Low Back Pain
Low back pain can be one of the most common problems that people experience with 80% of people experiencing it at some point in time. In the majority of situations back pain is caused through issues with the muscles and joints that support the spine. Fortunately back pain responds very well to physiotherapy intervention.
Common Structural Causes of Back Pain
- Neural/nerve irritation such as sciatica
- Disc Injuries
- Muscle spasm/strain
- Facet joint irritation
- Age related changes to the spine such as spinal stenosis and degenerative changes
There are two main categories to help decide what type of issue you may have. They are
- Non specific low back pain (the majority of cases) and;
- Radicular pain
Non Specific Low Back Pain - approximately 90% of cases
- Generalised ache that can be felt either centrally or slightly to the side of the spine. It can also be referred into the gluteals or around/through the hip
- Restriction in range of movement of the lower back
- Absence of Radicular symptoms
- A shooting pain that can be traced out along a path. This can be into the gluteals or down the front, side or back of the leg
- Loss in leg strength
- Diminished sensation
- Presence of pins and needles, numbness or burning sensation
- Pain that can shift around
Treatment For Lower Back pain
Both radicular and non specific low back pain respond very well to a combination of hands on physiotherapy and exercise rehabilitation. It is the goal of treatment to normalise movement around the affected area and position the back in such a way that it facilitates healing. Another aspect of treatment is making sure that behaviours don't develop that can further aggravate the back pain.
Non specific lower back pain usually takes between 2 to 5 weeks to resolve, with radicular pain often taking slightly longer. In some specific circumstances the use of MRI, CT scans and X-ray imaging are used, however they are frequently not required.
Chronic back pain treatment does differ from the treatment of acute back pain. There is commonly hands on physiotherapy initially to address any muscle length and/or movement deficiencies in order to help normalise movement patterns. However, there is more of a focus on the exercise rehabilitation component and addressing the beliefs and habits that can continuing to aggravate the lower back. For example you might have heard from a friend that bending to pick things up off the floor can be harmful. In limiting the amount that the back is bending it encourages structures to tighten, which in turn can cause pain. It is through addressing aspects such as this that people can become pain free.