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Do you have back pain? If so, you are not alone. It is a common problem that many Australians experience with around eight to ten suffering back pain at some point in their lives. While an equal number of women and men are affected, most are of working age. However, back problems can start early in life, as young as eight to ten.
What is lower back pain?
Lower back pain normally feels like an ache, tension or stiffness in the lumbar spine. A number of conditions related to the bones, joints, connective tissue, muscles and nerves can cause back issues. We will touch on these later.
We normally put back pain in one of three categories – acute, subacute or chronic.
Acute – lower back pain is often short-term or acute, lasting a few days to a few weeks. Quite mild, it usually improves on its own with self-management. It can at times, however, be quite severe.
Subacute – when lower back pain lasts between four and 12 weeks.
Chronic – lower back pain that can last for three months or longer and occurs in about 20 percent of people that suffer with acute lower back pain.
Who gets lower back pain?
Although anyone can suffer lower back pain there are some people more prone to it than others. Some risk factors include:
What causes lower back pain?
Lower back pain is inherently mechanical and occurs when there is a disturbance to the way the components of the lower spine fit and work together. These include the vertebrae (spine bones), intervertebral discs between the bones, spinal cord, nerves and surrounding muscles, ligaments and tendons. Together, these parts work seamlessly as they would in a complex machine, but if one part gives out, the whole system can malfunction.
With this in mind, let’s have a look at some causes of lower back pain.
Strains and sprains of surrounding muscles, ligaments and tendons
Often, lower back muscle pain is related to myofascial pain syndrome, (pain and inflammation of soft connective tissue) causing muscle spasms and tenderness.
Nearby joints
The joints connecting one spinal vertebrae to another are called facet joints. A common cause of chronic lower back pain, these can become swollen and inflamed, causing stiffness and extreme pain.
Myofascial pain
This is pain that occurs when there are problems with the surrounding muscles, ligaments and tendons. The muscles can develop little tight knots known as myofascial trigger points, which can be very painful and quite debilitating.
Osteoarthritis
Also known as lumbar spondylosis, osteoarthritis is lumbar spine degeneration and arthritis. It is an age-related condition affecting the joints, discs and ligaments of the lower back but can also occur in the lower spine where it joins the pelvis (sacroiliac joint).
Degenerative disc disease
When the discs of the lower spine degenerate and change this can become painful.
Referred pain
Referred pain is where pain in one part of the body can be felt in another as a result of the different parts sharing the same nerves sending signals to the spine and brain. Facet joint arthritis or prolapsed disc (inner soft part of the disc bulges through) can compress nerves as they leave the spinal column (pinched nerve). This can result in shooting pain down into the buttocks, legs or feet.
Acute lower back treatment
Most people recover quickly from acute lower back pain whether they manage it by themselves or seek treatment. Over-the-counter pain relievers, remaining active, massage, and heat or cold packs often lessen the pain and help you move on with your life. In March 2018, The Lancet produced a paper supporting recommendations for self-management, physical and psychological therapies and some complementary medicine over pharmacological and surgical treatments. We will look more closely at these recommendations.
Self-management
There are so many ways you can manage your lower back pain from a holistic viewpoint, such as:
Physical and manual therapies
In Australia, chiropractors, physiotherapists and osteopaths use physical and manual therapy to treat lower back pain. Treatments often involve some form of spinal manipulation and massage. In 2013, The Lancet carried out a trial on people suffering low back pain and compared the effects of manual therapy with those of Voltaren, (diclofenac) a non-steroidal and anti-inflammatory drug. Manual therapy was discovered to be significantly better than Voltaren in reducing pain, disability and the need for medication.
With a five-year training program under their belts, Australian osteopaths are not unlike chiropractors and manipulative physiotherapists. The differences involve their underlying philosophy, diagnosis approach and frequency and duration of consultations. Characterised by a holistic view to patient care, osteopathy emphasises the reciprocating relationship between physiological and anatomical structures and addresses psychosocial, environmental and ergonomic factors that may impact on pain and disability. When reaching a diagnosis, osteopaths assess not only symptomatic tissues but other related parts of the body that may affect biomechanical function.
Psychological treatments
Cognitive behaviour therapy or CBT involves working with a mental health professional to help you change unhealthy habits of thinking, feeling and behaving, and can help you alter the way you think about pain.
Mindfulness-based stress reduction will help you focus on increasing awareness and acceptance of physical suffering and troubling emotions connected to pain.
Exercises
Exercises that focus on restoring strength, coordination and control of the deep core muscles can work wonders. Such exercises include Tai Chi, yoga and pilates. Aerobic exercises such as walking, swimming and cycling are also beneficial.
Finally, if your lower back pain is affecting your life and well-being contact us at Movements Studio Training. Our osteopaths use a combination of hands-on techniques to treat your pain and restore your optimal health.