The lumbar spine, or low back, is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility.
Low back pain is extremely common in the general population and among sportspeople. Back pain affects up to 85% of the population at some time in their lives. That vast majority improve over a three-month period, but nearly 50% will have at least one recurrent episode.
It is often not possible to make a precise anatomical and pathological diagnosis, however this does not hinder management and treatment. In the majority of cases of low back pain, the principles of management depend on careful assessment and the appropriate treatment. Low back pain that has been present for longer than 3 months is consider chronic.
Causes
Chronic low back pain is usually the result of a relatively minor movement such as bending to pick up an object. This minor incident may be more indicative of fatigue or lack of control, rather than tissue overload.
Symptoms
Low back pain can incorporate a wide variety of symptoms. It can be mild and merely annoying, or it can be severe and debilitating. The pain is usually in the lower lumbar area and may be central, bilateral (both sides) or unilateral (on one side). It may refer/radiate to the buttocks, hamstrings, or lower leg. Other symptoms include muscle spasms/tightness, pain that worsens after prolonged sitting or standing, and/or difficulty standing up straight/walking/moving from standing to sitting.
How can Physiotherapy help?
Physiotherapy assessment aims to identify impairments that may have contributed to the onset of the pain or increase the likelihood of developing persistent pain. These include biological factors (e.g. weakness, stiffness), psychological factors (e.g. depression, fear of movement and catastrophisation) and social factors (e.g. work environment). Lower back pain physiotherapy treatment reduces the likelihood of recurrent back pain flare-ups and helps prevent the development of further chronic lower back pain.
