Back Pain
Back pain is often poorly understood but it is the biggest cause of disability worldwide! The World Heath Organisation estimates that 60-70% of the population in industrialised countries will experience non-specific back pain in their lifetime.
Let us dispel some of the myths surrounding back pain…
- Most episodes of low back pain settle reasonably quickly. It is believe that 60% of those who suffer from acute low back pain recover in 6 weeks and up to 80-90% recover within 12 weeks
- Back pain does not get worse with age. It is actually most common between the ages of 35 to 55
- Our backs are designed to move! Movement and exercise are essential to keep our spines healthy and strong
- Back pain is influenced by many factors including our mood, attitudes, coping strategies, sleep pattern and expectations
What do we mean when we talk about acute back pain?
Acute pain is short-term pain that lasts no longer than 3 months. For example, if you injure your lower back, it is likely you will feel pain associated with spasm and inflammation – this is acute pain. Usually it will settle as your body heals as the affected area no longer needs protecting. Acute pain can be a helpful reminder to avoid activities that may cause further damage.
Our emotions can also play a huge part in acute pain. The natural chemicals your body releases when you are tired, anxious or stresses are similar to those released to communicate danger or damage to the brain. This can therefore cause an injured body part, such as the lower back in the example above to become over sensitised, increasing the intensity of the pain. By doing activities such as yoga or taking a relaxing bath can release the natural chemicals associated with happiness which can help to prevent the nervous system from being over worked, helping to decrease pain levels.
When does pain become chronic?
When pain persists for lower than 3 months, we class this as chronic but this doesn’t always indicate ongoing damage. As mentioned above, the sensitised nerves can continue to send signals from stiff joints or poor muscle control although the original injury may have healed as much as it can.
What should you do if you are experiencing pain on everyday activity?
When the nervous system is sensitised, you may find common everyday activities such as walking and bending cause pain. Sometimes, even just thinking about the activity can trigger pain and this leads to “fear avoidance”.
In order to prevent and manage your back pain, you should keep fit and active. Regular physical activity improves fitness, strength, balance and your mental health. Yoga or Pilates with a qualified instructor can be very helpful.
Back pain is often self-limiting and responds well to continued physical activity and the right mobility and strengthening exercises. It very rarely requires any surgical intervention.
Foam rolling or trigger point therapy can be used to perform self-massage techniques at home. This can help to release the fascia and improve mobility and flexibility and can feel similar to having a deep tissue massage. Short term improvements may be noticed in doing range of movement, meaning this can be especially useful before exercises as well as after,
If you continue to struggle, manual therapy and exercise prescription from a Physiotherapist can be very helpful. Click here to book an initial consultation with one of our expert therapists.
Understanding “Slipped” Discs
You may have heard the terms “herniated”, “prolapsed” or “slipped” disc to describe your back pain. They sound harmful and are often feared as they give connotations of persistent, worsening pain. However, it is actually very normal for people to have changes to their spinals discs and experience no symptoms, in fact it is a normal, age related change! This is often why X-rays and MRI scans aren’t recommended as a first line of action when dealing with low back pain.
Looking at the diagram above, you can see that the internal nucleus may move only a small amount and stay within the disc such as in a prolapse. Or may extend through the fibres and begin to irritate nerves in an extrusion or sequestration. Small bulges as well as large can irritates the nerves, along with any associated inflammation. Most importantly, research has shown that the severity of symptoms doesn’t always correlate with the degree of herniation.
What are the symptoms of disc pathology?
- Symptoms can be varied but most people present with pain in the back as well as referred pain into the lower limbs.
- It is usually a dull, aching, toothache kind of pain but can be more severe with sharp, burning sensations.
- Sleep can often be affected by the pain.
- Tingling, pins and needles are numbness may be present.
What causes disc pathology?
The simple answer is that we don’t really know! In most cases, pain is a result of a combination of factors such as poor general fitness, fatigue, stress and sudden changes in activity.
Treating Disc Pathology
Avoiding activity and resting will only make pain worse, you should try to stay as active as possible. Focus your active exercise on walking, cycling and gentle swimming.
Taking over the counter pain medication can be helpful for short periods and is best discussed with your GP.
Manual therapy performed by a Physiotherapist can be beneficial for the management of symptoms alongside a structure exercise programme. This will address your specific problems, flexibility, strength and confidence in returning to activity.
Disc related pain can be very painful but all is not lost and it is very treatable. Ensuring you continue to exercise and effectively manage your early symptoms as detailed above will reduce the risk of more serious pain and dysfunction developing.
If you’re suffering with back pain, book an appointment to see one of our physiotherapists today.
