How Do I Know if My Back is Out?

Is my back out? Out of alignment? Out of place?

These are some of the most common questions I get asked in private practice. I’m here to tell you, however, that your back doesn’t go in and out like a fiddler’s elbow. In fact, if you had dislocated a joint in the spine… well… you certainly wouldn’t be making your way onto my treatment table.

back's out

Something must be out I can’t bend to the right!

Of course, you can’t, because your body doesn’t want you to bend to the right. When there is an injury to your body, it goes into protection mode. The brain sends molecules designed to heal (inflammation) to the site of injury. Your muscles then tighten to prevent further damage and the nervous system goes into a hypersensitive state in an attempt to protect you from anything that may be a threat to tissue health.

But this other therapist I went to just cracked me back into place!

Manipulation increases your circulation, decreases muscle tension and causes a local change in the nervous system. This is why it feels better and allows your body to move more freely. It has nothing to do with your bones being cracked back into their original place.

While potentially providing an explanation of pain for the patient, terms such as tibial torsion, twisted pelvis, short legs and joints being “out” can affect our fears and belief system. It can begin to make us guarded in movements which we believe may put our ‘back out’. A lack of movement causes stagnation of fluids which may prolong healing. A developing sense of fragility accompanies how we view the injured structure, and our focus becomes not on the complex nature of pain itself but fixated on the supposed mechanical cause. We use this as a rationale for a pain response, potentially without tissue damage.

It is language like this that promotes a passive reliance upon treatment on putting the patient ‘back in’. A management strategy which is good for the clinic’s business but not so great for a complete resolution of your symptoms.

So if you have a practitioner that tells you you’re out again… it may be time to look elsewhere.


Published by Dr Damon Ashworth

I am a Clinical Psychologist. I completed a Doctoral degree in Clinical Psychology at Monash University and a Bachelor of Behavioural Sciences and a Bachelor of Psychological Sciences with Honours at La Trobe University. I am passionate about the field of Psychology, and apply the latest empirical findings to best help individuals meet their psychological and emotional needs.

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