Have you got a stiff low back? Stiffness is often part of the picture of low back pain. Why is this?
Stiffness is a conscious experience–a feeling that we sense, interpret and then label as ‘stiff’, usually describing difficulty moving a body part. And just like any other conscious experience, there are the embodied dimensions as well as cognitive and emotional elements: how does it feel? What does it mean for me? Hence to think about stiffness is to think about the body-body systems that create the feeling and meaning.
Stiff low back: there are three common types of stiffness that are addressed in different ways.
- Stiffness from actual shortening of the muscles and their compounding tissues
- Stiffness from muscles being told to be ‘on’
- Stiffness from changes at the joint
Stiffness from actual shortening occurs due to sustained positions or repeated positions being held so that the tissues change in their length. In so doing, there is less freedom of movement at the joints. This tends to gradually worsen as time progresses, with less and less movement at the joint causing further shortening. Regular movement, nudging into the limitation is key in overcoming this aspect of stiffness along with manual treatment that gives you the experience of movement into that part of the range. The manual treatment must sit alongside your understanding of what is happening and why this therapy is being applied, otherwise ‘top-down’ influences can interfere with success (see next section).
Stiffness from muscles instructed to be ‘on’ by the brain is part of the way that the body protects. Otherwise called guarding, the body-brain’s continual planning, expectation, anticipation and desire are embodied, responding to the environment and the context of the situation at that moment. Within our consciousness, different experiences seemingly appear and then fade away as others emerge. Stiffness and pain are no different in this respect, however they may emerge repeatedly in response to normal situations that pose no actual threat. But, due to the sensitive state and vigilance to the environment, non- or low threat stimuli are now interpreted as potentially dangerous and therefore the body responds. The first we know about this is the pain or tightening — the stiff low back. The pain and stiffness are motivators for us to take action, both in thought and behaviour. These thoughts and behaviours seek to reduce the threat and therefore reduce the pain (pain emerges in the person as a result of a perceived threat) and how the body is responding with it’s natural armour, the muscular system. As the need for defence diminishes, so the muscle tension eases and movement improves.
What reduces the threat and muscle tension?
- Relaxation–this is a skill to learn
- Understanding pain and knowing that you are ‘safe’
- Motor imagery
Changes at the joints can, but not always, affect the quality of movement. It is not a given that if your joints show arthritic change, movement will be problematic. Many people have arthritis but suffer no pain or stiffness. Whether you feel pain and stiffness or not is determined by many inter-related factors: e.g./ genetics, gender, past experience, beliefs, expectations, the environment; also known as pain vulnerabilities that all have an underpinning neurobiology that is becoming increasingly understood.
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