Patients suffering from most types of low back pain are often referred for physical therapy for four weeks as an initial conservative (nonsurgical) treatment option before considering other more aggressive treatments, including back surgery. The goals of physical therapy are to decrease back pain, increase function, and teach the patient a maintenance program to prevent future back problems.
Causes of back pain: Lower back pain has many causes. Most lower back pain causes are musculoskeletal in origin and known as non-specific low back pain. Most commonly, these back injuries are caused by muscular strains, ligament sprains and joint dysfunction, particularly when pain arises suddenly during or following physical loading of the spine.
The good news is that you can take measures to prevent or lessen most back pain episodes. Your physiotherapist is an expert who treats and can help you to prevent low back pain.
Early diagnosis and treatment is the easiest way to recover quickly from lower back pain and to prevent a recurrence.
The causes of lower back pain are numerous but roughly fall into either a sudden (traumatic) or sustained overstress injuries.
Most people can relate to traumatic injury such as bending awkwardly to lift a heavy load that tears or damages structures. However, sustained overstress injuries are probably more common but also easier to prevent.
In these cases, normally positional stress or postural fatigue creates an accumulated microtrauma that overloads your lower back structures over an extended period of time to cause injury and back pain.
Common Lower Back Pain Causes
Back Muscle Strains
Back muscle injuries are the most common form of back injury. Muscle fatigue, excessive loads or poor lifting postures are the most common problems. Inefficient back muscles can lead to poor joint stabilisation and subsequent injury
Ligaments are the strong fibrous bands that limit the amount of movement at available at each spinal level. Stretching ligaments too far or too quickly will tear them with subsequent bleeding into the surrounding tissues, causing swelling and pain. Awkward lifting, sports injuries and motor vehicle accidents are very common causes. Just as in other regions of the body, physiotherapy hastens ligament healing and relieves pain so that you can enjoy life again as soon as possible.
A bulging disc injury is a common spine injury sustained to your spine’s intervertebral disc. Spinal discs are the shock-absorbing rings of fibrocartilage and glycoprotein that separate your bony vertebral bodies, while allowing movement at each spinal level, and enough room for the major spinal nerves to exit from the spinal canal and travel to your limbs.
The annulus is the outer section of the spinal disc, consisting of several layers of multi-directional fibrocartilaginous fibres all densely packed to create a wall around the glycoprotein filled jelly-like disc nucleus. A disc bulge (commonly referred to as slipped disc), can potentially press against or irritate the nerve where it exits from the spine. This nerve pinch can cause back pain, spasms, cramping, numbness, pins and needles, or pain into your legs.
You can also fracture your spine if the force involved is highly traumatic or you have low bone density (eg osteoporosis).
Poor posture when sitting, standing and lifting at work can place unnecessary stress upon your spine. Muscles fatigue, ligaments overstretch, discs stretch and this places spinal joints and nerves under pain-causing pressure.
Specific Lower Back Pain Causes
Common forms of physical therapy include:
- Passive physical therapy (modalities), which includes things done to the patient, such as heat application, ice packs and electrical stimulation. For example, a heating pad may be applied to warm up the muscles prior to doing exercising and stretching, and an ice pack may be used afterward to sooth the muscles and soft tissues
- Active physical therapy, which focuses on specific exercises and stretching. For most low back pain treatments, active exercise is the focus of the physical therapy program.
- This article focuses on active physical therapy and exercise as a means to help recover from back problems and prevent or minimize future flare-ups of low back pain.