Lower back pain and what to do about it

Low back pain (LBP) is a common presenting complaint for the general population. A majority of the active population also experience back pain at some time in life. The athletic population, by virtue of higher level of demands, may be at increased risk of low back problems. Certain sports may be at increased risk compared with others (1). LBP can be caused by quite a few problems in any parts of the complicated, interrelated set of connections of the spinal muscles, nerves, bones, discs or tendons in the lumbar spine. The symptoms of low back pain typically get better within a small number of weeks from the time they begin, with 41-90% of people absolutely better by six weeks (2).

A lot of the population who suffer with chronic LBP (pain that lasts longer than 6 weeks) and there are several causes for this, and a few risk factors might include age, lack of exercise, excessive weightlifting, disease, improper lifting and psychological conditions.

Here at the IAC, we are regularly treating patients with chronic pain. Our aim is to break them out of the pain cycle allowing them to return to their everyday lives in the absence of pain. This looks different for every patient that comes through the door, whether they haven’t been able to pick up and hold their grandchildren or if their pain has been inhibiting their sporting performance, we always drive to get them pain-free and returning towards normality.

Most people who suffer from chronic LBP are often worried or frightened because it’s something wrong with their spine. Studies have shown that as many as 80% of patients with chronic LBP exhibit signs of psychological distress (3), but by seeking professional advice instead of accepting that you’re in pain and that’s the way is, it lowers that statistic to between 5-10%. The most effective way to protect your mental health and reduce pain is to seek help.

How can the IAC break you out of the chains of pain?

Firstly, it’s crucial to identify the root cause of pain. This is something we begin to investigate from the moment we begin that initial conversation when you come into the clinic. By digging into your lifestyle habits, sporting background and any other clinically relevant history, our practitioners will start to find that out so we can get to work and begin to correct it. There are so many different causes for the pain to present in your everyday life.

Commonly, we see that the vertebrae have become a source of pain because the facet joints have become irritated. The reason for this is different for every patient. Frequently, we find that our clients have put their back through an overload in an activity that they are not used to. We regularly see patients following a long day in the garden etc. The brain creates a pain response to this overload to try and protect the area.

After identifying what may be responsible for the pain, we must try and restore pain free movement. We know how horrible it can be moving first thing in the morning, especially putting on socks. This is what we are both likely to value as success. Our methods of breaking into those painful ranges involve a method of de-sensitising the area using soft tissue therapy, manual therapy, movement therapy and strength training to help us towards that goal.

How do we prevent this from happening again?

For some patients we can simply address the reason as to why it occurred and work on rectifying that dysfunction, but that is not the case for everyone.

Education is high up on our priority list. Back pain can be extremely frightening. In most cases, we must try and understand why it may have occurred and that movement is medicine. The sooner we can get you moving pain free, the faster the brain realises there is no danger, and the pain response will diminish.

Strengthening the surrounding musculature and improving neuromuscular control in the area will improve the capacity of the lower back to perform with a smaller chance of injury. Like any soft tissue in the body, the stronger the tissue, the better it can perform when under load.

Our therapists like to give you some homework when you leave our clinic. Exercises we might have you performing could include hollow holds- to improve the isometric strength of the abdominals, dead bugs – to improve neuromuscular control across the limbs and to utilise the myofascial sling effect, Romanian deadlifts or good mornings – to not only improve hamstring function but to get the spinal musculature stronger.

Lower back pain can be debilitating. Our advice is to get this addressed as soon as you can. We are here to help.

Reference:

Lower Back Pain in the Athlete: Common Conditions and Treatment. Robert J. Baker, MD, PhD, ATC, FACSM, Dilip Patel, MD, FAAP, FACSM, FAACPDM, FSAM. VOLUME 32, ISSUE 1, P201-229, MARCH 01, 2005.

Lower Back Pain Expert System Diagnosis And Treatment. Abu-Naser, Samy S.; ALDAHDOOH, RAMI.

Worrying about chronic pain. An examination of worry and problem solving in adults who identify as chronic pain sufferers. Petra De Vliegera, Geert Crombeza, Christopher Ecclestonc. Pain, Volume 120, Issues 1–2, January 2006, Pages 138-144.

Nonspecific Lower-back Pain. Surgical versus Nonsurgical Treatment. Nordin, Margareta DrSci; Balagué, Federico MD; Cedraschi, Christine PhD. SECTION I: SYMPOSIUM II: SURGICAL VERSUS NONSURGICAL MANAGEMENT OF SPINAL DISORDERS.

Low Back Pain. Deyo, R. and Weinstein, J. (2001). New England Journal of Medicine, 344(5), pp.363-370.

An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Koes, B.W., van Tulder, M., Lin, C.C. et al. Eur Spine J 19, 2075–2094 (2010).