Can Tight Muscles Cause Low Back Pain or Sciatica?

It's a question I am often asked, can tight muscles really cause low back pain or sciatica, and I always answer the same... absolutely.

The body relies on muscles for movement and stability. All muscles have what is referred to as an origin (where the muscle begins and this part of the muscle is typically attached to the bone that does not move when the muscle contracts) and an insertion (where the muscle ends and this part of the muscle is typically attached to the bone that does move when the muscle is contracted). When the muscle contracts i.e. we work the muscle, one of two things can happen:

Movement: The muscle shortens which brings the origin and insertion closer together. It is this action which creates movement e.g. your biceps muscle contracting and bringing your forearm up towards your upper arm/shoulder.

Stability: With this situation, the muscle is working, but no-where near to the intensity that it does when movement is required. It is more a case of there being increased tension in the muscle to help support the joint that the muscle passes across.

The muscles throughout our body are each designed for their own specific function, with some being primarily for movement and others stability. However, regardless of their specific role, if the muscle becomes tight, for whatever reason, there will be too much stress placed upon the joint it crosses and is supposed to move or stabilise. This increased stress will begin to aggravate the joint concerned, and/or adjacent structures, and consequently this will potentially lead to pain.

Low back pain or sciatica which results as a consequence of tight muscles can have a gradual or sudden onset. The reason for this is as follows:

Gradual onset: with the tight muscle(s) placing increased stress across the joint and associated structures, this stress will slowly but surely build up. Eventually, the threshold level at which you begin to feel pain will be breached and consequently you will feel pain. If you do not address the cause of this pain i.e. the tight muscle(s), then this pain is likely to increase further as time passes.

Sudden onset: this is more a case of 'the straw breaking the camel's back'. If you have tight muscles which are placing increased stress across the structures concerned, that stress will be creeping nearer and nearer towards your own pain threshold level, at which stage you will perceive pain. However, it may be the case that this stress is still a some way from causing you pain, yet you then perform a specific activity or movement which pushes the stress above your pain threshold level and therefore you will feel pain.

A classic example of this latter point is when people bend forward to put some socks or shoes on or maybe pick something up as innocuous as a piece of paper. I have had many patients say to me that 'all they did' was perform such an activity and they felt pain. The situation is that under normal circumstances a movement like that would not have caused them pain, however due to the tight muscles driving the stress across the structures of their lower back/sciatic nerve nearer and nearer to their own body's pain threshold level, what seems like an innocuous movement can be enough to cause severe pain.

I have no doubt that such pain can be quite straight forward to cure, however, it is imperative that the cause of the pain is addressed i.e. the tight muscles, and not just the signs and symptoms. If this is achieved, then not only will the pain be resolved, but the chances of such an occurrence happening again will also be greatly diminished, if not eliminated.