Low Back Pain: Lumbar Pain

Low back pain is a common musculoskeletal condition which will affect many individuals at some point in their lives.

So, if you suffer from low back pain, you are not alone.

Many cases of low back pain are caused by stresses on the muscles and ligaments that support the spine.

The most common form is non-specific low back pain, which cannot be attributed to a known pathology (no specific structural cause).

Other forms can be from disc injuries, facet joints, ligament injuries, muscle injuries, arthritis, fractures and other less common conditions.

How Does Low Back Pain Occur

Low back pain has many causes. 

It can be caused by muscular strains, ligament sprains, herniated or bulged discs, facet joint irritation.

Often low back pain be caused by minor incidents e.g. bending awkwardly to lift something or during sports;  but is more often due to sustained overstress injuries and lack of movement. 

Low back pain is considered chronic when your symptoms last longer than 3 months.

Following 3 months, the structures in your back are well healed, and the remaining pain can be due to sensitised nerves, overprotective muscles, or poorly functioning muscles. 

Conditions Affecting the Lower Back

  • Lower back muscle pain
  • Facet joint sprain
  • Postural pain
  • Lumbar radiculopathy or sciatica
  • Pinched nerve
  • Lumbar disc bulge or prolapse
  • Lumbar disc pain
  • Lumbar Stress Fracture
  • Osteoarthritis
  • Sacro-iliac joint sprain
  • Spondylosis / Spondylolysis / Spondylolisthesis
  • Ankylosing Spondylitis
  • Scoliosis

Signs And Symptoms Of Low Back Pain

  • Pain
  • Stiffness
  • Muscle spasm
  • Difficulty bending, turning, sitting, walking, lifting
  • Leg pain / numbness / pins & needles

Do You Need to Have Scans If You Have Low Back Pain?

Imaging (X-ray, CT, MRI) is not always indicated in low back pain, and doesn’t necessarily reflect the amount of pain you are feeling.

Changes seen on scans do not necessarily relate to the symptoms or your function. 

It generally does not provide much information that will change treatment or management of your low back pain.

In the absence of progressive neurological deficits or other unusual symptoms there is strong evidence to avoid any imaging for low back pain.

Treatment Of Lower Back Pain

Physiotherapy treatment of low back pain focuses on restoring pain free movement, and helping you maintain improvement long term. 

This may be achieved by through hands on treatment to reduce pain, mobilise stiff joints, and reduce muscle tension.

Exercises are important for strengthening, core stabilisation and retraining movement patterns to take pressure off painful structures and teach you to move in the most effective way.

What Can You Do?

  • Avoid sitting for prolonged periods – take regular breaks; standing, stretching, or going for a walk
  • Back supports may help to relieve pain
  • Avoid poor working postures such as working in a bent forward position 
  • Avoid heavy or repeated lifting
  • You may benefit from gentle exercise such as walking, swimming, cycling and Pilates
  • Heat packs, warm showers/baths may provide pain relief
  • Try gentle stretching e.g. the Cat Cow Stretch (see video below)

For more information, see our blog Lower Back Pain Explained 

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