The Lower Back Pain Remedy
September 14, 2016 5:45 pm
Lower Back Pain – The Real Deal, from Someone Who Knows!
So here’s a story almost everyone has heard: “I was bending over putting on my socks when all of a sudden my back seized up on me!” Or “I was bending over to get something off the floor when I had to cough. I had this sharp pain and I couldn’t stand up straight for a week!”
Lower back pain affects 75% of the population at some point in their lifetime. Besides the common cold, lower back pain is the most common complaint for family physicians, and for physiotherapists it is THE most common complaint! Thankfully, almost everyone who experiences lower back pain will have almost total relief within about 6 weeks. The real problem is when the lower back pain strikes again…and again…and again.
What Causes Lower Back Pain?
In the vast majority of cases, there’s a simple explanation. When there’s been a trauma or some over exertion, most lower back pain falls into the sprains and strains category. That means muscles, ligaments, joints, and occasionally the discs of the lumbar spine can be aggravated or injured. Occasionally, the nerves that exit from the spine can become compressed, causing the proverbial “pinched nerve.” Then there’s the pelvis, which sits just below the lower back. This is generally known as the SI joint or sacroiliac joint. This represents the area where the pelvis joins the spine. This can also be affected by trauma, however the vast majority of cases where SI joint pain exists occur during or after pregnancy.
Occasionally, people are affected by an inflammatory problem, known as Arthritis, which can also affect the spine. This can be caused by gradual breakdown of the joints over time (wear and tear) or due to an autoimmune condition. These are forms of Rheumatoid Arthritis.
Finally, there are more sinister causes of lower back pain, the ones nobody wants to talk about. Tumours, Cancer, Infections, Blocked arteries, and kidney stones can all cause significant lower back pain as well, which is why when faced with an episode of lower back pain it’s always best to consult either your physician, or your physiotherapist. Thankfully, these are extremely rare, and the path to recovery can start right away.
How Long Should my Lower Back Pain Last?
This is always an interesting question, because there really isn’t a simple answer. Tissue healing generally occurs within weeks, so in optimal conditions recovery should be fairly quick. (It’s never as quick as we’d like, but most people would accept 6-8 weeks over 1-2 years, so perspective is key!) By definition, Acute lower back pain lasts less than 4 weeks, sub acute lower back pain lasts between 4 and 12 weeks, and (scary music inserted here) Chronic lower back pain is any pain persisting beyond 12 weeks. About 20% of people who experience acute lower back pain progress on to have persistent back pain that lasts greater than 1 year.
How Can Physiotherapy Help?
A physiotherapist will start by taking a thorough history and doing a clinical exam which helps to determine what is causing your lower back pain in the first place. This is followed by education about what to expect, how to modify your activity to speed up your recovery, exercises to regain mobility and strength around your spine, and either hands on treatment, acupuncture, and/or electrical modalities to assist with pain management. Most likely, your physiotherapist will be in contact with your doctor so your medical team can take a multi-modal approach so that your recovery can be as fast and complete as possible.
How Can I Help Myself?
There’s many different ways we can either prevent back pain from occurring (or re-occuring as the case may be), or coping with a current episode of back pain. First, maintain an active lifestyle. Whether you have pain or not, it’s important to stay active. A sedentary lifestyle leads to muscle imbalances, weakness, poor posture, obesity, and poorer coping mechanisms. While staying active can seem like a giant hurdle to get over, all it takes is 30 minutes a day. This can include walking and stretching to more vigorous activities such as running, yoga, weight lifting, pilates, etc. Research shows that a strong core (both stomach muscles AND back muscles) will help to reduce occurrences and recurrences of lower back pain. So it’s very important to stay strong.
Second (and almost as important as the first!) is to maintain a positive outlook! While this may seem far-fetched, people who perceive that they are in control of their lives have a much better prognosis than people who believe that some outside force is responsible for their pain!
Another key point in helping yourself is to seek professional advice early in the process of dealing with your lower back pain. Early intervention has been shown to drastically improve outcomes in a shorter period of time. Take care of yourself, you are important!
Back Pain can be short term or long term, it can be simple or complex, and it will affect almost all of us at some point in our lifetime. By taking a team approach including your physiotherapist, physician, and most importantly yourself, you can limit the consequences of a back injury and stay functional and pain free.
Written by: Mark Metcalf MSc.(PT) FCAMPT