Lower back pain is one of the most common causes of pain and disability in our modern world with up to 80% of people experiencing lower back pain at some point in their lives.
In the majority of cases, the cause of lower back pain is not a lifelong diagnosis and like the rest of the body injuries to the lower back will heal. There are many things that can contribute to your pain.
Common Causes of Lower Back Pain
There are multiple structures that make up the spine and these include;
The spinal cord
Peripheral Nerve Roots
Any of the structures above can be injured and cause pain. The important thing to know is that the ligaments, muscles, discs and joint structures in your back are very strong and more sinister injuries are rare.
Disc Injuries EXPLAINED
Discs are fibrous structures that are designed to absorb and transfer force between the vertebrae. The vertebrae and discs are firmly connected to each other and they cannot fall in and out of alignment day to day and for this reason while hands on treatment can help reduce your symptoms and help manage pain regular ‘adjustments’ are not needed to regularly re-align the spine.
Disc abnormalities in the spine are very common with studies showing bulges or herniations are present in 30% of 20 year olds and 84% of 80 year olds who have no pain at all. Like other injuries, disc herniations will heal and are not a lifelong diagnosis. Degenerative changes of discs and other structures in our bodies are like wrinkles on the skin in that they are very normal as we age.
What is Sciatica? CAN PHYSIOTHERAPY HELP SCIATICA?
Radiculopathy refers to a range of symptoms caused by nerve root compression. It can occur throughout the spinal cord and symptoms will vary depending on their location but can include pain, weakness, numbness and tingling. In the lumbar spine radiculopathy is often referred to as sciatica because the lumbar nerve roots help to form the sciatic nerve.
The Pain Experience in Persistent Lower Back Pain
For the majority of people, structural injury becomes less and less important in our pain experience as time goes on. Persistent pain is pain that lasts for more than 3 months and 1 in 4 people will experience it. It can limit you in your daily activities and previous treatments you’ve tried may not have helped. Sometimes it may persist long enough that you feel it’s now something you have to live with.
One important thing to realise is that pain is not an accurate measure of tissue health. Pain is simply a protective mechanism that sends us warning signals when the brain perceives we are in danger. Sometimes, when our system has been experiencing pain for a long time our detection system is very sensitive and unnecessary warning signals are sent. The longer we are in pain, the better the body gets at producing it.
Pain can actually occur without any physical stimulus.
Thoughts, stress and certain places can activate the warning signals and reproduce your pain. You may notice your pain spreads or comes on without warning. Your pain may change with your mood and old injuries may start to hurt again.
Thinking about your pain beliefs and seeing a credible physiotherapist that will help you get moving again can help address these issues.
Movement and Its Effect on LOWER BACK Pain
Throughout your day your muscles and other tissues are producing chemicals and acids as a by-product of cell activity and energy use. During long periods of inactivity these by-products start to build up within our tissues as movement will usually help to flush them out.
This chemical build up will send danger signals to the brain and if your brain decides you should do something about it, it will hurt.
For those with persistent pain, and a system that has become more sensitive, it will require far less of a stimulus for a pain signal to be produced. For this reason, movement is strongly encouraged to help keep desensitise our system and reduce your levels of pain.
We recommend aiming for 30 minutes of walking 5 times per week at a brisk pace. A sports physio can help you get back on track with your exercise journey and provide strategies to work around your pain to get moving again.
Massage - in the early stages post injury massage can help reduce muscle spasm and desensitise your system to provide pain relief. As you progress through your treatment
Joint Mobilisations - joint mobilisations can be used to get your joints moving in a pain free way, offload the are and reduce muscle spasm surrounding the joints. As previously stated your spine is strong and can’t shift in and out of place. Commonly people look for cracks when getting manipulated as a sign of a successful treatment but the click or crack heard is simply air releasing from within the joint not something being realigned.
Dry Needling - Similar to the above options, in the early stages dry needling can help reduce pain and muscle spasm. Often when you’re really sore, dry kneeling can be a more tolerable form of therapeutic treatment.
Strength Training - Often with persistent or recurring injuries there is an underlying strength or control problem that is causing you to have repeat injuries.
Whether you enjoy going to the gym or would prefer to do a few exercises at home addressing these issues can be crucial for reducing your risk of reinjury in the future.
Can we help you? I need a physio near me!
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If you’re struggling with a new or persistent back injury, book in with one of our expert sport physiotherapists so we can help you reduce your pain or stiffness. With clinics in Essendon and Blackburn we can help the broader Melbourne community get back to living their life.