Lower Back Pain
Lower Back Pain
What is Lower Back Pain (LBP) and how common is it?
LBP can be experienced anywhere in the lower back, but can also be felt as pain in the buttock or the lower limb, even into the feet and toes, often described as referred pain. LBP can be described as acute, sub-acute or persistent/chronic. Self-reported data from the Australian Institute of Health and Welfare (AIHW) showed that about 4 million people have back problems (approximately 16% of the population) and between 70-90% of people will experience LBP at some point in their lives. Approximately 90% of LBP sufferers will recover, but recurrence is common. The good news is that most acute lower back pain isn't dangerous and will typically resolve in 3-4 weeks.
Who gets LBP?
Lower back problems tend to increase with age and those aged 0 to 24 are the least likely to experience Lower Back problems (AIHW, 2019). The overall prevalence of back problems, after accounting for age, is similar for males (16%) and females (15%) (AIHW, 2019). There are a number of risk factors that can increase your chance of LBP, such as weight, physical inactivity, age, poor health (smoking etc), stress and more. LBP can often come on for no particular reason and often the most trivial things can set off an episode of back pain. For example, bending down to pick something up and feeling immediate pain in the lower back and or buttock. Occasionally there may be a clear mechanism or cause for LBP, but more often than not, LBP is influenced by SO many different factors and not just the tissues/structures in the lower back.
Everyone experiences pain very differently, but LBP can often be described as an ‘ache’ or ‘sharp’ pain. This may also be associated with a feeling of ‘tightness’ in the lower back and or buttock area. When there is a neurological component, someone might describe ‘tingling’ or a ‘burning’ sensation anywhere in the lower limb, even into the feet and toes. Pain that tends to move around and change is common and often suggests that the pain is non-specific in nature.
Those with acute LBP often talk about having difficulty getting up from sitting or bending over. Sometimes certain activities can make the pain better or worse.
Often when people seek care for back pain, they also mention ‘degenerative changes’, which have been found on an x-ray or an MRI. While LBP pain is often attributed to such degenerative changes, this is often not the case. We now know that degenerative changes are common and don’t often correlate with symptoms. That is, you can have findings on imaging, but have no pain at all. LBP, like all pain, is more complex.
How can Physio help?
Your Physiotherapist will conduct a thorough assessment, to determine possible causes and contributing factors of your LBP. This will include taking a thorough history of your current problem as well assessing things like range of movement, strength and other relevant tests. This assessment also includes the exclusion of anything sinister (otherwise known as Red Flags). While we know that a smaller proportion of people will present with pain that is sinister in nature, it is really important not to miss these presentations.
Provided there are no Red Flags or contraindications, your Physio will then work with you to establish some goals for your treatment and then create an individualised treatment plan. This may include education, activity modification, lifestyle changes, exercise to improve mobility and or strength and manual therapy for symptom relief.