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Writer's pictureJoachim Low

The Low Back

Low back pain (LBP) is perhaps the most common condition I see and manage. Low back pain is pain anywhere in the region below the last rib to the buttocks region. If we examine the anatomy. The low back region is made of 2 main parts: the spine and the pelvic area.


The spine classified as the low back is often referred to the lumbar spine. By definition, it is the vertebrae below the last rib. You may hear us calling it by a letter followed by a number. i.e. L4, where L refers to lumbar region and the number refers to the segment below the thoracic spine (where the last rib is attached to). It is common knowledge that there are 5 vertebrae in the lumbar region. For those who might be interested, it is possible to have 4 or 6 segments. So some people have L1 to L4 where some people have L1 to L6. But most of us have 5.



The last vertebra in the lumbar region (could be L4, L5 and L6) sits on top of the sacrum. The sacrum is a series of bones fused together to form a V-shaped bone. The sacrum is pretty interesting. In early times, it is thought to be sacred and referred to be the "seat of the soul". The sacrum ends off at the bottom with a sharp, pointed bone known as the coccyx, otherwise tailbone. The sacrum is flanked on both sides with the pelvic bones. We call the pelvic bones as the ilium, ischium and pubis. It is amusing to me that the pelvic bone doesn't really have a name. So much as that it is called the innominate bone. Literally no-name bone! The joint where the sacrum meets the ilium can be easily identified through a dimple. You may try feeling it on yourself. We have it on both sides, typically at the level where the belt line is. Doesn't work for the high waisted pants though. Lol.


The confusion with most of us is that we refer the pelvic region as the hip. Technically, the hip joint is the area of the thigh bone connects to the innominate bone (to the ischium specifically). So now you know! If you want to sound smart, instead of saying the "hip", tell your specialist that your pain at the sacro-iliac joint where the sacrum meets the ilium. I am sure he/she will be thoroughly impressed. :)


The goal of these articles are mainly for the intent of education and interest. I hope to give my perspective and opinion on everything health or spine related as well. Do you find this interesting? Is it too long or short? Is there something else you might want to write about instead? Feel free to comment.


Take care of yourself, and if you can, take care of someone else!


Joachim Low, Chiropractor



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