Advice & tips : Low back pain
Three out of four people experience lower back pain. A majority of these pain symptoms normally subside on their own unless they stem from serious back injuries. Keeping fit and maintaining an active lifestyle can keep lower back pain at bay. Painkillers can also alleviate pain symptoms. However, chronic back pain can develop in some people, which may make additional treatment necessary.
Types of lower back pain
Simple low back pain
The most prevalent type of lower back pain is the simple lower back pain, also known as ‘non-specific’ lower back pain. This means that pain symptoms are not caused by any other disease. A sprain, or an overstretched ligament or muscle can be a cause for pain. The pain could also be caused by a minor disc or facet joint problem. It is often very difficult to identify the exact cause of the symptoms. Because of this, nearly 19 in 20 cases of acute lower back pain have been diagnosed as ‘simple lower back pain’.
The onset of pain is often sudden and follow an incident of lifting or after making an uncomfortable twisting motion. Some people wake up to lower back pain.
Simple lower back pain can range from minimal to severe. The pain is usually confined to the low back but can radiate to the buttock or thigh area. Lying prone on a flat surface can sometimes ease symptoms, but any movement of the back, like a cough or a sneeze can exacerbate the pain. Simple lower back pain is often ‘mechanical’ in nature as it can vary depending on posture or movement.
Nine out of ten cases report the absence or considerable reduction of pain within six weeks. Although the pain symptoms do improve, they may reoccur periodically afterwards and it is advisable to consult a physiotherapist to assess posture and muscle function to minimise the chances of the pain recurring and the risk of developing chronic back pain.
2 Nerve Root pain
Nerve root pain occurs when a nerve is involved and becomes compressed or constricted. A common cause of this type of constriction is a ‘slipped disc’ where the disc does not literally “slip”, but is manifested when its soft interior portion prolapses or protrudes out of a breach in the harder outer disc perimeter.
With nerve root pain the pain is felt along the course of the nerve and may travel down the leg, calf or foot. Often symptoms are more severe in the leg or foot than it is at the nerve origin. Sciatica is the most commonly heard of example of nerve root pain, this is a condition where pressure is placed on the sciatic nerve, irritating it and causing pain.
Pain can range from mild to severe. Similar to simple back pain, symptoms can be alleviated by lying flat on a surface, or aggravated by back movement, coughing or sneezing. Other symptoms may include tingling, numbness, and a feeling of weakness along the regions of the buttocks, leg or foot.
Other Causes of Lower Back Pain
1.) Arthritis – this condition is caused by inflammation of the joints. When it occurs within the spine, it can cause back pain.
2.) Osteoarthritis – the most common form of arthritis in older people.
3.) Ankylosing spondylitis – may be manifested in young adults, causing lower back pain and stiffness.
4.) Rheumatoid arthritis – can affect the spine as well as other joints in the body (refer to separate leaflet on the different types of arthritis).
5.) In less than one in a hundred cases, lower back pain can be caused by rare bone disorders, tumours, infectious diseases, and constrictions caused by other bone structures close to the spine.
A physiotherapist will be able to advise you and reassure you as to the most likely cause of your symptoms and advise you accordingly.
If any of the following situations occur it is best to schedule an appointment with a doctor prior to consulting your physiotherapist:
• Numbness experienced within the region of the buttocks, around the anal area, or in a leg or foot.
• Bladder or bowel disorders, like inability to urinate or incontinence.
• Fever, loss of weight, and general feeling of poor health.
Cauda Equina syndrome (Rare but would require urgent medical attention)
Cauda equine syndrome is a very serious type of nerve root problem that is classified as an emergency case. This syndrome leads to lower back pain, inability to urinate, numbness within the anal area, and a feeling of weakness in one or both legs. This situation occurs when the nerves at the end of the spinal cord are subject to constriction. If left unattended, Cauda equine syndrome can permanently destroy the nerves connecting to the bladder and bowels. As soon as these symptoms are present it is advisable to consult a doctor as soon as possible.
