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Q: According to my massage therapist, I may have over-stretched ligaments in my lower back that run from my lower lumbar spine onto my gluteus maximus. Can this be corrected through deep-tissue massage or would it require surgery?

A: I hope those are not the only treatment choices you are considering!

There is little doubt that massage can make people with back problems feel better. Improvement may be temporary or long lasting.  But, I would not consider deep-tissue massage a treatment that can “correct” over-stretched ligaments. Finding a fitness routine with a good balance of rest and exercise—and avoiding activities that may have triggered your symptoms—can often help the body heal such injuries on its own.

In considering various treatment options for back problems, it’s important to be sure the diagnosis is correct. I’m guessing from your massage therapist’s diagnosis that you have low back pain that radiates into the buttock. In this situation, a physician might diagnose sciatica or muscle spasm rather than over-stretched ligaments. However, the diagnosis depends on the details of your symptoms, the results of your physical examination, and, in certain cases, the results of tests such as X-rays.

Keep in mind there are many causes of low back pain. Some of the most common include:

  • Disc herniation or tear (a “slipped disc”)
  • Muscle spasm or other muscle injury
  • Sciatica, a condition in which the sciatic nerve is compressed as it travels from the spinal cord to the leg
  • Osteoarthritis (also called degenerative joint disease)
  • Spinal stenosis, a degenerative or congenital disorder in which the spinal cord is compressed by the surrounding bones, discs, and ligaments.

Rarer and more serious causes of back pain include fracture (especially common among people with osteoporosis), infection, and cancer. Even after full evaluation, the cause of low back pain is often uncertain. However, your doctor can usually rule out serious causes of back pain with confidence. And, while the uncertainty can be frustrating, the good news is that the vast majority of new back pain resolves within a few weeks, regardless of treatment.

Most back problems (including ligament injuries) do not require surgery. Surgery is generally reserved for people who:

  • Have conditions that can be improved with surgery, such as disc herniation or spinal stenosis
  • Have severe symptoms that are unresponsive to more conservative treatment, and
  • Are healthy enough to endure surgery and the recovery process that follows.

If you haven’t done so already, I would recommend that you see your doctor for a detailed review of your symptoms and a complete physical examination. If your doctor suspects an unusual or serious cause of back pain, or believes your condition may require surgery, your doctor will likely order additional testing, such as x-rays or an MRI.

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