Low Back Pain

What is Low Back Pain?

Low Back Pain (LBP) is defined as ‘any pain arising from the region of your lower back to the buttock folds’. LBP can be sub-catagorised into distinct catagories:

  1. Specific LBP means that the pain is due to the presence of structural injury. To supplement a comprehensive physical examination, a diagnostic investigation like x-ray or MRI scan is able to confirm if such an injuryis present:
  • Intervertebral disc injury with/without nerve root compression, also known as ‘slipped disc’
  • Spinal stenosis (Narrowing of the spinal canal)
  • Spondylolysis (Bony defect), spondylolisthesis (displacement of a spinal segment) with instability
  • Vertebral fracture
  1. Rheumatological disease: Spondyloarthritis is a group of auto-immune (meaning that the body’s own immune system is turning on parts of the body) arthritis that causes multiple sites of inflammation and commonly in the area of the lower back and buttocks. A battery of diagnostic tests can check for this condition. If diagnosed late, this condition can cause irreversible deformity in the spine.
  1. Cancer: In rare cases, LBP can be a symptom of cancer in the spine. There are certain signs and symptoms unique in cancer that makes it different from the rest of the LBP conditions. Your healthcare provider is constantly on the lookout for this to ensure that you get early medical attention if necessary.
  1. Non-specific LBP: When the presence of structural injury or disease has been ruled out via a thorough clinical examination and diagnostic investigations, LBP is being catagorised as ‘non-specific’. This means that the pain is not caused by structural damage but less serious strain of your muscle, ligaments or intervertebral discs.Although less serious, these types of strain may still present with significant pain.

Causes

There are many reasons why you may hurt your back. Some people hurt their back from lifting heavy loads or simply lifting too repetitively, some people sustain heavy impact from road traffic accidents,jumping and landing from height or falling onto their backs or buttocks. In the elderly population or people at risk of osteoporosis, they may even sustain a fracture just from a sneeze!

Risk factors

In most cases, LBP develop in people who have not hurt their backs, or they might have a history of a back injury a long time ago that have healed. Therefore, the chance of them suffering from actual structural damage in the spine is lower. We need to consider the various risk factors that position them at risk of LBP. Risk factors, once targeted, can bring resolution to LBP. From well conducted research over the years, experts have identified these risk factors for the development and prolonging of LBP. The more ‘risky’ you are, the more likely you will develop LBP or the higher the chance that it may persist.

 

Lifestyle

Poor sleep quality

Deskbound work

Physically inactive

Chronic stress in life, work

Smoking

 

Emotional status

Low mood, depressed

Anxiety

Fearful of becoming active again

 

How physiotherapy can help

Physiotherapy is widely accepted as being the safest and first line of treatment for lower back problems. Treatment for LBP depends on the diagnosis, severity and the progression of the condition from initial onset. Once these have been established from a clinical examination, targeted treatment can begin. A Musculoskeletal Physiotherapist will be able to perform these. If anti-inflammatory medication or diagnostic investigations are needed, we can refer you to a doctor. Physiotherapy treatment may comprise:

  • Electrical stimulation for pain relief
  • Movement re-training
  • Individualised exercise program
  • Manual therapy to improve joint movements
  • Two-way discussion to help you work out a holistic plan to target the risk factors