Understanding Low Back Pain: Causes and Effective Treatment Options
Introduction
Low back pain, often simply referred to as “back pain,” is a common ailment that affects millions of people worldwide. It has been estimated to affect up to 25% of adult Canadians (1). It can be debilitating, affecting daily activities, work, and overall quality of life. In this comprehensive guide, we will explore the causes of low back pain and delve into effective low back pain treatments, including back pain exercises, to help you find relief and regain control over your life.
Part 1: What Causes Low Back Pain?
1.1 Poor Posture
One of the leading causes of low back pain is poor posture. Many individuals spend long hours sitting at desks or using computers, leading to slouching, hunching over, and straining the lower back. This puts excessive pressure on the spine and surrounding muscles, leading to discomfort and pain.
Solution: Improving your posture through conscious awareness and ergonomic adjustments can make a significant difference. Use an ergonomic chair, take breaks to stand and stretch, and practice exercises that strengthen your core muscles.
1.2 Muscle Strains and Sprains
Overexertion, sudden movements, or lifting heavy objects improperly can strain or sprain the muscles and ligaments in your lower back. This can result in sharp or dull pain that ranges from mild to severe.
Solution: While it may be tempting to lay in bed until the pain feels manageable, activity and movement is often the most helpful treatment for acute low back pain. Over-the-counter pain relievers may also provide some relief. Ice can be applied to the painful area for 10-15 minutes at a time in order to further manage pain. Gradual return to physical activity is recommended, accompanied by exercises that focus on strengthening the back muscles.
1.3 Herniated Discs
Herniated or “slipped” discs occur when the soft, gel-like material within a spinal disc pushes through its tough outer shell. This can irritate nearby nerves, causing pain, numbness, or tingling sensations in the lower back and legs. Some hallmarks of disc related low back pain include sharp pain with coughing or sneezing, and difficulty bending.
Solution: Physical therapy is an effective first line treatment for low back pain. Physiotherapy will focus on modalities to reduce pain, exercises and hands on therapies to improve mobility and education on how to best manage your pain. Exercises to improve flexibility and core strength can provide long-term relief. Education on good postural habits and lifting techniques can be helpful as well.
1.4 Arthritis
Arthritis, especially osteoarthritis, can affect the joints in the lower back, leading to chronic pain and stiffness. As we age, the cartilage that cushions the joints may wear down, causing discomfort and loss of flexibility.
Solution: Managing arthritis-related back pain often involves a combination of medication, physical therapy, and lifestyle adjustments. Low-impact exercises like swimming or cycling can help maintain joint flexibility and reduce pain. Medical management can help with pain control. A directed, personalised exercise program designed by a physiotherapist can address specific strength and mobility issues, and help retain as much functional capacity as possible.
1.5 Sciatica
Sciatica is a condition that arises from irritation or compression of the sciatic nerve, which runs from the lower back down the back of each leg. This condition can cause shooting pain, numbness, or tingling sensations along the path of the nerve. It can be caused by a disc herniation or by advanced arthritis.
Solution: Treatment typically involves pain management techniques, physical therapy, and exercises specifically targeting the sciatic nerve. Depending on the cause of the nerve compression, whether it is due to a disc herniation or a lateral stenosis, specific exercises and treatment can be prescribed to either reduce the herniation, or increase space in the lateral recess of the spine to remove pressure on the sciatic nerve.
Part 2: Effective Back Pain Treatment Options
2.1 Medication
For short-term relief, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can reduce pain and inflammation. For chronic pain, your doctor may prescribe stronger medications or muscle relaxants.
Caution: Always consult with a doctor or pharmacist before starting any medication regimen, as they can advise on potential side effects and interactions with other medications.
2.2 Physical Therapy
Physical therapy is a cornerstone of back pain treatment. How can a trained physiotherapist help you to manage back pain?
2.2.1 – A detailed physical assessment and clinical diagnosis
When you consult a physiotherapist for low back pain, they will carry out a detailed history taking and complete physical assessment. They will assess the integrity of the neurological system and rule out any red flags related to your low back pain. They will examine your range of motion, mobility, flexibility and strength. Once the assessment is completed, the physiotherapist will explain what the cause of your back pain is, and present a plan for how to manage it.
2.2.2 – A Comprehensive treatment plan
Depending on the cause of your low back pain, your physiotherapist may suggest stretching exercises, strengthening exercises, nerve ‘flossing’, or manual therapy. An McKenzie approach, comprising repeated movements to reduce low back pain may be indicated.
Your physiotherapist will also advise you on how to safely get back to all of your usual daily activities, and will guide you throughout the process. They may also give advice on how to improve your ergonomics at work, home and during heavy lifting tasks.
2.2.3 – Coordination with your medical providers
As allied health care professionals, physiotherapists can relay important information regarding your symptoms and care plan to your treating physician in order to optimise and streamline your care. They can also alert medical professionals of the need for further investigation if ever concerning signs or symptoms arise during treatment, leading to better outcomes for you.
Benefits: Physical therapy helps reduce pain, improve mobility, and prevent future episodes of back pain.
2.3 Heat and Cold Therapy
Applying heat or cold to the affected area can provide temporary relief. Heat relaxes muscles and improves blood flow, while cold reduces inflammation and numbs the area.
Usage: Apply a hot water bottle or heating pad for 15-20 minutes or use an ice pack for 10-15 minutes as needed.
2.4 Exercise & Physical Activity
Exercise has been recommended as an effective treatment for acute low back (2). When you are experiencing an acute episode of low back pain, the last thing that you may feel like doing is going for a walk, but activity has been shown time and time again to be effective at reducing pain. Do whatever level of activity you can manage without a major increase in pain, even if that is just a quick walk around your kitchen table.
Part 3: Back Pain Exercises
3.1 Stretching Exercises
Stretching is crucial for maintaining flexibility, preventing back pain, as well as treating existing low back pain. Here are some basic exercises for back mobility. Incorporate the following stretches into your daily routine:
a) Cat-Cow Stretch
- Start on your hands and knees.
- Arch your back (like a cat) while tucking your chin to your chest.
- Then, round your back (like a cow) while looking up.
- Repeat this motion 10-15 times.
b) Child’s Pose
- Kneel on the floor and sit back on your heels.
- Stretch your arms forward on the floor.
- Hold for 20-30 seconds, breathing deeply.
3.2 Strengthening Exercises
Strengthening your back and core muscles is essential for long-term pain relief and prevention. Try these exercises:
a) Bridge
- Lie on your back with your knees bent and feet flat on the floor.
- Raise your hips off the ground, creating a straight line from your shoulders to your knees.
- Hold for 10-15 seconds and lower.
- Repeat 10-15 times.
b) Bird-Dog
- Get on your hands and knees.
- Extend your right arm and left leg simultaneously.
- Hold for 5 seconds, then switch sides.
- Repeat 10 times on each side.
- c) Dead Bug
- Lie on your back, arms extended straight upwards towards the ceiling, hips and knees bent to 90 degrees
- Extend your right arm and left leg simultaneously.
- Hold for 5 seconds, then switch sides.
- Repeat 10 times on each side.
3.3 Yoga and Pilates
Yoga and Pilates offer gentle yet effective exercises to improve flexibility and core strength, helping to alleviate and prevent back pain.
Recommendation: Consider joining a local class or using online resources to practice these disciplines safely.
Conclusion
Back pain is a widespread issue that can be caused by various factors, including poor posture, muscle strains, herniated discs, arthritis, stenosis and sciatica. Effective treatment options include medication, physical therapy, heat/cold therapy and general physical activity. Additionally, incorporating stretching and strengthening exercises into your daily routine can provide long-term relief and help prevent future episodes of back pain.
Remember, it’s essential to consult with a physiotherapist before starting any treatment plan or exercise regimen. They can provide personalized guidance based on your specific condition and needs. By addressing the root causes of your back pain and incorporating these effective treatments and exercises, you can take steps toward a pain-free and active life.
If you are suffering from low back pain, make an appointment with one of our expert physiotherapists today. They can help treat your low back pain and get you back on your feet.