The lower back is a very important part of the body. It is uniquely designed in that it can move in all directions and it can generate big forces and bear huge loads, as it has a specialized set of muscles that control it. Similar to our general health, the health of the structure of the lower back is maintained through regular movement, keeping the back, trunk and legs strong, exercising regularly, maintaining a healthy body weight, caring for our mental health, sleeping well regularly, and not smoking or drinking too much alcohol. So, when these things go wrong, the structures of the back can become sensitized and unhealthy and we experience back pain (bodylogic.physio).
What Is Back Pain?
Back pain refers to a pain problem that occurs anywhere between the rib-cage and the buttocks. It can associated with pain referring down the buttocks, legs and to the groin region. Common terms used to describe it are – degenerative disc disease, disc bulges, disc prolapses or herniations, facet joint arthropathy or osteoarthritis, annular tears and sacroiliac joint pain (bodylogic.physio).
How common is it?
Back pain rarely presents below the age of 10, however it is common during adolescence and becomes even more prevalent through life. It often occurs with other pain problems such as hip pain, pelvic pain, neck pain and headaches. Problems such as incontinence are also common with it.
Up to 80% of the population will experience back pain in their life, and most people (70%) who get back pain will recover to a large degree, although recurrences are common. For a smaller group of people (up to 30%) it may become distressing, persistent (lasting beyond 6-12 weeks), disrupt many aspects of a person’s life and need treatment. This can include limitations in the ability to do activities of daily living, exercise, work and participate in social activities. This can be very scary and lead to anxiety and depressed mood in many people. This is why back pain is the leading cause of disability. It is important to know, that it is very rare (1-2%) for back pain to be caused by a serious health problem such as cancer, fracture, infection or inflammatory disorder (bodylogic.physio).
The below videos summarize a research paper co-authored by Physiotherapists Professor Peter O’Sullivan, Dr JP Caneiro and Kevin Wernli. They share ten scientific low back pain facts presented by patients, as well as patient stories behind the facts.
TEN LOW BACK PAIN FACTS:
The FACTS about back pain often surprise people. These include:
✔ Back pain is the leading cause of disability – it can ruin lives, but it doesn’t need to if you seek back pain treatment!
✔ It is rarely linked to serious tissue damage or life threatening disease
✔ Scans often can’t identify the cause
✔ So called ‘abnormal findings’ on scans like disc bulges, disc degeneration and arthritis are common and normal in most people without pain especially as they get older
✔ Backs don’t go out of place … ever!
✔ There is no perfect posture … a variety of postures is good for the back … even slouching is OK.
✔ Backs become healthier with movement and physical activity
✔ Gradually loading the back is safe and makes the spine stronger
✔ There are lots of ways to treat back pain, even when you are elderly … so don’t give up, get a good plan and stick to it.
✔ 30% of people that have back surgery are no better. Benefits from injections as a back pain treatment option are often short lived and strong drugs such as opioids are not effective for persistent back pain and have many negative side effects (bodylogic.physio).
What Are The Risk Factors?
Pain in the back is usually linked to things like: being stressed and tense, run down, carrying too much weight around the belly, sleeping poorly, low mood, inactivity, smoking, poor conditioning, overdoing it and doing things we are not fit for.
This can make your spine’s structures very sensitive. The good thing is that many of these things can be modified and you can seek effective back pain treatment (bodylogic.physio).
What Does Serious Back Pain Look Like? (1-2% of population)
- If you have had a traumatic injury like a fall off a ladder, seek medical advice and treatment to ensure you don’t have a fracture.
- If you are over 50, have had a previous history of cancer, aren’t feeling well, and have developed back pain for no apparent reason and it isn’t settling, then get checked by your doctor.
- If you have back and leg pain, a loss of sensation and power in the legs and have trouble passing urine, get checked by your doctor (bodylogic.physio).
What Happens For Most People When It Suddenly Occurs (acute back pain)?
Acute back pain can be really scary and painful. This can occur with awkward or unaccustomed movements of the back. Usually, it is associated with muscle spasm where the back gets locked up making it very difficult to move. This usually settles within a few days. Although it’s scary, it’s important to try and stay mobile and active as possible.
What Happens For Most People When The Pain Becomes Persistent?
When back pain persists beyond 6-12 weeks it is important to identify the factors that are keeping the spine sensitive in order to address them.
These factors can include: having a negative mindset about the back (“my back is damaged and can’t be trusted”), high levels of stress, worries or anxiety, low mood, fear of pain and or movement, avoidance of movement and activity, resting too much, carrying excessive weight (especially around the belly). These factors can cause changes to the nervous system making the spine’s structures very sensitive. Over tensing the ‘core’ muscles and over protecting or stiffening the spine can also be unhelpful, leading to more back pain – a bit like clenching the fist all the time (bodylogic.physio).
What Usually Causes Pain Flares?
Pain flare-ups are common and can be very scary. Ironically, they are usually predicted by things like being run down, unwell, inactive, stressed, doing unaccustomed activity and not sleeping well … not by damaged tissue.
Assessment of Back Pain:
It’s very important to understand that back pain usually improves with the right treatment, even if you have had it for many years. Physiotherapists at Core Physical Therapy play a very important role in the treatment of back pain.
The first and most important thing for us is to take time to hear your story and pain experience in your own words. We want to know how your pain feels to you and how it impacts on all aspects of your life so we can help you get back doing what you like. We will also screen you to ensure your back pain isn’t caused by serious health problems.
Following this we will conduct a comprehensive examination. This will usually involve looking at where you hurt, how your posture and spine move, your ability to relax your back and core muscles, as well as screening for your strength and fitness. We may also check things like your sensation and reflexes and do tests to check if your nerves are sensitive.
Based on all this information, we will then explain to you in simple language the factors that are contributing to your back pain, and discuss the best treatments options available to you (bodylogic.physio).
Treatment of Back Pain
If your back pain is acute (sudden onset), the key is to help you to get comfortable and moving as this helps with recovery. We will also identify the factors that caused the back pain and make a treatment plan to prevent it in the future.
If your back pain is persistent (longer than 6-12 weeks), we will work out a plan with you to help you take control of your pain, obtain treatment, and get back to living based on your goals.
Treatment may involve some hands-on techniques to relax you and get you moving, coaching you in body relaxation, training you to restore relaxed spinal movement, help you get strong and confident, resumption of physical activity and where relevant sleep rehabilitation.
A long-term plan is the key to prevent back pain from recurring and stop it interfering in your life. We also work with your doctor and or psychologist if additional care is needed.
At Core Physical Therapy, we are not interested in ongoing band-aid type treatments for your back pain. We know that the best way to manage back pain is to help you understand why you have pain, and get you back in control, moving, active and living again.