Lower Back Pain
 

What is it?

Lower back pain is extremely common. It is estimated that 70-80% of the population will suffer from lower back pain at some point in their lives. People of all ages can suffer with lower back pain, from children, students, office and manual workers, those with new children or in pregnancy and the Elderly. Symptoms of back pain can vary from a general ache to sharper fleeting type pains. Sometimes pain can track into the buttock or even down the leg and into the foot. Occasionally changes in sensation such as pins and needles or numbness can be present.

Causes

Lower back pain causes are extremely varied, it may occur due to a one-off quick movement or following repetitive movements or adopting sustained postures. As occupations have generally become more sedentary and less manual, the mechanism of lower back pain has seen a shift. For example, the position in which a person will sit for numerous hours each day will put specific stresses on that person’s spine, potentially predisposing him or her to an injury. If lower back pain is severe or persists for more than a few days, it is important to see a physiotherapist who can assess and treat the problem.
 

The Physiotherapist can then tell if the pain is coming from the muscles, discs, vertebral joints, sacro-iliac joints (pelvis), ligaments or nerves. Most lower back pain involves a combination of these structures being affected, especially if lower back pain goes untreated. For example, following a back strain it is more likely that walking and other movements will be altered to avoid placing further strain on injured tissues and causing more pain. This adaptation can overload other areas of the body and can cause strain to other muscles and soft tissues. Many experts believe that over time this can lead to an overall imbalance in the spinal structure and possibly to the body's alignment, increasing the likihood of recurrent episodes or exaccerbations of back pain. This is why it is important not to allow lower back pain to go untreated. 
 

Treatment

As already stated, low back pain is an extremely common problem. It is therefore surprising that low back pain is often poorly managed. Most back pain is simple and self-limiting but some back pain can involve structures which have a much poorer tendancy to heal themselves. Some patients with intractable or longstanding back pain may require a referral to an Orthopaedic Surgeon or Rheumatologist who can advise on specialised management, further investigations (MRI scan) or indeed surgery.
 

Following a thorough examination and assessment of the presenting problem, advice and treatment may include the following:

• Advice and education initially to reassure patients that 95% of all back pain gets better

• Acupuncture to restore normal muscle tone and reduce pain

• Specific joint and soft tissue mobilisations to restore normal movement and function

• Electrotherapy i.e. Ultrasound, Interferential, Laser or Game Ready TM to help control pain and inflamation

• Postural education and retraining including ergonomic work station advice

• Progressive tailored exercise rehabilitaion to include core stability retraining (pilates classes) and appropriate stretches

• Use of Back Pain Accessories i.e. lumbar rolls, back supports, cushions, core stability balls, back braces and strapping if appropriate