Lower back pain is extremely common – The Australian Bureau of Statistics estimates that 70-90% of people will experience lower back pain at some stage of their life.
The lower back is a very complex area of the body, and pain can come from various structures – facet joints, discs, muscles, ligaments, nerves –sometimes multiple. Sometimes it may be coming from the pelvis (sacro-iliac joint). It can be caused by poor posture, a specific injury, repetitive loading of the back, or could be completely random with no obvious cause.
The Australian Physiotherapy Association states that most people with lower back pain DO NOT require imaging (such as X-ray or MRI). This is because changes on imaging are very common, and often don’t correlate to pain or symptoms, or change treatment at all. Therefore, unless recommended by your GP, specialist or Physio – imaging could result in avoidable costs and unnecessary worry over the results.
- Stay active – bed rest is no longer routinely recommended. Gentle exercises and short walks are suggested – within your pain limits.
- Use pain relief –paracetamol, anti-inflammatories (oral or topical), heat (heat-pack, warm shower).
- Stay positive and be reassured that lower back pain is common and the prognosis is very good. On this note, factors such as stress, depression, and sedentary lifestyle can contribute to the chronic nature of back pain. Often managing these factors can positively affect your lower back pain.
A Physiotherapist will initially do a subjective interview and objective exam. Then they can identify what structures are most likely contributing to your pain. Treatment often involves:
- Muscle/soft tissue release – via massage, dry needling, or sometimes the Physio will teach you your own releases with a trigger ball or foam roller.
- Joint mobilisations.
- Advice in regards to what activities/movements to avoid, what to do, how to manage pain.
- Postural education and ergonomic advice – particularly if your pain is related to your occupation.
- Exercise therapy/Pilates – to strengthen particularly muscles (usually core control), lengthen tight muscles, re-teach movement patterns.