A Pain in the Back!

Most people are affected at least once in their lives by lower back pain. This can be anything from niggles, to something that’s preventing you from doing what you like or need to do.

The spine is designed for mobility, to hold the body upright and support the head and neck. The back is made up of bones, muscles, nerves, ligaments, tendons and intervertebral discs. It has natural curvatures to allow for movements in all directions, some greater than others! And allow for different forces to travel through the body that generally allows us to move freely and easily.

The best ways to prevent back pain and maintain a healthy back are by keeping muscles strong and flexible, practicing proper lifting techniques, having a good posture and maintaining a healthy body weight. Back pain can be broken into different types:

• Acute OR
• Chronic, or
• Acute on Chronic

Acute cases are generally caused from an injury or jolt. They can take up to 6 – 12 weeks before complete resolution.

Back pain becomes chronic when it has persisted for 3 – 6months beyond the expected healing time. Only 15% of lower back pain cases progress to from acute to chronic.

Acute on chronic cases occur when there is an acute flare up of an already underlying chronic back injury or problem – the problem may be worse and other factors can contribute to further muscle spasm, pain, joint dysfunction and immobility.

There are 3 different types of back pain that are based on their cause.

1. Non-Specific low back pain, in which there is no single known cause. This accounts for about 85% of all lower back cases, and can be attributed to activities which may be strenuous or positional such as gardening, house work, or playing sports. This most commonly occurs in people who are quite sedentary during the week.
2. Back pain caused from spinal conditions. This might include sciatica, disc pathology – such as bulge or prolapse, spinal stenosis, arthritis and osteoporosis
3. Back pain caused from a specific trauma like a fall or car accident.

Signs and symptoms

Back pain can present in different ways according to the mechanism of injury.

• Muscle ache
• Shooting or stabbing pain which can be present in the back, bottom region or the legs.
• Limited flexibility or range of motion in back, hips and legs
• Inability to stand straight

Chronic pain sufferers may experience:

• Poor sleep quality or broken sleep
• Lack of concentration
• Inability to perform tasks well at home or work
• Irritability
• Depression

Back pain can indicate a serious condition and can be accompanied by other symptoms such as unintentional weight loss, pain that worsens at night and does not resolve with rest, bladder or bowel incontinence, and weakness in the hands and/or feet. It is important for patients to tell their health care professional about all occurring symptoms and seek medical advice from their GP.

Risk factors

Some risk factors we are able to avoid, others we have no power over but need to be aware of in order to manage our health.

• Age
• Physically strenuous work
• Overstretching
• Poor physical condition

Other contributing factors that can lead to non-specific lower back pain:

• Obesity
• Inappropriate posture
• Poor sleeping position
• Weight gain during pregnancy
• Smoking
• Stress
• Anxiety and/or depression
• Build up or scar tissue from repeated injuries.

Treatment and Management

The goal of treatment for low back pain is to reduce pain and restore function. We want to increase strength, and prevent injury reoccurrence. A combination of treatments and management options may be recommended by your osteopath. In a few serious cases, referral to a surgeon is required and surgery may be performed to help low back pain.

Your Osteopath may recommend some management options. Please seek advice to see what’s most suitable to you

• Ice and/or heat
• Physical activity; staying in bed and not being active or moving during recovery can make back pain worse
• Medications; Recommended or prescribed by your GP, sports physician, rheumatologist or other medical professional can include
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen
  • Opioids to help manage pain
  • Muscle relaxants
  • Medications for sleep and depression

Your Osteopath can assist with hands on manual therapy for:

• Loosening tight muscles,
• Improving joint articulation and mobility.
• Assisting with decreasing inflammation
• Aiding compensatory dysfunctions from the underlying injury
• Restoring optimal function to the musculoskeletal system

Alternative hands on treatment can include:

• Acupuncture
• Spinal manipulation
• Massage therapy
• Yoga and relaxation techniques
• Cognitive behavioral therapy
• Exercise Physiology Sessions

Prevention

Maintaining a healthy back is very important in preventing low back pain. It’s much easier to prevent something than to repair it.

Focusing on physical and mental well being:

• Exercise regularly with low-impact aerobic activities such as walking and swimming
• Strengthen abdominal and back muscles with core-conditioning exercises
• Exercise for strength and flexibility – such as yoga or pilates, and stretch well after exercise
• Eat a well balanced diet
• Maintain a healthy weight
• Quit smoking
• Manage stress levels

Ensure proper body movements.

• Practice proper lifting techniques – lift with your knees, keeping your back straight and stomach muscles contracted. Do not lift anything excessively heavy without assistance.
• Maintain proper posture when sitting or standing.
• Ensure your workspace has been ergonomically assessed for you.
• Wear comfortable low-heeled shoes
• Sleep on a firm surface and on your side to reduce curving of your spine.

If you are suffering from back pain, please contact us at St Kilda Osteopathy and we can help you out!

Dr. Catriona Bauld
B.Sci (Clin.Sci), M.H.S.(Osteo)
Member of Osteopathy Australia

References: Wolkers Klwer; Lippincott Williams & Wilkins (2008) Understand Low Back Pain.