Correcting ‘Australian Posture’ – Chronic Back Pain
Case History: Chronic Lower Back Pain, Forward Head Carriage and ‘Australian Posture’
Mr. M. is a 44 year old male sales and office worker who attended the Practice with ‘Australian Posture’. Yes a real patient, real person.
He was suffering with chronic lower back pain (CLBP). He had been enduring spinal pain for 25 years and things were getting progressively worse.
In terms of postural distortion; Mr. M. had what we affectionally call an ‘Australian Posture’. Australian Posture is something we commonly see in Practice and is a driver of many lower back and neck conditions.
Australian Posture is not to be confused with ‘American Posture’, a distortion we will explain on another blog post.
Australian Posture is the forward translation of the torso and head forward of the vertical green axis line, in the manner you see below. Not only does this create tremendous pressure on the lower back, but also the neck and shoulders.
As a general rule of thumb, if your entire head translates forward of the green line (the vertical axis) you are quite likely to develop chronic lower back pain. In time, due to the difficulty in holding this position, you will commonly end up with neck pain and disability as well.
Remember, You can not fight gravity forever. Gravity will win.
Mr. M. was enduring diffuse spinal pains, stiffness, radicular changes (nerve damage) with weakness and altered sensations into the legs. In particular, he also suffered disc injuries at L4 and L5 which had not resolved creating even more pain, disability and frustration.
The last two years had been quite bad. He would need a hot shower in the morning just to get moving. His occupation involved constant sitting. Whether working from home or sitting in car for extended driving around the state.
Pain had been constant during winter, with lack of mobility exacerbated by the cold. Mr. M. had been receiving standard Chiropractic care (not Corrective Chiropractic, like we do) once a month over a period of time however had not improved. Basically, he had almost given up and learnt to live with the pains.
Sold the surf board. Given up running. And about to sell the mountain bike!
The patient had tried an Osteopath for one year, which did not work well. He developed more pains in the mid lower back (through the muscles of quadratus lumborum) and ended up ‘pulling muscles’ in to the buttocks (gluteus medius and piriformis).
No X-rays or neurological assessments where taken by other practitioners.
The spine would lock up for weeks on end. In between these episodes there was chronic dull pain with numbness into the left thigh and leg. He used to enjoy running but had to stop due to the pain with the leg going numb and tingling badly.
As you can see from the postural assessment above, he was translating to the right in the X axis (-TxT). In easy terms is was unloading the left leg by translating to the right in an effort to manage his lower back disc injuries.
In terms of health impact, he used to enjoy adventure racing, fishing from a kayak and paddling. Wave skiing at Cape Patterson and Point Leo were a thing of the past.
Further assessment noted patient blood pressure was normally high, he had put on weight (as he could not train anymore) and lost energy.
This is the lateral thoracic, or mid back X-rays before and after care. Prior to care the patient has a noticeable thoracic kyphosis (hunching of the mid back). He appears to have a history of Scheuermann’s Disease, a form of juvenile arthritis and advanced spinal decay. The spine will always wear more aggressively with an increased kyphosis.
Of particular note is the forward translation of the thoracic spine (+TzT) and hunching (+RxT) have reduced considerably. He initially had a translation of 50.9 mm and was reduced to 5.2 mm. Fantastic.
Now due to the Scheuermann’s Disease and alteration of the vertebral body height, it is quite likely this could be his optimal outcome.
Overall, he is standing much straighter with less forward head carriage. For the patient’s point of view; ‘he doesn’t look like his old man’
Lower back pain gone. Radicular changes and nerve damage resolved. Increased mobility. Increased functional capacity in sitting, standing and working. Lost weight and exercising again.
Back on the bike. Going for the occasional run. Bought a new board for stand up (SUP) surfing. Hasn’t surfed in years – but getting back in to it!
This Is Not a Testimonial.
Disclaimer: This is a Case Study of a real patient who attended the Practice.
As part of the Chiropractic BioPhysics Advanced Training Protocols, we will be collecting and writing up case studies of patients within the Practice. It is the only way to show the very real and measurable changes we see in patients under care.
Once sufficient case studies have been acquired, and in submission through CBP Seminars advanced training, we will look to publish these studies in peer reviewed journals where appropriate.
The Australian Health Practitioner Regulation Agency (AHPRA) forbids the use of testimonials in Australia. This is not a testimonial. There is no guarantee of outcome in treating complex neurological and spinal conditions such as those presented in the Case Study.
In keeping with the regulations of the Authority, we provide this case for your interest as an example of the type of patient we regularly assist within the Clinics.
If you like this article be sure to visit the Spinal Centre website at www.thespinalcentre.com.au and view more content by Dr. Hooper and the Spinal Rehabilitation Team.
© 2019 The Spinal Centre. All rights reserved.