Lower Back

Explanation:

Low back pain is an extremely common symptom in the general population (80-90% of adults in the UK suffer from low back pain) and incurs great economic and social cost. The majority of low back pain sufferers improve over a 3 month period (90%), but unfortunately nearly 50% of those have recurrence episodes later on.

Most low back pain is classified as non-specific low back pain (somatic low back pain). This means that the pain is not due to any underlying disease process, and generally is due to ‘irritation’ of a number of tissues in the spine (facet joints, intervertebral disc, muscle, ligaments) rather than one distinct specific structure.

Causes:

There are many possible causes of lower back pain, but the most common include:

movements such as bending, leaning and sitting
poor function of the stabilising muscles

Despite common beliefs, low back pain due to slipped discs or slipped vertebrae is not very common (less than 10% of patients). Pain is generally mechanical in nature in that it is provoked with specific directions of movement/patterns of loading such as bending, leaning, and sitting. Since the nerve tissues which innervate the muscles and skin of the lower limb originate from the low back it is not uncommon for leg symptoms including pain (sciatica), pins and needles, numbness and even muscle weakness to be present. Back pain can be categorised into severe or acute low back pain and mild to moderate low back pain. Most people have mild or moderate low back pain.

Due to the mechanical nature of most low back pain successful management depends on identifying and treating the underlying causes of the problem. Poor function of the stabilising muscles of the region (often referred to as the ‘core’ muscles) is one of the more common causes of low back pain and it is thought to be one of the reasons why back pain is so recurrent in nature. Research has demonstrated that pain itself causes inhibition of these stabilising muscles. Further to that these muscles do not recover their function after injury unless specifically retrained, even if the pain disappears overnight.

Treatment:

In more recent years studies have shown that retraining of this stabilising musculature significantly decreases the rate of recurrence. Our physiotherapists will employ different treatments depending on the nature of your back pain. Because there are so many causes of back pain and so many back pain conditions and injuries no single treatment programme is going to work for everyone.

Treatments may include:

correction of faulty biomechanics
mobilisation and manipulation
soft tissue therapy
dry needling
taping
neural mobilisation and exercise therapy including retraining of stabilising muscles
exercise of the core musculature and motor relearning of inhibited muscles
longer term pilates, also offered at our clinic, can be an effective means of rehabilitation and maintenance as it retrains the core stabilising muscles to activate at the right time and function properly again
good postural alignment and staying active prevent and treat back pain and facilitate activity in the stabilising muscles