain Syndromes of the Low Back:

It is now possible to apply trigger point therapy to pain-causing myofascial trigger points and adhesions at home by utilizing the Fenix Rehab System. You can learn how to do this by placing you cursor over “Self-Training Program” link then click on there or here to Basic Fenix Treatment pop-out link. There you will be shown how to apply the Fenix Rehab System step-by-step. To find your treatment points place your cursor over “How to Find a Trigger Point and click on to get step-by-step instructions.

The “Joker of Low Back Pain” Muscle-Quadratus Lumborum:

One of the most frequent causes of chronic myofascial pain syndrome of the low back is the quadratus lumborum muscle. The quadratus lumborum runs from the top of your pelvis to your bottom rib on each side of your low back and works hard to stabilize your spine. The quadratus lumborum refers pain down over the sacroiliac joint area, (the area under the big dimples on each side of the bottom of your low back) and to your buttock. Severe pain can be referred to the hip joint and disturb sleep. You will find this major low back trigger point at the outer end of line C in the picture of the model. It is found at your waist slightly below your bottom rib, about a hands width lateral to your spine. (See pictures provided). See the location of the muscle indicated on the model.

The accompanying picture demonstrates the position for trigger point therapy for the quadratus lumborum muscle. Use a digit just long enough to apply adequate pressure to create a referral sensation. A slight angle to the digit is sometimes helpful angled inward toward the spine. Trigger points in the quadratus lumborum many times cause the gluteus medius (see in up-coming explanation) to form myofascial trigger points. These two muscles together are often times the cause of chronic low back pain that fails to respond to treatment. Always stretch the quadratus muscle after trigger point therapy, go slow and easy, only do as much as you can without pain (see picture), hold for about 60 seconds.

The “Deep Lumbago Muscles”:

Moving in toward your spine along line C, before you come to line B you will find the iliocostalis and longissimus spinal muscles known as the “lumbago muscle.” The myofascial trigger points of these muscles refer pain down, all along the entire low back (lumbar spine) to the mid-buttock. The Fenix Rehab System has been designed to specifically treat these pain-causing spinal muscles on each side of the vertebra. The ililcostalis and longissmus spinal muscles are farther out from the spine are deactivated with the paired angled outward digits (see picture). For location and deactivation of these trigger points see pictures of the model in the guidebook or located here. Always stretch the muscles around your back after applying trigger point therapy. Go easy. Only do as much as you can without pain, (see picture) maintain for about 60 seconds.

Moving in further on line C you come to line B which parallels the boney ridge at the middle of your back. Line B lies about 2 finger widths away from or these boney bumps of the spine (lateral to the spinous processes). Deep in these paraspinal tissues lie the deep multifidi and rotatore muscles connecting the lumbar vertebra together. These muscles cause severe deep aching pain right around the level of the myofascial trigger point.

These deep muscles around the spine generally develop active pain-causing myofascial trigger points from sudden over work of the lower back. This happens when lifting objects too far from the body or with the back twisted, or when bent over for long periods of time. These deep myofascial trigger points easily become chronic and disabling. These deep myofascial trigger points, when positioned at the bottom of your low back (on each side right above the large dimples); can also refer pain to the posterior and outside aspect of your leg, mimicing sciatica.

The Fenix Rehab System has been designed to specifically treat these pain-causing spinal muscles on each side of the vertebra. The multifidi and rotatore muscles deep and close into the spine can be treated with the paired angled-in therapeutic digits (see picture). For location and deactivation of these trigger points see pictures of the model in the guidebook or located here. Always stretch the muscles around your back after applying trigger point therapy. Go easy. Only do as much as you can without pain, (see picture) maintain for about 60 seconds.

The “Lumbago Muscle”- Gluteus Medius:

Another major “lumbago muscle” is in the upper buttock called the gluteus medius muscle. Many times this muscle with previously described quadratus lumborum above cause severe chronic back pain that will not respond until the myofascial trigger points in both these muscles are deactivated. This important muscle can be found along line A in the picture of the model. To locate line A find the large boney bump next to the dimple in your low back (models left hand) and the boney bump at the front of your bony pelvis. Now draw an imaginary line connecting these two bumps, about 1 ½” below the top of your pelvic rim (iliac crest).

You will find these muscles three major trigger points by moving outward or lateral along line A. These gluteus medius myofascial trigger points lie ¼ to ½ the distance outward or laterally along the length of line A. The halfway mark would be approximately at the letter A on the model. These trigger points, if you have them, will be extremely tender to pressure and will refer pain strongly into the low back especially over the sacrum or “tail bone” area. See pictures of the model for location and deactivation position for these myofascial trigger points.

The Pseudo-Sciatica Muscle – Gluteus Minimus:

Moving out laterally ¾ the distance along line A you will find the gluteus minimus muscle. This muscle will generally have a cluster of myofascial trigger points, so gently search around. They all tend to be extremely tender and send severe pain down the back and/or lateral aspect of you leg. This is why the gluteus minimus is known as the “pseudo-sciatica” muscle. See pictures of the model for myofascial trigger point location and deactivation position.

The Fenix Rehab System can and should be shared with your doctor or therapist. They can help you pin-point the trigger points needing treatment. The Fenix Rehab System is an ideal home-care active therapy program to assist you and your healthcare provider in keeping you as pain-free and drug free as possible. Don’t forget to stretch the gluteus minimus after performing trigger point therapy, see picture of the model and follow the instructions. Do the stretch slow and easy without causing yourself any pain for about 60 seconds.

Special Technique-Spinal Traction/Decompression:

A revolutionary aspect of the Fenix Rehab System design is the ability to apply a light traction to the low back and mid-back. This 4-angled therapeutic digit technique stretches the tight muscles on each side of the spine and decompresses the small joints of the spine. These joints, called spinal facets, can be a source for a great deal of pain and tension in the low back and mid-back, see detailed explanation and pictures below.

Strengthen the Core Muscles of the Low Back

Once you have begun to remove the chronic myofascial trigger points from your low back, with a Fenix Rehab System, you will want to fully strengthen the core muscles that support your lumbar spine. The rehab of these core muscle is best targeted utilizing an inexpensive exercise ball. Through FRE, Inc. you can purchase an exercise ball; either the one from DynaFLex which comes with an excellent video and sells for $32.95 or the Valeo Body Ball without a video selling for $19.99.

You wan to focus on strengthening the muscles on each side your lumbar spine called the Erector Spinae muscles. Also further out are the lateral stabilizers of the low back called the Quadratus Lumborum. You also need to strengthen the muscles that stabilize your pelvis, the Gluteus Maximums and Gluteus Medius. By following the pictures below you can see how to stretch and strengthen these core muscles, either by laying face down and raising one leg at a time or laying on your side and raising your leg, it’s that simple.

After strengthening the posterior and lateral muscles of your lumbar spine, it’s important to strengthen the front stabilizer the abdominal muscles. You do this with the exercise ball by doing a reverse abdominal crunch. Start at a sitting position on the ball and then lower your upper body slowly down.

Do not cause yourself any pain with exercises and check with your doctor before doing any home care program. Perform these exercises in three light sets of 8 to 12 repetitions. But only do as many as you are comfortable with, without causing yourself pain.