The Kidneys Relating to Pelvis and Low Back Pain

As I return from another week of 4^th year Osteopathy classes in Vancouver, I am fascinated by the complexities and opportunities for treating low back pain.  We can get stuck in a groove of treating low back pain as purely mechanical in nature, when consideration of the visceral organs may result in a different conclusion and can provide advantages.

This latest set of classes on the Kidneys and Gynaecological structures opened my awareness and palpation to alternatives for treatment of pelvic and low back pain.  I have previous training courses in Visceral Manipulation from over a decade ago, however my studies in Osteopathy have enhanced my approach.

Low back pain, inclusive of anterior pelvic and sacral regions, can be structural in nature.  Misalignment of joint articulations, muscle tightness and/or weakness, nerve irritation and asymmetrical work/life/movement patterns are common reasons for pain.  When low back pain is treated as musculoskeletal in origin, and the pain resolves, perfect.  Case closed.

What if the pain isn’t being resolved?

Here I believe lies an opportunity.  An opportunity to think differently, ask different questions about the same pain presentation to arrive at a potentially superior conclusion.

For instance, the uterus rotates in a torsional pattern during the gait cycle.  When walking or running, as one leg moves forward and one side of the pelvis rotates, the uterus moves in its torsional patterns because of the fascial attachment to the inner iliac crests and the utero-sacral ligaments that anchor onto the sacrum.  As the sacrum moves, so does the uterus.  A sacrum that doesn’t move properly will cause a cascade of compensatory patterns through the pelvis and spine.

Patient symptoms to consider the Uterus:

• Pre and post pregnancy
• Painful menstruation
• Lumbar, pelvic and sacral pain that won’t resolve
• Lower abdominal tension
• Hard fall/impact on the hips or sacrum
• Post-surgery
• Bladder pressure

Another example are the kidneys.  The kidneys are situated lateral to midline of the body near L2 and L3 vertebra, housed within rib 11 and 12.  During the gait cycle, the kidneys can glide approximately 3cm in motion along the rail of the psoas major muscle. Tightness and cramping in the low back during exercise can be muscular, but other considerations for the origin of the pain could be the diaphragm that also anchors onto L2/L3 vertebra, and the kidneys which are housed within the adipose and fascia layers of the lumbar spine region.

Patient symptoms to consider the kidneys:

• Thoracic, lumbar and sarco-iliac pain that won’t resolve with treatment
• Medial knee and ankle pain (kidney meridian in acupuncture)
• Flexion of the hip and knee when sneezing
• Lower limb swelling and/or poor circulation
• Abdominal bloating
• Hard fall/impact on the hips or sacrum

In summary, a multitude of considerations can be made for treatment of low back pain.  The end goal with any treatment is to improve structure and function, promote circulation, reduce pain and enhance the vitality of the individual.