LOWER BACK AND SCIATIC
PAIN
1 in 6 Australians will experience back pain. That is 3.7 million people. It is also estimated that 70–90% of people will suffer from lower back pain in some form at some point in their lives.
Often niggles in the back can turn into significant injuries, which may prevent you from working or being able to partake in your daily activities. It can be useful to attend to these niggles in your back to reduce the likelihood of them triggering a more severe response, as it can take longer to resolve through treatment.
It is wise to attend to these niggles in your back, before they trigger a severe response, often by something small, like tying your shoelace or picking up some fluff off the floor. A big flare-up or serious injury can be far more debilitating and take much longer to get on top of through treatment.
LOWER BACK PAIN
COMMON PAIN COMPLAINTS
Low back pain is often caused by a simple strain of muscles or joints, in the back, usually at a time when we are more vulnerable - for example, when we are run down, tired, stressed, tense, sad, inactive or overactive.
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Our increasingly sedentary lifestyle can also lead to poor posture and musculoskeletal problems, which may result in lower back pain.
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Lumbar facet sprains
Lumbar disc issues
Myofascial trigger points
Spondylosis
Arthritic degenerative change
Muscle strains or tears
Scoliosis
Hip flexor issues
Pelvic imbalances or weaknesses
Sacroiliac Joint (SIJ) dysfunction
Osteitis pubis.
HOW CAN MY PHYSIOTHERAPIST HELP MY LOWER BACK PAIN
PATIENT RESOURCES
Generally, acute (short-term) back pain resolves without the need for ongoing treatment or surgery.
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Your physiotherapist will provide information and advice about your lifestyle and daily activities. This may help you to identify activities that may prevent or help manage pain, especially if certain movements or activities make the pain worse. You may be given exercises to do at home.
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In most cases, scans (X-rays) are usually not needed, but in Australia, Osteopaths can refer for bulk-billed spinal X-rays, if indicated.
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Self-care tips for back pain:
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Avoid bed rest – it can do more harm than good as it can lead to shortened or weaker muscles, and joint stiffness
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Stay active as much as possible
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Stay at work, even if only on restricted duties. If required, discuss a return-to-work plan with your employer
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Pace yourself – try to do a similar amount of exercise every day
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Ice or heat packs may help in the first few weeks
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Learn about your pain – identify which activities make your pain worse or better and change your activities to suit
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Seek help early if you are fearful, anxious, depressed or stressed
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Relaxation and mindfulness strategies may help you cope
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Stop smoking – it can increase your chances of developing back pain
What the evidence says...
Manual therapy, either alone or in combination with exercises, needling therapy, or GP care, may provide some relief from short term (acute) or long term (chronic) back pain. Relief may occur fairly quickly or in the days after treatment (Bronfort 2010, Hayden 2005; Kent 2010, Bronfort 2004, Rubinstein 2011a,b, Furlan 2005, Licciardone 2005). References Bronfort, G., et al (2010) Effectiveness of manual therapies: the UK evidence report. Chiropractic and Osteopathy 18, 3 Bronfort G., et al (2004) Efficacy of spinal manipulation and mobilization for low back and neck pain: a systematic review and best evidence synthesis. Spine Journal; 4 Hayden, J., et al (2005) Systematic Review: Strategies for Using Exercise Therapy to Improve Outcomes in Chronic Low Back Pain. Annals of Internal Medicine 142 (9) Kent, P., et al (2010) Does targeting manual therapy and/or exercise improve patient outcomes in nonspecific low back pain? A systematic review. BMC Medicine 8, 22 Rubinstein, M., et al (2011a) Spinal manipulative therapy for chronic low back pain. Cochrane Database of Systematic Reviews 16, (2) Rubinstein, M., et al (2011b) Spinal manipulative therapy for chronic low back pain: an update of a Cochrane Review. Spine 36, (13) Furlan, D., et al (2005) Acupuncture and Dry-Needling for Low Back Pain: An updated Systematic Review within the framework of the Cochrane Collaboration. Spine 30, (8) Licciardone, J., et al (2005) Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders 6, 43