One-sided lower back pain is very common afflicting millions of individuals every year. It can present itself as sharp or dull pain, or general achiness, and it can be either constant or intermittent.
While there are a variety of medical conditions which can account for it, such as a herniated disc or degenerative disc disease, these are much less common causes.
More commonly, this problem results from a muscle strain or muscle spasm.
This can result from a torsion in the pelvis which pulls one hip joint up higher than the other. When this occurs, the leg on that side is pulled up as well, creating a functionally short leg.
This is called a functional leg length difference. It’s termed functional because the bones of the affected leg are not actually shorter than the bones of the other. This is to be distinguished from a structural leg length difference in which one leg is actually shorter than the other.
In either case, the body will tilt to one side when standing or walking, but will not remain tilted over like the Leaning Tower of Pisa. Instead the body will attempt to straighten out the tilt with a powerful act of muscular contraction, very often involving the muscles of the lower back.
As long as the torsion in the pelvis and the resulting body tilt remains, the compensating muscles will be forced to work very hard and will eventually become painful.
A functional leg-length difference requires that the torsion in the pelvis be corrected. In this case, a lift is not a good solution because the leg length would be evened out but the pelvis would still be out of balance.
A structural leg-length difference requires that a lift be put inside the shoe on the short side to correct the imbalance. A podiatrist should be sought out for this type of problem.
Muscular compensation such as that described above will very often lead to significant one-sided lower back pain. The muscles on one side of the body are forced to perform an impossible task: to oppose gravity.
When the body is upright and balanced in gravity, the lower back muscles can exist in a state of relaxed equipoise. However, as soon as the body moves off it’s center line, even to a small degree, a wrestling match with gravity ensues.
For finite periods, such as during the performance of work or exercise, this is a healthy thing, creating a positive challenge to muscles and helping them grow strong.
However, the constant contraction required when muscles are forced to oppose gravity is not unlike holding a clenched fist all day. The knuckles would go white for lack of blood (ischemia), and without blood the hand muscles would cramp and eventually spasm.
This is what occurs in chronically contracted muscles
in a compensating back. The muscles become ischemic and that predisposes
them to further strain and injury.
When individuals have one-sided lower back pain, they often can feel
that their bodies are tilted to one side, as described above. If you
suspect this to be true, it’s essential to correct the problem at it’s
core following a two-pronged approach:
1) First, the postural distortion must be corrected. Osteopathic physicians, chiropractors, and structurally trained therapists, like Neuromuscular Therapists, are trained in this area.
A Neuromuscular Therapist will not employ high-velocity adjustments, but will achieve the correction by re-patterning the soft tissues.
2) Second, the painful muscles must be directly treated in order to improve blood flow and assist in healing the tissues.
If you choose to see an osteopathic physician or chiropractor to help with your one-sided lower back pain, make sure that part of their protocol is extensive direct treatment of the soft tissues (the muscles), as well as performing a high-velocity adjustment for the pelvic torsion.
This type of adjustment alone is not as effective as when it is combined with detailed, soft-tissue treatment.
3) It's possible that you are suffering from Iliopsoas Syndrome, which is a muscular dysfunction of the primary hip flexors. Be sure to read my article, The Hidden Root of Pain, to see if this might be at the root of your discomfort.