Almost everyone will have low back pain at some point in their lives. It can affect anyone at any age, and it is increasing—disability due to back pain has risen by more than 50% since 1990 (see more HERE).
Lower back pain is an extremely common problem for many Australians. If you have found yourself reading this, it is likely that you, or someone close to you is suffering from low back pain (you may refer to it as back pain. lower back pain, chronic back pain or Sciatica) and you’re not alone.
Musculoskeletal conditions have become the number one national health priority, affecting over 6.9 million Australians. More than half of these musculoskeletal problems are attributed to back pain, or injury. Low back pain is so common that it is predicted up to 85% of us will experience an acute bout of low back pain over our lifetime, with some of these progressing to recurring, or persistent problems. This is not only having a significant impact on the function and quality of life of the individual; it has a significant influence on the Australian society.
Low back pain is now considered a major health burden globally, and medical researchers agree that the current use of X-rays, scans, injections and surgery to both investigate and treat low back pain is often unnecessary and can be harmful for the individual.
The good news is that through research we are understanding low back pain more and more and there are safe and effective treatments for low back pain; the challenge is ensuring patients get the right care at the right time.
Anatomy of the Lower Back
The lower back is robustly built, specifically designed for movement as well as support.
There are many components that come together to enable seamless movement that is required for functions like twisting, lifting, pushing and pulling.
The low back is made up of 5 strong bones (vertebrae) stacked on top of each other. Between each of these bones, there is a shock absorbing intervertebral disc which helps to distribute day to day forces evenly throughout your back. An intricate series of ligaments join and encase these bones to provide further structural support, this is further supported by many layers of muscles. The job of the muscles is to support and offload the joints in your spine, whilst facilitating each movement that your back can provide. Lower back pain is often blamed on one of these areas, with some common diagnoses of low back pain including:
- Disc injuries
- Fractures and bony injuries
- Sciatic pain
- Skeletal irregularities such as scoliosis
- Radiculopathy or referred pain
- Disc degeneration
- Ligament sprains
- Muscle injury or strains
However, in many cases it is not one singular structure that is the cause (or driver) of low back pain. We know that back pain is difficult to correlate with structural changes and pathology. More and more research findings confirm that many structural abnormalities, for example disc bulge, facet joint arthritis or spondylolisthesis, are also common findings amongst people who don’t experience back pain as seen in the table below (find more information HERE).
So, whilst there are many reasons for having lower back pain, the good news is that it can often be treated effectively. If you have been told that you have degenerative disc disease; bulging discs; or arthritis, this does not mean that you will suffer from persistent back pain, have to stop daily activities, or have to stop participating in sport.
In fact, it is well known that avoidance of painful movement and activity is an important risk factor for the initiation and maintenance of chronic low back pain.
An episode of acute low back pain can be extremely disabling and frightening; fear of more pain and re-injury often makes people avoid certain movements and activities, as well as complete activities more cautious and guarded. Whilst this seems a common-sense approach, as a long-term strategy this results in increased muscle tension, stiffening of the spine and general deconditioning. All aspects that can make the pain persist longer, see more HERE.
Effective treatment for low back pain
So now we know that avoidance of movement and activity, increased muscle tension and guarding, spinal stiffness and general deconditioning are some of the main drivers of the pain persisting; it makes sense that an approach aimed at restoring quality movement, reducing muscle tension and spinal stiffness is an effective treatment to get rid of the back pain. This is particularly powerful when combined with pain education. When you understand why you are experiencing pain, what is contributing to the pain and why it is important to get moving again.
The physiotherapists at Aspire Physiotherapy Bunbury offer a complete solution for your back pain. Whether this is acute low back pain, or pain that has been hanging around for longer.
Together with your help, we identify contributing factors, for example muscle tightness or weakness, spinal stiffness, underlying fear of re-injury to name a few, and we can offer a treatment plan that addresses all these aspects. Often this is a combination hands on treatment modalities, such as massage, dry needling (acupuncture), spinal mobilization or manipulation, education and advice and exercises specifically tailored to get you moving freely again.
Exercises for low back pain can be aimed at achieving a couple of different things:
- Improving flexibility (spinal mobility and muscular flexibility);
- Improving strength of the muscles supporting the lower back (core muscles);
- Improving movement control, quality of the movement, restoring normal movement patterns;
- Reducing the fear associated with movement, or movement in certain direction.
With any exercise, it is important that it is tailored to the needs of the individual, your physiotherapist at Aspire Physiotherapy Bunbury can give you excellent guidance on this. The following exercises are a selection of exercises that can be great for people with low back pain. However, it should be noted, that this advice is generic in nature and should not be seen a medical advice. It is possible that some of these exercises may not be suited for you, feel free to contact us to discuss your individual case and we can make sure to select a treatment approach and exercises most suited to your individual situation.
This common yoga pose is an excellent way to stretch out the muscles in your lower back aiming to improve your lower back mobility.
Start on all fours, feet together and knees apart. Push your hips towards your heels and rest your buttocks on your heels, stretch forward with your arms, whilst keeping your buttocks in the same position. Hold this position for at least 30 seconds and repeat 5 times.
Back Extensions or Cobras
Back extensions are a versatile exercise that can be done in standing, sitting, or lying. Lying on your stomach is a great way to isolate the stretch to your lower back whilst being in a safe position.
Lie on your stomach, arch back and come to rest on your forearms and elbows, look up, extending your neck towards the ceiling. Hold this position for around 10 seconds. Repeat 5 -10 times
This exercise improves your balance and coordination, boosts mobility, and builds core strength. It also stretches your spine, which helps ease pain and discomfort.
Sit on your fours, with the palms of your hands grounded on the floor. Raise your right arm and left leg simultaneously with a slow, controlled motion. Do not arch your back! Return to the starting position. Repeat about 10 times on each side.
This excellent exercise targets movement control, mobilises the spine, and strengthens the core muscles.
Start in a crook-lying position (on your back with both knees bend). Gently tilt your pelvis backwards by tucking your tailbone in and flattening the hollow in your back, continue to roll up all the way to your shoulder blades (if comfortable), on return slowly roll down. The key is to try and move each individual segment of the spine (imagine like a bicycle chain).
Knee To Chest Stretch
This exercise aims to improve the mobility in your lower back and stretch the muscles around your hips.
Lie on the floor with your knees bent and feet flat on the ground. Reach down and pull your legs towards your chest. Hold for around 30 seconds, then rest your legs down before doing the same again. Repeat 5 times.
These exercises are an example of the exercises available to improve your low back pain. As mentioned before, this is generic advice and should not be considered specific advice for your individual situation. If you are reading this and have been struggling with low back pain feel free to get in touch with us and find out how we can help you get back moving freely and feeling great.