Lower back pain

Did you know that back pain affects up to 85% of the population and nearly 50% of those people will have more than one episode? Lower back pain is the most common disability in people under the age of 45 and is the most expensive healthcare problem in people aged 20 to 50.

So why do people develop back pain? There are a number of risk factors for back pain which can include your age, gender, posture, smoking status, occupation, strength and psychological factors.

The pain itself is typically related to a combination of structures generating pain. These structures include the intervertebral disc, facet joints, ligaments, muscles, nerves and synovium.

Acute lower back pain is usually of sudden onset and is often triggered by a relatively minor movement such as bending to pick up an object. We often hear about people injuring their back while getting their washing from the machine or picking up their toddler. This minor incident may be more indicative of fatigue or lack of control in the lumbar region.

The pain may increase over a period of hours due to the development of inflammation. The pain may radiate to the buttocks, hamstrings or lower leg. Sharp pain radiating down the leg is “radicular” pain and is associated with nerve root irritation, commonly as a result of intervertebral disc prolapse.

People with chronic lower back pain may also have acute exacerbations that may become more frequent and/or more easily triggered.

When your back is sore it is advisable that you adopt the position of most comfort. This position varies considerably from person to person and may be lying on your stomach, back or, commonly, side-lying.

Movements that aggravate pain should be avoided, whereas movements that reduce pain should be encouraged. This may be walking, stretching or mobility exercises prescribed by your physiotherapist.

With severe episodes of pain, bed rest may be continued for up to 48 hours. Bed rest longer than 48 hours has been shown to be detrimental.

Prolonged sitting, prolonged standing and high impact exercise should be avoided in the early part of the recovery process.

Exercise in a direction away from the symptoms should be commenced as early as possible. For example, for people who have pain with forward flexion may respond well to extension-based exercises.

Intervertebral joints, paraspinal muscles and local nerves may all contribute to low back pain and must be corrected. A physiotherapist can use various techniques to treat these areas. These manual therapy techniques may include: Massage, dry needling, trigger point release, joint mobilisation and taping. Manual therapy in combination with a progressive exercise routine is the gold standard for rehabilitation.

Strength exercises should be focusing on the superficial and deep abdominals in combination with gluteal muscles. Flexibility should focus on spinal and hip musculature. Mobility of the joints of the spine is also beneficial.

If you’ve got acute or chronic lower back pain then let us help you get back to your best. Book an appointment now!