Simple Guide to Low Back Pain

 

Introduction

Low back pain or lumbar pain, is very common, with it affecting two-thirds of adults in their lifetime. So you are not alone!

 

I understand that there is a lot of info coming at you about what you should and should not do for low back pain. This article will provide information around the injury and some strategies to implement in the early stages of your journey.

 

What is Low Back Pain?

Lower back pain can be categorised into the following categories:

  1. Specific Spinal Pathologies (<1%)
  2. Radicular Syndromes (5-10%)
  3. Non-Specific Lower Back Pain (90-95%)

As you can see, the majority of lower back pain cases are non-specific in origin. Meaning there is no specific structure that we as health professionals can state is injured and is the cause of the back pain.

 

Let’s go further into Non-Specific Lower Back Pain

Non-Specific Lower Back Pain is an experience of pain typically due to the following overarching factors:

  • Traumatic back injury
  • Erratic physical loading
  • Insidious onset

 

Within these categories, there is a multitude of reasons that are associated with why someone has spinal pain. These include [1]:

  • Sustained or repetitive positions and postures
  • Physical deconditioning
  • Life stresses
  • Emotional factors: stress, anxiety, low mood, anger
  • Poor coping strategies
  • Poor beliefs around pain and injury
  • Poor sleep
  • Poor nutrition
  • Low or highly erratic activity levels

 

What are the symptoms for low back pain?

You may experience sensations from a dull ache to sharp persistent feeling locally or into the buttock.

It may stay local to the lower back region, but it is not uncommon to have referral pain into the buttock and legs.

You may struggle doing normal daily activities such as bending down, straighten your back, getting up from a chair.

Your mornings will feel stiff and sore and will take about 30 minutes to get up and moving.

DON’T FRET…. All of these are normal symptoms!

 

What are the recovery expectations?

The above symptoms are all part of the body’s natural healing processes. So realistically, by having these sensations means you are on your way of getting back to normal life!

It won’t be smooth sailing! The duration of healing for most soft tissue injuries will take up to 6 weeks.

Pain itself will vary from person to person, but the worst of it is usually within the first 2 weeks and it will decrease in intensity over the 6 week period.

 

What should you do initially?

The very first thing to do when experiencing acute low back pain is to apply hot or cold therapy (this is a contentious issue and an article in itself), which is up to you but both can be tried to know which one is most effective.

Cold Therapy – Shortly after encountering the pain, apply an ice pack on the location and this can help by reducing the inflammation and interfering signals of danger to the brain.

Heat Therapy – Right after the occurrence of the ache, place a heat pack to the back muscles affected and this can provide comfort by giving good blood flow to the injured area and by increasing mobility to areas with stiffness. Another way of doing heat therapy is by engaging to moist heat like hot bath or shower.

 

What are some simple exercises to do for acute low back pain?

When experiencing an acute low back pain one must bear in mind to never stop moving. Daily routine and activities should be continued for as long as it is well tolerated.

 

The best advice is to remain active using these simple exercises:

 

Walking

If still able, a 10 to 20 minute walk once or twice a day will do a world of good. Walking will not only do all the good stuff that a heat pack can do, but also tell your brain that movement is safe and okay! This is key to the whole process!

 

Gentle Movements 

If you feel better standing up, then do some simple movements based on that position such as a standing lumbar extension.

…or a lying lumbar extension

If sitting is a preferable position, then we can choose a movement that promotes flexion such as a lying knee-to-chest exercise.

Or you can also complete gentle knee rocks moving from side to side whilst lying on your back

 Who should you see?

Pain usually subsides for lower back pain with or without treatment.

For specific guidance, an individual assessment from a physiotherapist with a special interest in back pain, such as a musculoskeletal physiotherapist, is the best option.

Your physiotherapist should be able to categorise your back pain, rule out any serious spinal pathologies, provide a management plan that not only looks at self-management but strategies that will reduce the risk of injury in the future.

 

 

David Bruzzese (MPA, AEP)

APA Musculoskeletal Physiotherapist & Accredited Exercise Physiologist

 

References

[1] O’Sullivan, et al (2018) Cognitive functional therapy: An integrated behavioural approach for the targeted management of disabling low back pain

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