Sore lower back for months- anterior tilt?

dandygirly

I can’t shake my sore back since Oct 2022 or even before. So you think by looking at me - do I have an anterior tilt? I’ve always had this pot belly too. Things I’ve tried: PT app called Hinge for 15 weeks- lots of the basic exercises and stretches every day. Chiro for ten weeks- ok alignment. X-ray- normal. MRI- normal. Doc recommended three weeks on anti inflammatory pills- did nothing. I also tried fodmap diet to see if it would help. I sit on a five inch ball for three mins a day (lol) I read it is good for the pelvic floor. I’m 48. I’m so stiff and sore across si joint lower back, into glutes and hips too sometimes. I still work out- Zumba and yoga once a week each. Every two to three days I hit the weight machines doing most of the core muscles and have been slowly increasing the weight. I also tried relaxing with cbd oil . Have not tried masseuse yet…or in person pt, but have an orthopedic referral. I did try rest too- took two weeks off here and there- almost was worsened.I’ve seen progress to my tone since Jan though Thanks for any advice.

dandygirly

dandygirly

Progress

claireychn074

Yes, you look to have a bit of anterior tilt (many of us do), but without meaning to be rude, it might just be your posture. Slumping a bit can also cause that shape, and sometimes retraining ourselves to stand up tall can really help. There is also a great thread on here which I can’t link called something like “does my uterus look fat in this” - have a look for it and do read some of the posts / look at the pictures. There’s some great examples of normal bellies in there, highlighting that many women have protruding lower tummies.

I can’t say if the tilt / posture is causing the back pain, but if it’s recent (as in months rather than years) it is more likely to be muscular. The SI is a tricky little region, and often pain there can come from somewhere else, like the QLs, any of the muscles which attach to the hips, even the hamstrings. Personally (as someone with joint pain and physical aches) I would start with a sports massage and sports physio. There are often small things we do on a daily basis which cause pain, like favouring one side, not sitting straight, using a computer mouse etc. I had back pain a while ago which turned out to be caused by an inflamed toe joint; I was favouring the other side and it caused back pain. No way would I have guessed that until the sports physio got me to move in front of him. You’ve excluded serious and nasty conditions through tests which is great, now have a look for a muscular specialist and see if some assessment and exercises may a difference. Good luck!

AnnPT77

Really good advice above, from @claireychn074.

I won't hazard a guess, because I can't really tell exactly where your pelvic bones are (not a problem with your pelvis, a problem with my amateurish assessment ability). If you poke, you should be able to find the top front of your pelvis bones, and the lower front. They should be pretty much stacked vertically.

I'm not endorsing this site in general (I found it at random because I thought the diagram was clear):

https://www.mbmyoskeletal.com/learning/pelvic-tilt/



There's also a thing that some people do - I can't really explain it - sort of locking the knees, that looks a little like anterior pelvic tilt. There's a video about that here:

https://youtu.be/Hf27o0VLPco

(In case you haven't run across them before, Bob & Brad are actual experienced physical therapists. Their advice seems pretty good when they stay in their lane. Sometimes they talk about diet, which is outside the standard physical therapy scope of practice IMU, and I think some of their advice about that is pretty shallow, maybe even bad.)

The PP mentioned slouching, now (rudely) also called "nerd neck". It's a sort of rounded-shoulders, chin-forward slump that a lot of us get from spending a lot of time hunched over desks, keyboards, phones, etc. It can encourage the abdominal area to protrude forward, too.

Finally, FYI, the uterus thread the PP mentions is this one:

https://community.myfitnesspal.com/en/discussion/10689837/does-this-uterus-make-my-stomach-look-fat/p1

Whether any of that is causing your back pain, I'm not expert enough to say. I rely on my osteopath (real doctor, faculty member and clinician at a major university) to keep me tuned up, have used physical therapy, professional massage, etc., in the past with some helpful results.

Chieflrg

Hi, I wouldn't hold much water in the notion of the idea of anterior tilt is any issue especially by a visual review of internet strangers.

I would look at your load management since or just before October. Did you start resistance training or something physically novel just before that time period until now? You state you've been performing core work 2-3x a week with focus of increasing weight. What is your load management in this time period? What is the frequency of removing the accumulation of stress of your resistance training? My professional opinion that somewhere in the answers to these questions is a reasonable starting point to relief.

dandygirly

Thanks for advice and the thread to look at. Yes, resistance training started around the same time- I had not done too much machines weights prior- for years really. I was diagnosed with osteoporosis at this point too, and the scare of that got me to the weights. Another factor was I had a hysterectomy in sept 2021, and had time off gym to heal (normal was zumba mostly with a free weights class here and there too, lots of walking) but after a year of no estrogen before they let me on it, I just got sore and stiff. Yes, I probably hit the machines too hard though it didn't feel bad at the first time at all, and once I got sore, I didn't stop much) I probably should have done them every 3 days at first. I'm a bit over-zealous sometimes, but really didn't think the weights felt too hard for me at the time.
Yeah I know my posture is crap- my neck is def forward tilting.
Sports masseuse is my first next thing then

Also, not so sure what you mean with these two qs - just the lingo I mean...What is your load management in this time period? What is the frequency of removing the accumulation of stress of your resistance training?
if you mean breaks between reps? I use the Jifit app, am on the beginner workouts, and use their 60 secs break and 10-12 reps.

dandygirly

Gosh you guys are so helpful- thanks for the thread again.
I had another clue to share---
My bouncy 5" ball, when I roll my butt and hip all over it, lol, the right side of my butt deep (looking at a the butt muscles, around the area of the Gluteus Medius perhaps)- is really sore when pressed on, like it is bruised way in there. I've noticed that before when I tried a massage gun, and it got my scared that the gun did it, rather than the other way around.
Could it be this? If so, should I stop the weights for that area, and let it heal, and for how long is typical?
I'm loathe to give up the machines cos I'm making progress, but I need to stop being a dingbat about it haha

AnnPT77

dandygirly wrote: »

Gosh you guys are so helpful- thanks for the thread again.
I had another clue to share---
My bouncy 5" ball, when I roll my butt and hip all over it, lol, the right side of my butt deep (looking at a the butt muscles, around the area of the Gluteus Medius perhaps)- is really sore when pressed on, like it is bruised way in there. I've noticed that before when I tried a massage gun, and it got my scared that the gun did it, rather than the other way around.
Could it be this? If so, should I stop the weights for that area, and let it heal, and for how long is typical?
I'm loathe to give up the machines cos I'm making progress, but I need to stop being a dingbat about it haha

I don't have an answer for your question - we don't know what the actual problem is, so (even if I weren't just some random non-medical-expert idiot on the internet), I couldn't rationally tell you what to do to resolve it . . . other than repeat that you should see a doctor.

There are forms of irritation that can show that symptom, but I also had a friend who cracked a bone in there (unlikely, but possible) and had similar symptoms.

See a doctor. Get a diagnosis.

cmriverside

I feel like you also have a bit of a spinal curve which may or may not be related, like when looking at those images of you from the rear it appears to me that your left hip is higher than your right and that about mid-back your spine is trying to "compensate."

It could be something as simple as hip abductors, tight hammies or muscular issues.

I agree with watching some Bob & Brad videos, but this might need a proper osteo diagnosis first.

dandygirly

thanks, yes it is a long journey investigating this so far with 2 docs, a PT vid consultation, and a chiro wellness practitioner all having input, but I know you are right about persuing the specialists next.
Yes I've watched SO many Bob and Brad vids too since Oct they are a national treasure

cmriverside

Try the Bob & Brad hip abductor exercises. Also I find that lying on the big yoga ball face up, arms over my head for 90 seconds to be a great lower back stretcher...B&B have a floor exercise that suggests the same thing, I just like the way the ball feels.

https://www.youtube.com/watch?v=ywTjMGE5fA0

dandygirly

thanks! Also thanks for the encouragement to move along with the appointments (I was ready to give up with that), I have booked a walk-in appointment for tomorrow with an orthopedic office. Will be interesting to hear what he says.

AnnPT77

dandygirly wrote: »

thanks! Also thanks for the encouragement to move along with the appointments (I was ready to give up with that), I have booked a walk-in appointment for tomorrow with an orthopedic office. Will be interesting to hear what he says.

Let us know how it goes, if you're willing? I often wonder how these things turn out after someone has posted, and your experience may provide some insight for others.

Hope you get good-as-possible news, and some potential remedies!

dandygirly

hello! I'm back after my Orthopedic visit this morning. This is what I learned. He wrote "Segmental and somatic dysfunction of pelvic region" "Segmental and somatic dysfunction of lumbar region" "Other low back pain" on my notes.
Nothing is wrong with my structure looking at the xray they took, spacing on spine is all good etc.
He asked me a bunch of Qs, and show where it hurt.. then he did some tests while I stand, sit, and lay down on the table. He noticed the clicking in my pelvis... I told him "I'm soooo clicky, all the time" which he thought was funny phrasing! He adjusted me in a couple of ways, one by twisting my back. Then he showed me an exercise to do to reset my pelvis lay flat on back, I clasp the back of my knee, knee up and push against 3 secs, then a bit higher do again, then a bit higher and do again, final step being knee up highest for a final stretch and let go. Both sides

He did say I have big hips for being slight and that was maybe why my pelvis moves out-? and causes, rubs? on the sacrum? Illium? not sure what he said actually. He said some specifics about the pelvis, pointed to the diagram, but I only caught some of the words lol, posterior something, (after I said I wondered if I had an anterior tilt) sacrum, illiac. Not sure... lol he talked fast- I wonder if recording the docs is allowed ! I can never remember everything right.
He said I was very strong for being so slight :-) He said that was good and to keep it up, and that to watch my form when lifting, pushing shoulder blades together.
He gave me a document to takeaway.. about Sacroiliac pain- exercises and information on it.

Do you have any thoughts on that? I'm going to spend some time watching Bob and Brad videos on this of course- see if I can trigger the memory of what he was talking about when he was using the lingo.

cmriverside

Yeah, sacro pain is something I've dealt with in the past.

Fast walking is good for that (I heard that one on Bob and Brad) but you do really have to do all the exercises daily.

Did you get a referral to a Physical Therapist?

dandygirly

no, he didn't mention that at all. But he already knew I used the Hinge app daily after I did a onetime online session with a PT. They gave me the SI sheet of exercises and some are different from the app, so they said to add them in to my routine too.