What is back pain? Is it really just back pain?

What is non-specific lower back pain?

Non-specific lower back pain is defined as lower back pain not attributed to a recognizable, known specific pathology. (e.g, an infection, fracture, later stage osteoarthritis, radicular pathology, malignancy, inflammatory disorder or cauda equina symptoms). It can be caused by either a traumatic injury, lumbar spine or strain or could in fact be a postural strain.

Does this sound like you/Do you have any of these symptoms?

• Do you have pain localised the lower back that could or could not be going down into the front/back of your leg?
• Does it hurt/is your normal movement reduced when you bend forward, rotate or extend from your hips/lower back?
• Having difficulty or pain with getting up from a chair?
• Having trouble or pain in the lower back with lifting something you normally could?
• Having issues with sitting or standing for long periods compared to normal?
• Do you feel more stressed/anxious about your current situation in life?
• Is lower back pain common?

Lower back pain is the 5th most common reason why the general population would visit a medical professional. It affects about 60-80% of the population in their lifetime.

About 11-12 % of the population are disabled by low back pain. There has been a 5-fold increase in lower back pain over the last 15 years even with more research into this topic.

The recurrence rate of LBP is extremely high and these individuals are likely to experience another episode with 3-6 months. About 80% of LBP resolves within the first 3-6 weeks of the onset of symptoms. Do you have any of these Risk Factors as studies have shown these factors below could be contributing to developing lower back and how it can change once you have had it once.

The above information could be useful to help make some lifestyle changes or give a better understanding of the multi-dimensional issues with lower back pain to try and prevent a recurrence.

What can we do at FUNCTION PCP?

Here at Function, we incorporate the guidelines used by the APA(Australian Physiotherapy Association) mixed with a functional movement assessment to try and identify the area of concern/cause.

These guidelines include:

• Advice to stay active
• Manual therapy to help reduce pain in the short term
• Education regarding activity modification for household activities until symptoms resolve
• Structured exercise program tailored for the person – Including aerobic activity, movement instruction/correction, muscle strengthening, postural control and potentially stretching.

These guidelines are great for the general population, however, do we ever step back and think that why even though we have spent so much money on the research our back-pain statistics are increasing? Does this mean we are looking at the wrong area? Concentrating too much on local structures of the back and not understanding that movement is a combined task with many different structures working in synchrony?

Sure, we do have a change in our jobs and the way we spent most of our days In front of a computer or at as desk-based job or tied to our phones/computers/TVs in our spare time which could be contributing to it. But in my opinion, maybe the issue isn’t always at the back?

Maybe it could be a weakness in the hip internal rotator muscles causing more load onto the back in a squat type movement, which would need the body to adapt and change to perform the movement, overloading the surrounding tissue at the back-causing pain?

Or maybe it could be a decreased range of motion(stiff) thoracic region which should generally be mobile, causing the lumbar spine to be more mobile than stable causing increased movement not tolerated by the tissue?

Is this the reason your back isn’t getting better? Or gets better in the short term yet to have it injured again in 3,6 or 12 months?

Well, why not come into Function PCP and get a movement assessment, and let us help you peel back layers of movement and identify what may be the true cause of your pain if this sounds way too familiar, or maybe even come in to find out what movements are compromised and could be leading to your current dysfunction before it turns into pain or an injury.

As always, prevention is better than a cure.

Neeraj Sampelly

Physiotherapist