Why you are having sharp low back pain in the morning?

hey guys it's Hina chef here at

rebalance physical therapy and wellness

in Center City Philadelphia as well as

on the main line in Narberth

Pennsylvania and I am a orthopedic and

pelvic floor physical therapist that

treats with a holistic kind of

integrative functional medicine kind of

background to help treat a lot of

complex spine hip and pelvic issues and

today I want to address something that I

had a patient recently call and ask

about because I think some of you might

be having the same questions if you're

watching this video so they basically

said you know all of a sudden I've

started developing this sharp pain in my


that kind of wakes me up in the morning

or it starts in the morning and then it

actually improves as the day goes on I

feel better by nighttime but then it

comes right back in the morning so you

know I've gone to my primary doctor or

family physician they've done x-rays

they don't really see a whole lot going

on so they gave me some medications

muscle relaxers and you know it improved

but as soon as I stopped the medication

my symptoms are starting to come back

and can you help me with this and what's

going on

so again if you're watching this video

this is more of an explanation video I

am gonna talk about what things can help

but it's not gonna be a demonstration

video okay so basically what is going on

and what can you potentially do about it

so basically first I gotta talk about

the spine so the spine is made up of

several several vertebra and what

vertebra are is they're like blocks in

your body okay so if you I'm gonna grab

an image

right over here okay if you basically

peel off all of the muscles take out all

the organs and things like that for the

body you're kind of left with the

skeletal structure now there's some

muscles still here but basically if you

look back right over here this is your

spine this is the back part it is the

front part but this is that lumbar or

the low back part of your spine and they

basically stack like blocks on top of

each other and those blocks can

basically move so again if you look at

the side of your spine so here it is

again this is your your vertebra or your

spine okay and then it comes down here

and eventually you get the tailbone down

here okay

you see that these are kind of stacked

on top of each other like blocks okay

and these blocks basically move on top

of each other and this is what's known

as your joints or your low back joints

so oftentimes sometimes that sharp pain

could be coming from these joints that

are kind of stacked on top of each other

but in order these bones are also held

together by tissue otherwise if there

wasn't any tissues that was holding

these guys together then you know the

blocks would just fall over so though

that tissue is called ligaments so

they're not shown here on this photo

right over here but you basically have

ligaments that stabilize or secure these

blocks in place but they're they're not

so sturdy that they can't move okay so

there's some nice shifting that happens

in between those joints and then on top

of those joints or muscles and that's

what basically you you know normally

think about when you think of your back

muscles is you got all these muscles

that basically layer on on top of your

back in various different layers so

you've got a deep layer you've got

what's called an intermediate or a

middle layer and you've got an outer

layer of musculature on top now sharp

pain can be coming from the joint

because it's either moving too much or

it's moving too little and that just

from that it can cause irritation within

the joint and then that can cause even

partially some of the ligaments okay

those are the tissue that holds those

blocks together to become irritated and

then on top when that's irritated it can

also get those must

tools to become spasmed okay so when you

think of this sharp pain in your back

sometimes yes it could be just you know

coming from the muscle or could you

speak umming from the joint but it could

be a combination of all three of those

things and we often see that in our

clinic that it's sometimes not the joint

so just going in and possibly having

some chiropractic adjustments you know

might not maybe I'll give you temporary

relief but it may not give you full

relief because there's still these

ligaments that might be irritated or the

musculature on top now I've also heard

that some people say well I went and had

massage therapy and I went and had

chiropractic and you know I had some

strengthening exercises as well maybe

I've already gone to physical therapy

and they did some strengthening well if

you had a lot of these things and it

seems like it gave you some relief but

not full relief or maybe I didn't give

you relief at all or maybe I did give

you full relief for a temporary period

of time but then it started to come back

well you have to understand the the back

works not just with the back muscles but

it works with a bunch of other muscles

as well and I'm gonna go back to this

picture right over here to show you

here's your low back okay but there is a

bunch of other muscles that connect on

deep inside to your spine and some of

them this right here okay is your

diaphragm it's actually the muscle that

you breathe with and then you've got

other deeper muscles further inside okay

I'm gonna go back to my first foot over

here that also connect up onto this bagg

so there's that diaphragm again and you

can see it's got little connections

there but then you've got other muscles

that actually start in the back and they

dive deep down in the front and that

could be influencing and causing issues

in your back okay and there's several

other muscles so these are just two I'm

gonna point out but know that there's

many other muscles that could be

problematic that is creating the

spasming in your back so sometimes you

have to not only address the back but

you have to address other muscles that

are also attached on to the spine and

oftentimes what we find at least when in

our clinic is sometimes we're treating

the ribcage

sometimes we're treating the hip

sometimes we're treating the pelvis

sometimes we're treating deeper inside

the pelvis sometimes we're even going

all the way up to head and neck

sometimes to balance a lot of these

muscles out because once the muscles are

balanced out then it takes the stress

off of the ligaments remember those are

the tissues that connect those blocks

together and when the stress comes off

of the ligaments cuz you know if they

feel like they have to work a lot then

they're gonna get irritated but once

they don't have to work as much then it

takes the stress off of the joint okay

which is where your problem may be

coming from but it's because of

potentially these imbalances between a

lot of the musculature and possibly a

stiff joint or a joint that moves too

much so sometimes you need a combination

of working on some of these muscles you

might need that strengthening but you

might need some stretching but you may

need release work of a lot of these

different muscles and the combination of

release work of these muscles

combination of addressing a lot of the

you know the ribcage the pelvis the hip

all of these things other muscles that

have connections on to the spine or

maybe sometimes even indirect

connections on to the spine may just

help balance the whole system okay the

system meaning the whole you know your

whole musculoskeletal system meaning

your bones and your muscles in the


in and around the trunk okay that then

comes just calms everything down and

then you may notice that hey my pain is

actually gone in the morning and it's

not due to that little arthritis that my

physician found on the x-ray or that

little disc bulge or even that moderate

disc bulge that I saw on my MRI or

something else because in reality you

know as you're kind of creeping into

your late 30s late 40s you're gonna have

changes in your spine it's kind of like

the normal wear and tear of a car you

use it you're going to end up breaking

certain things down we're not all


some of us are but we're not all perfect

so just realize don't be scared from

anything that you see on an x-ray or an

MRI these things could just be a big

imbalance of a lot of

musculature and you just need to have

that addressed addressed so so I hope

this video helps to kind of explain that

maybe it calms some of those who are

having some anxiety about their back

pain that there is help out there it's

just perhaps it's not being seen in this

holistic kind of integrated way and so

you know if you live in and around the

Philadelphia area or around the

surrounding suburbs or you can get to us

or you want to see us then great hop on

to our website it's rebalance PT calm

that's our e ba lan c e PT calm we have

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consult if you are looking to have

treatment with us and so I hope that

this video helps and for all of you have

a wonderful day