At some point in your life, like most Australians, you’ll suffer from lower back pain. Current research indicates 70–90% of Australians will experience an episode of low back pain in their life. But first things first — what exactly is the lower back?

The lower back is known as the lumbar spine, an area that contains the five robust vertebrae with strong intervertebral discs between them. Many things can cause lower back pain, with most not being a serious sign of injury.

So what causes pain in the lower back?

A specific event

• A specific incident refers to an injury that is caused by a certain activity or movement. It is easily the one you remember most!
• Common specific incidents include lifting an object that’s a bit too heavy or twisting and bending over and feeling a sudden pain.
• This type of mechanism might involve a joint sprain, muscle injury or nerve irritation.
• Managing these types of injuries initially focuses on settling down symptoms to help the injured tissues to recover, then a gradual early return to activity to assist in full recovery.

Gradual onset and overuse

• Gradual onset and overuse injuries are usually linked to those tasks we do at home or work that require repetitive movements or sustained positions. Pain can arise if we perform these activities or positions in awkward postures.
• These types of injuries are very common, as a vast majority of us spend a significant time at home or work at a desk. Sustaining an awkward position for eight hours or more can cause overloading on your back joints and muscles causing pain.

For these types of injuries, it is important that we not only focus on making the sore tissue happier, but more importantly identifying the specific cause such as: poor desk set-up, inadequate strength for the requirements of the job/activity or poor technique with performing the task.

Other names for lower back pain

Facet joint syndrome

The facet joint is the main load bearing part of each vertebrae, with the lumbar spine designed to be able to withstand large amounts of force. Over an extended period of time the joint can gradually wear down, resulting in less mobility and flexibility. This is usually pain free. The area can become painful, but only when a specific incident of trauma occurs or due to repeated loading or a sustained awkward posture. Like all other lower back injuries, it is important to identify the cause, encourage gradual movement and let the tissue settle. It is also important to identify and modify the activity that caused the area to become painful in the first place!

Lumbar disc pathology

Situated between each of the five lumbar vertebrae are fibrous, shock-absorbing cushions called intervertebral discs. Over time, these discs can naturally lose some height due to loss of water content. As such, It is very common to be completely pain-free, while on a scan they don’t look picture perfect.

There are specific complications that can arise which result in this tissue becoming an issue. However, there are usually specific signs and symptoms associated such as neurological changes, muscle strength changes and pain in specific patterns.

Below are a few common names for disc injury:

• Degeneration: Refers to a condition where, over a long period of time, gradual wear and tear can result in changes to the disc such as loss of height. The condition is usually benign and pain-free.
• Herniated disc or slipped disc: The term slipped disc really shouldn’t be used. The disc certainly doesn’t go anywhere and makes it seem like they are fragile structures when the opposite is true — the disc is a robust structure! A herniation refers to when the shock absorbing inner layer of disc can protrude into the outer fibrous layer. In an acute injury where a herniation is potentially suspected, a thorough assessment is needed. Even though this can be very painful, the pain generally gets better with time, performing specific exercises and with education from your therapist. In many cases, the presence of a herniation is symptom and pain-free, and is a common finding on individuals without back pain in low back scans.
• Sciatica: Is a common name (we prefer to call it neural tissue irritation) that refers to the pain caused by irritation to the sciatic nerve, which extends from your lower back to your hips and buttocks and then into the back of the lower leg. Irritation of the sciatic nerve can occur anywhere along the line of the nerve but most commonly is due to an injury in the lower back. A thorough assessment is required to identify where the nerve pain irritation originates from and management focuses on settling that tissue as well as modifying activities to avoid further aggravating the nerve.
• Pars Defect: Referred to as spondylolisthesis, pars defect is a stress fracture affecting the pars (part of the lumbar vertebrae bone) and is typically caused by repeated heavy loading to these joints. This is commonly seen in repetitive sports such as fast pace cricket bowlers. Management can vary but requires a reduction in load as well as letting the tissue settle and heal.

Spinal stenosis

Spinal stenosis is a narrowing of the spaces where the nerves exist from your spine into the rest of the body. Narrowing is common in the over-50 population and is often pain-free. In some cases though it can irritate and affect the function of nerves resulting in tingling, numbness, and weakness.

Remedial physiotherapy and massage treatment for lower back pain

Lower back pain can be a complex issues with many factors contributing to the overall problem. With the correct diagnosis and a comprehensive management it can be treated effectively to get you and your lower back, back up (dad joke!) and running.

At Life Ready Physio, we’re driven to not only to reduce you discomfort and pain but also to develop a treatment plan to identify the cause and to work towards rehabilitation and prevention.

Get in touch with one of our specialists for a rejuvenated tomorrow, or click here for more information on the services we offer.

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