What is lower back pain?
Lower back pain affects almost everybody at some point in their lives and can be incredibly uncomfortable. However, the vast majority of back pain gets better and does not require any invasive treatment. Sometimes there’s a clear cause for the problem, but sometimes it comes out of the blue. Muscles, nerves or joints in the area can become irritated but there is usually no significant or long-term damage to any of these structures.
Lower back pain – common symptoms
The most common symptoms include:
- Pain in and around the lower back and hips
- Pain going down the back or front of the legs, usually on one side
- Difficulty with bending and twisting movements, such as putting on your socks or getting out of bed
Other symptoms can include pins and needles or numbness in the legs, again usually on one side.
Symptoms vary from person to person and can vary a lot during the recovery period. Extent of the injury, age and pre-existing conditions can affect the recovery rate. As a result, it may take a few days, several weeks, or months for symptoms to improve.
Do I need a scan of my lower back?
This is a question we hear a lot, and it’s understandable – people want to know exactly which bits of their back are to blame. While this might seem to make sense, we now know that the human body is not as simple as a car with faulty parts. Occasionally a scan will be helpful and can guide treatment, but a lot of the time they don’t really give us any useful information. We also know that if you scan people who don’t have any lower back pain, many of them will have something show up – a bulging disc or a “degenerative” joint. Here are the results from a review done in 2015, broken down by age group:
So, given that scans can be expensive, time-consuming and often less than enlightening, it’s usually best not to have one and get going with physiotherapy instead.
Should I rest until it passes?
In times gone by, many doctors thought that the best treatment for lower back pain was several weeks of bedrest:
We now know that this is one of the worst things we could have done! Prolonged rest – whether on your sofa or in a 1940s-style hospital bed being fed out of a gravy boat – leads to a loss of muscle and strength and can encourage a fear of moving. In the first day or two after an acute episode it may be necessary to rest somewhat, but then it really is important to start getting moving. This is where physiotherapy can help.
Physiotherapy and lower back pain
Thankfully, physiotherapy can really help for lower back pain by reducing soreness, getting you moving gradually and building you back up to your normal activities like work and sport as soon as appropriate.
Depending upon the presentation of symptoms and individual differences, treatment will usually consist of:
– Information about your symptoms and what is causing the pain
– Exercises to do at home (see below for some examples)
– Joint mobilisation techniques
– Soft tissue therapy techniques like massage
– Ways to pace yourself and manage your day-to-day activities
One of the main things we find beneficial is reassuring patients that moving will not cause more damage and that it is in fact a very helpful thing to do! Patients are usually surprised at the benefits of getting mobile because lying still and waiting for it to pass feels like the right thing to do. I usually say that sometimes we need to listen to our body, but not always – if you’re on a diet to lose weight, your body might be telling you to tuck into pie and chips every night but that is probably the opposite of what you need to do!
Exercises for lower back pain
Here are some gentle exercises that we often recommend for lower back pain, to be done throughout the day:
Lumbar rotations in supine:
Lie on your back and roll your knees gently side to side ten times
Lumbar tucks in supine:
Lie on your back and hug your knees up towards you, holding for 30 seconds
Sit to stand:
Practise getting up and down out of a chair as a squat exercise, five to ten times
Hopefully this article has given you some reassurance about the nature of lower back pain – if you need more advice, then physios at any of our clinics across the south east would be happy to help.