Lower back pain – A guide to understanding my treatment options
What is lower back pain?
Lower back pain is an uncomfortable musculoskeletal condition which often involves the nerves of the lower spine. Pain sensation varies in nature but can manifest as sharp, stabbing, dull ache, pinching, numbness and tingling in feeling. Pain usually occurs due to muscle imbalances, hyperactivity in the musculature of the lower back, nerve compression caused by bulging discs, disc degeneration and/or stenosis of spinal canals.
Who suffers from lower back pain?
Lower back pain as it stands today is the single most common injury experienced by 70-85% of the population said to report varying levels of Lower back pain throughout their lifetime. Additionally, Lower back pain is the most prevalent reason for work absenteeism and is the second most frequent reason for visits to GP. For some time, it was believed that both male and female were equally affected by LBP however recent studies suggest higher prevalence in females.
Why do I experience lower back pain?
An abundance of research has gone into understanding the mechanisms and risk factors involved in causing LBP. Although still not fully understood listed below are some of the most common risk factors for LBP:
- Biomechanical Differences (during stance phase)
- Greater hip adduction
- Greater knee abduction
- Greater hip internal rotation
- Greater tibial external rotation
- Low side-to-side hip extensor strength/symmetry
- Weak core and excessive anterior pelvic tilt.
- Weak Quadratus lumborum
- Link Theory – Lower extremity injury can lead to LBP and vice versa
How do I treat lower back pain?
Lower back pain has three stages of progression of which are important to have a good understanding of if you wish to overcome or relieve your symptoms. The stages are as follows:
So, you might be thinking this is all too much or why do I need to know all this?
Well, firstly it’s important to know where you currently are in terms of treatment stage. Secondly, this will help you know who to consult for optimal treatment. According to the Australian Physiotherapy Association (APA), the evidence is mounting around management through manipulation therapy and early activation during acute and sub-acute phases of lower back pain as the preferred treatment. A meta-analysis performed on lower back pain studies currently indicates that exercise based treatment is best incorporated no earlier than the sub-acute phase with optimal results seen in chronic sufferers of lower back pain as seen above.