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
  • Osteoarthritis
  • Facet joint  syndromes (“pinched nerves”)
  • Spondylolisthesis
  • 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:

  1. Referred Pain, Sciatica
  2. Localised Pain
  3. Muscle Pain

Referred 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.

lower back pain
Facet Joint Pain Referral Patterns

Localised pain

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

Lower back pain
Localised Lower Back Pain

Muscle pain

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.

Referred lower back pain
Trigger point referral of lower back some muscles
Referred lower back pain
Trigger point pain referral from the gluteus medius to the lower back
Sciatica
Gluteus Minimus Trigger point referral – Often called Pseudo Sciatica

Treatment for lower back pain

Chiropractors may utilise several treatment methods and modalities to treat lower back pain:

Spinal manipulation/Adjustments

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.

lower back pain treatment
Lower back adjustment

Decompression techniques

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.

lower back pain treatment
Inversion table

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.

lower back pain treatment chiropractor
Massage
IASTM – Instrument Assisted Soft Tissue Mobilisation

Dry needling

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.

Dry Needling

Other modalities

Heat and cryotherapy can assist in pain relief and decrease inflammation. Electrotherapy such as interferential current or ultrasound may also be used.

 

Ultrasound

 

IFC

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.

Guide to desk ergonomics

 

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