Low Back Pain and Sciatica - The Role of Core Stability

I'm sure you have heard the term "Core Stability" banded around of late, especially with the way Pilates has become very popular over the last few years.

By the term 'core' we primarily, although not exclusively, refer to the lower back, pelvis and abdominal area. Any muscles which have an influence over these areas need to be assessed to ensure they are providing optimum core stability.

Muscle Imbalance.

Before I go any further however, I would like to explain my perception of core stability, as it may differ a little from others...

Rather than use the term core stability, I prefer the term "Muscle Imbalance" as I believe it is this which is the main cause of nearly all low back pain and sciatica problems.

If our lower back and pelvis are working in perfect harmony, the muscles will be playing the role of mobiliser (i.e. contracting and therefore allowing us to move our back) and stabilizer (i.e. providing the lower back with support & stability).

However, due to either the way we are born or habits we have developed over our lifetime, the muscles can become tight, weak or both.

Weakness:

Those muscles that become weak will not be able to provide the lower back and pelvis with the support it needs. This in turn will result in excess movement occurring across certain joints and soft tissues, potentially resulting in pain.

Tightness:

Those muscles that become too tight will be 'pulling' or 'tugging' on the structures they are attached to. This increased force will also be encouraging further movement across certain joints and soft tissues, once again potentially leading to pain.

Weakness & Tightness:

This is the worst case scenario. If there are weak muscles present, they will be unable to resist the natural stresses being placed across joints and soft tissue. However, if there are also tight muscles present, these will be placing abnormal increased loads across the same structures which cannot be supported properly due to the weak muscles present. This is a kind of 'double whammy' and is an almost certain recipe for pain.

The aim of treatment is to gently strengthen the weak muscles, while also stretching the tight muscles.

The most common muscles responsible for problems in this area are the piriformis and hamstring muscles (which are typically tight) and the abdominals and multifidus muscles (which are typically weak). However, this is not an exclusive list and there are other muscles which can become either tight or weak and therefore contribute to low back pain or sciatica.

Nearly all low back pain and sciatica suffered is a result of muscle imbalance, be it tight muscles, weak muscles or a combination of the two. However, if you know what to look out for and also what to do, there is no reason why these painful conditions cannot be resolved.

If you address any muscle imbalances present related to your lower back and pelvis, this area will regain the strength and stability it needs to function correctly with no pain at all.