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What causes low back pain?

Low back pain affects almost 60-85% percent of people in their lifetime. Low back pain is usually categorized in 3 subtypes: acute, sub-acute and chronic low back pain. This subdivision is based on the duration of the back pain.

  • Acute low back pain: pain that lasts less than 6 weeks
  • Sub-acute low back pain: pain that lasts between 6 and 12 weeks
  • Chronic low back pain: pain that lasts 12 weeks or more.

There can be many causes of low back pain. In general, it can help characterise back pain into 3 different categories:

Musculoskeletal

This type of back pain is caused by changes in the muscles, bones, and joints in your back. Common injuries include: a strain or “pulled” back muscle, a sprained or irritated ligament of the joints in the back, and arthritis or “wear and tear” of the joints in the back.

Neurological

This type of low back pain can be caused by injuries or irritations to the nerves in your back. You can think of your back as a nerve “highway” that houses the spinal cord and has multiple branches of smaller nerves that lead to different places in the body. The nerves that leave the spinal cord through small openings between the vertebra of the spine can become compromised and cause pain in the back and down the legs. Sciatica is a common example of a nerve in the back that has been compromised and results in pain in the buttocks, or even the entire leg. It is possible for pain to be both musculoskeletal and neurological. For example, a nerve, such as the sciatic nerve can be the results of a dysfunctional muscle, disc, or arthritis. In this case, the physiotherapist would treat both.

Chronic

Studies have shown that once back pain persists past 12 weeks, the muscles and nerves of the body can undergo changes. In chronic back pain, the original cause of the pain actually resolves, but the pain persists nonetheless. If may be best to think of pain as a car alarm. The car alarm will go off to warn you that something is wrong, ie. There is someone trying to break into your car. The alarm will often scare away the perpetrator, but will not shut off until you actively intervene. Back pain acts like a car alarm. The pain can let you know that something is wrong, ie. You strained a muscle in your back, but it can sometimes persist even when the injury is gone. This is why chronic back pain can be complex, and warrant specialised physiotherapeutic intervention.

How can physiotherapy help low back pain?

Physiotherapy can be an effective way of treating low back pain. Arguably the most important aspect of physiotherapy intervention is the assessment. The physiotherapist should spend a good amount of time learning about the history of your back pain and assessing your movement. Once the physiotherapist determines the cause of your back pain, they will be able to make a rehabilitation plan in order to get you back to peak function. The rehabilitation plan may consists of exercises, both general and very specific, education, and “hands on” techniques such as massage, joint mobilisation and manipulation, and acupuncture.

In the case of chronic back pain, physiotherapy not only ensures the original injury resolves, but also engages the parasympathetic nervous system to reduce central drivers to persistent pain. Simply put using the car alarm analogy, it focuses on not only getting rid of the perpetrator, but also on “turning off” the car alarm.

What causes low back pain?

Low back pain affects almost 60-85% percent of people in their lifetime. Low back pain is usually categorized in 3 subtypes: acute, sub-acute and chronic low back pain. This subdivision is based on the duration of the back pain.

  • Acute low back pain: pain that lasts less than 6 weeks
  • Sub-acute low back pain: pain that lasts between 6 and 12 weeks
  • Chronic low back pain: pain that lasts 12 weeks or more.

There can be many causes of low back pain. In general, it can help characterise back pain into 3 different categories:

Musculoskeletal

This type of back pain is caused by changes in the muscles, bones, and joints in your back. Common injuries include: a strain or “pulled” back muscle, a sprained or irritated ligament of the joints in the back, and arthritis or “wear and tear” of the joints in the back.

Neurological

This type of low back pain can be caused by injuries or irritations to the nerves in your back. You can think of your back as a nerve “highway” that houses the spinal cord and has multiple branches of smaller nerves that lead to different places in the body. The nerves that leave the spinal cord through small openings between the vertebra of the spine can become compromised and cause pain in the back and down the legs. Sciatica is a common example of a nerve in the back that has been compromised and results in pain in the buttocks, or even the entire leg. It is possible for pain to be both musculoskeletal and neurological. For example, a nerve, such as the sciatic nerve can be the results of a dysfunctional muscle, disc, or arthritis. In this case, the physiotherapist would treat both.

Chronic

Studies have shown that once back pain persists past 12 weeks, the muscles and nerves of the body can undergo changes. In chronic back pain, the original cause of the pain actually resolves, but the pain persists nonetheless. If may be best to think of pain as a car alarm. The car alarm will go off to warn you that something is wrong, ie. There is someone trying to break into your car. The alarm will often scare away the perpetrator, but will not shut off until you actively intervene. Back pain acts like a car alarm. The pain can let you know that something is wrong, ie. You strained a muscle in your back, but it can sometimes persist even when the injury is gone. This is why chronic back pain can be complex, and warrant specialised physiotherapeutic intervention.

How can physiotherapy help low back pain?

Physiotherapy can be an effective way of treating low back pain. Arguably the most important aspect of physiotherapy intervention is the assessment. The physiotherapist should spend a good amount of time learning about the history of your back pain and assessing your movement. Once the physiotherapist determines the cause of your back pain, they will be able to make a rehabilitation plan in order to get you back to peak function. The rehabilitation plan may consists of exercises, both general and very specific, education, and “hands on” techniques such as massage, joint mobilisation and manipulation, and acupuncture.

In the case of chronic back pain, physiotherapy not only ensures the original injury resolves, but also engages the parasympathetic nervous system to reduce central drivers to persistent pain. Simply put using the car alarm analogy, it focuses on not only getting rid of the perpetrator, but also on “turning off” the car alarm.