Back pain when twisting to the right: What it could be
Low back pain (LBP) is a common condition that many individuals will experience sometime in their lives. Many times it can usually be managed conservatively.
The cause; however, is important to determine how long symptoms last, its intensity and the movements and activities that you can comfortably engage in.
What happens when you twist to the right?
Twisting and rotating the back can worsen symptoms due to aggravation of different structures in the back including:
muscles
ligaments
spinal discs
joints (such as facet joints or the joints between vertebrae, the bones that make up your spine)
bone (ribcage)
nerves
or it can indicate a more serious issue that is not musculoskeletal (relating to muscles, bones, tendons, ligaments, joints, cartilage) in nature such as referred pain from organs like the kidney, gallbladder, appendix or liver/lungs
Generally, referred pain from the organs are accompanied by other symptoms and the pain does not change based on the body’s position.
It is also important to consider the location and type of pain. If you notice these, it would be a good idea to get it checked out by your primary care provider to rule out more serious conditions.
This blog will mostly focus on conditions stemming from musculoskeletal origins given a physiotherapist's scope of practice, but it is important to note these (and other) red flags for back pain.
What musculoskeletal conditions can be the cause for back pain while twisting?
The musculoskeletal conditions that could be at fault if you have low back pain while twisting are:
Mechanical low back pain
Muscle strain or ligament sprains
Could be the result of overloading/stretching muscles or ligaments during exercise, physical activity, sports, movements that involve lots of bending, lifting, twisting, awkward movements etc.
Traumatic injury
Postural pain
Facet or sacroiliac joint dysfunction
Sacroiliac joint dysfunction is common in pregnancy due to ligaments being lax, muscular imbalances and postural changes
Sacroiliac joint connects the bottom of the spine and the pelvis
Pain can radiate down to the knee
Pain can increase with twisting, standing on one leg or prolonged siting, standing or walking
Herniated/bulging disc
Discs can press on nerves leading to pain that can be aggravated by twisting or bending movements
Can lead to pain radiating down the leg
Can be aggravated by movements like coughing, sneezing, or bending
Degenerative disc disease
Change to discs between vertebrae can lead to pain and stiffness,
Can lead to pain radiating down the leg
Can be caused by changes to the facet joints (facet joint dysfunction)
Can cause spinal stenosis: narrowing of the spinal canal, which can compress spinal nerves and can be aggravated with twisting or bending
Spinal stenosis can be due to osteoarthritis
Can lead to pain radiating down the leg
Pain often relieved by sitting/bending forward and aggravated by walking/standing
Repetitive motions can cause pain: such as repeated twisting
Many of these conditions and their associated symptoms can be successfully managed with conservative treatment like physiotherapy.
f you have back pain and it has not improved over a few days or weeks, it may be good to get assessed by a physiotherapist to determine what could be the cause of your pain.
Your physio can then provide education and the appropriate treatment (including hands-on, needling, exercises etc.) to help you feel and move better and to prevent further injury or re-injury.
Where to get in-person help for your low back pain
Here’s the thing, we know that it can be super frustrating to have low back pain.
Ideally, we figure out a way to make sure your back pain goes away for good.
If you want someone who is super specialized in treating low back pain and also someone who understands what it’s like to have low back pain (you can read my story about my low back pain here and the update to my low back pain here), we’d love to work with you.
You can book a free 10-minute consultation call at our Toronto-based clinic. We’d love to hear more about your back pain and get you on your way to being pain free.
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Written by Jessica Chiang, Physiotherapist