Throughout this website you will find reference to the concept of “underlying causes.” This concept is central to the way we locate and deal with the components parts of the patient’s presenting problems. The easiest way to understand underlying causes is to look at an example.
Low back pain afflicts most of us as some stage of life. A common explanation is that the pain is a result of a strain (a pulled muscle) or a sprain (a pulled ligament) or an injured disc (a commonly used explanation for what is a relatively rare event). These explanations are usually misleading and often simplistic, failing to fully explain the underlying causes.
Even where there may have been physical injury (a strain or sprain) the precipitating event is usually not that great. Examples would be; picking up an everyday object, slipping, tripping or falling, or adopting an odd working position such as when painting a ceiling. In their own right none of these situations should lead to back symptoms, it is only when the conditions are such that the body has “no room to cope” with additional challenge that injury occurs.
Why would the body “not have room to cope?” The answer is underlying causes. Consider this situation, prior to lifting a bag of cement (the sort of thing that is blamed for a back strain), the patient already had; low grade gut discomfort (see IBS for more detail), an old ankle sprain which appears to be fully healed but still has some residual scaring and joint restriction, chronic work stress that results in tightening of the shoulder, neck and diaphragm muscles, a cruciate ligament injury from a skiing accident twenty years ago, wakeful sleep from a new born and pressure to get the job done by EQC. You then lift a bag of cement on an uneven surface and trip on your first step and strain the low back. What was the true cause of your injury?
In this case we would remobilise the old ankle injury, release the diaphragm, mobilise the neck joints that have been restricted as a consequence of the chronic stress, treat the stress habit, mobilise the knee and ensure its supporting muscles are all working well, and treat the bowel problem by identifying triggering foods or underlying dysbiosis. We would do all of this in one or two visits. The result is that not only does your low back pain go away, you are much more stable the next time the body is challenged.