Back pain is a common problem that is predicted to affect up to 85% of the population at some stage in their lives. Although it can be debilitating, most can recover well if the right advice and strategies are in place. Often, the earlier you seek advice or treatment, the sooner you will get better.
Here is some information about the different causes or types of back pain, common management strategies, and general advice. This information is not appropriate for every individual, so be sure to speak to your Physiotherapist or Doctor before making any lifestyle changes.
Intervertebral discs act as a cushion between each vertebra, and can contribute to back pain through sudden injury, wear and tear, or repetitive activities that put strain on the disc. These types of activities can include heavy lifting, or sudden forward bending and twisting movements. They often present with pain with these movements or after prolonged periods in compressive positions like sitting or standing.
Similarly, joint or ligament sprains are often aggravated by repetitive or sudden forceful movements that overload or irritate the joints between vertebrae and can stretch ligamentous (supportive) structures around the spine.
Muscle strains can often involve the muscles along the spine. Usually small strains recover quickly, however more severe strains can take longer to heal. Physiotherapy can help here to relieve pain and promote healing.
As suggested by the name, this type of back pain is related to stress put on the back by poor postures at work, home, during sport, breastfeeding etc. Prolonged or repetitive poor postures tend to place the spine under stress, which can tighten or weaken the muscles along the spine and place the spinal joints and nearby neural structured under pressure. Postural back pain can present in the lower back, upper back, and neck.
Common conditions such as Osteoarthritis or Osteoporosis can contribute to back pain through degeneration or bony changes within the vertebrae (spinal joints) which then sensitise neural structures nearby, causing local, and sometimes referred pain into the back or leg. While arthritis is not reversible, there are now many treatment strategies such as Physiotherapy, exercise or steroid injections that can help alleviate or completely reduce pain.
Lower back pain can sometimes contribute to referred pain into the hip or leg as a result of compression or irritation of nerves around the back or spine. One of the common nerves that contribute to referred pain is the Sciatic nerve, which innervates from the back of the hip all the way to the toes.
Although most people recover well from back pain within 2 – 3 months, some can experience a recurrence of pain, and a smaller percentage may experience chronic, long-lasting pain.
There are many different types of treatment that may help back pain, including:
Physiotherapists are able to assess the back to determine the most likely cause of your pain. From there, we discuss a treatment plan with you to determine the best way to relive this pain. Often, management of back pain will include 4-6 weeks of hands-on treatment (depending on the injury) to release or mobilise relevant soft tissues, neural structures or joints. This is often done with a combination of home exercises to encourage spinal mobility.
Evidence strongly supports activity and exercise (Pilates, for example) as one of the most important strategies to treating and preventing back pain. Because of this, our Physios are likely to include a home exercise program as part of your treatment plan to optimise recovery. This often starts with gentle stretches and exercises to strengthen and improve control around the core and back
There have been many studies over the years to support Pilates based exercise for management and prevention of back pain – whether lower back, upper back, or neck related. In Pilates, your are properly able to focus on developing deep core and postural strength, as well as correct spinal mobility and control.
GPs are often involved when back pain requires prescription of pain relief or anti-inflammatory medications.
Back scans (such as Ultrasounds or MRIs) can be recommended when more severe causes of back pain are experienced, or when your back pain does not respond to conservative treatments as expected.
Being overweight has been shown to increase the compressive load through the spine, so changes in diet can often be beneficial in relieving pain as well as improving overall health by encouraging weight loss and reducing pressure on the back.
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