Lower Back Pain
Introduction to lower back pain
Lower back pain is very common, almost 80% of people will experience it at some point in their lives. The more common causes of lower back ache include muscle strains, acute injuries, overuse or specific conditions such as:
- Disc herniations
- Degenerative disc disease
- Facet joint syndromes (“pinched nerves”)
- Spinal stenosis
- Sacroiliac joint dysfunction
- Piriformis syndrome
Symptoms of lower back pain
The symptoms of lower back pain can vary depending on the underlying condition or injury. Well break it down into 3 categories:
- Referred Pain, Sciatica
- Localised Pain
- Muscle Pain
Pain shooting down the legs is usually called sciatica. Disc herniations or spinal stenosis commonly present as an electric or shooting pain referring down the thigh and leg. This is because of a compression of the nerve roots as they exit the spine. Acute facet syndromes (which patients often call a “pinched nerve”) can also cause pain referred into the butt and lower limb.
In cases of muscle strains, facet dysfunction or degeneration, a person may experience pain in and around the lower back. This is due to inflammation and aggravation of the joints of the spine
In almost all cases of lower back pain, there will be muscle involvement. This may present as a person simply experiencing localised pain in the lower back. However, muscles can also refer pain into the butt or lower limb. This type of pain referral is commonly seen in cases of myofascial trigger points.
Treatment for lower back pain
Chiropractors may utilise several treatment methods and modalities to treat lower back pain:
The technique most commonly used by chiropractors is the adjustment. This helps to relieve lower back pain by reducing pressure on sensitive structures such as nerves. It also increases movement and flexibility, increases blood flow and reduces muscle tension.
These include lumbar traction or flexion-distraction. Our spines are constantly under compressive forces and applying a traction force greatly helps offload the joints and discs within the spine. Inversion tables can also be used for decompression of the lower back.
Soft tissue therapy
When a problem occurs in the lower back, a common response in the body is a reactive muscle spasm to try and protect an aggravated area of the spine. Massage, fascial release and instrument-assisted soft tissue mobilisation (IASTM) are very effective in relieving muscle tightness in lower back pain.
When muscles become tight, it is possible to feel a knot or a tight band within a muscle. These knots are called trigger points and are often treated using dry needling. This involves the practitioner inserting an acupuncture needle into the muscle, which stimulates blood flow to the affected area and results in a reduction of pain, inflammation and muscle tension.
Heat and cryotherapy can assist in pain relief and decrease inflammation. Electrotherapy such as interferential current or ultrasound may also be used.
Exercise and ergonomics
One of the most common underlying causes of lower back pain is poor posture and weak core muscles. Incorporating a good exercise program as well as changing work habits, altering desk arrangements and making sure that you are sitting correctly is extremely important as these will help maintain the positive effects of your back pain treatment.