LOWER BACK PAIN
Lower back pain is the most common symptom in both general and sporting populations and one of the most common complaints we see at Excel Body and Health. It’s believed that up to 85% of the population will experience back pain at some point in their lives and the causes vary.
As lower back pain has many causes and pain severity varies, it is vital that we identify the underlying cause of the pain so we can manage it accordingly.
Some common lower back conditions we can assist with are:
FACET JOINT SPRAIN
WHAT IS THE CONDITION?
WHAT CAUSES THIS CONDITION?
- Sudden movements (turning the body)
- Sleeping or laying in an awkward position for a prolonged period of time
- Lifting or carrying (commonly little children)
- Traumatic injury
WHO DOES IT AFFECT?
SYMPTOMS
- Low back pain
- Limited range of movement - which can result in pain when the joint is moved in a particular direction (for example: bending over, leaning back), twisting or turning, rolling in bed, or prolonged sitting or standing
- Pain can be described as a sharp, dull aching sensation in the lower back
- Pain can be worse in the morning
- Tenderness of the lower back muscles and joints
OSTEOARTHRITIS OF THE LOWER BACK
WHAT IS THE CONDITION?
WHAT CAUSES THIS CONDITION?
WHO DOES IT AFFECT?
SYMPTOMS
- Gradual onset of lower back pain
- Reduced flexibility of the lower back
- Stiffness in the mornings or after long periods of immobility
- Pain worsening with excessive use of the lower back
- Referral pain into the hips
DISC INJURY
WHAT IS THE CONDITION?
Anatomically, your spine is made up of vertebrae (bones) and discs. These spongy discs are located between each bone and are designed to be shock absorbers. Therefore they contribute to protecting the health of the bones, joints and surrounding muscles. The disc comprises of the:
- Annulus Fibrosus: the strong outer rim made up of multiple diagonal layers
- Nucleus Pulposus: the central soft and gel-like substance
An acute injury can irritate and damage a disc, however, more commonly we find the Annulus Fibrosus (outer covering) becomes weak from minor tearing over time which can influence the integrity of the tissue. This weakened outer rim combined with excessive compression can make it vulnerable to injury.
WHAT CAUSES THIS CONDITION?
Acute trauma or significant force or impact to the lower back or hips can commonly cause disc injuries.
Other contributing factors to lower back pain include: age, degeneration, lifting or physical work/ labour, sedentary occupations, and repetitive movements or prolonged and sustained straining positions. A previous history of lower back pain over a period of time can predispose disc injuries.
A Disc Can:
- Bulge/ Protrude: As we age, our discs begin to deteriorate and can begin to look like they ‘bulge’ outwards
- Herniate: The outer covering of the disc tears, which causes the nucleus pulposus to leak into the spinal canal
WHO DOES IT AFFECT?
SYMPTOMS
- Broad lower back pain
- Reduced flexibility, especially bending forwards
- Tenderness of the lower back area
- Pain on reaching downwards and twisting
-
If nerve compression is present people can experience;
- Numbness or tingling in the groin, legs and feet
- Weakness of the leg or foot
SPONDYLOLISTHESIS
WHAT IS THE CONDITION?
Spondylolisthesis is the forward slippage of one vertebral body on the vertebral body below- which can create instability in the spine and cause pain. It normally starts with stress fractures around the joints, which once broken can allow for this abnormal movement.
WHAT CAUSES THIS CONDITION?
Common causes of spondylolisthesis are;
- Trauma, especially hyper extension
- Genetic underdevelopment (seen in babies)
- Degeneration
It is commonly seen in young athletes that partake in sports with back hyperextension (eg. cricket fast bowlers, and gymnasts)
The distance that the vertebrae has moved his measured and then graded for severity;
- Grade 1- 1-25% slippage
- Grade 2- 26-50% slippage
- Grade 3- 51-75% slippage
- Grade 4- 76-100% slippage
- Grade 5- Greater than 100% slippage
SYMPTOMS
- Low back pain
- Limited range of movement, especially with arching backwards
- Referring pain down glutes or hamstrings
- Pins and needles, weakness or tingling in the foot
- Pain can be worse in the morning
- Tenderness of the lower back
SCIATICA + NERVE IRRITATION
WHAT IS THE CONDITION?
WHAT CAUSES THIS CONDITION?
Irritation to the nerves of the lumbar spine can be caused by mechanical pressure and compression at the vertebral level by discs or bony components (including along their paths from the spine to endings in the muscle or skin) OR muscular compression by the piriformis muscle.
Other factors that can contribute to sciatica include: pregnancy, body weight, ageing, and overloading/ straining with repetitive activities.
SYMPTOMS
- Low back pain - can be localised or refer to the hip, thigh, leg or toes
- Limited range of movement - which can result in pain when the joint is moved in a particular direction (for example: bending over), twisting or turning, rolling in bed, or prolonged sitting or standing
- Pain can be described as a sharp, dull aching sensation in the lower back and lower limb
- Pins and needles or numbness sensations down the leg
- A sense of weakness in the lower back or the leg- making it difficult to perform activities
- Generalised tenderness over the affected area
- Usually affects one side of the lower body
SACROILIAC JOINT SPRAIN
WHAT IS THE CONDITION?
Your Sacroiliac Joints (SIJ) are joints formed on either side of your tailbone (sacrum) and the back of your pelvic bone (ilium). Like other joints, there are several strong ligamentous attachments to this joint to aid in stabilising it. When these ligaments become stretched or torn by repetitive movements, it can be reproducible of lower back pain.
WHAT CAUSES THIS CONDITION?
WHO DOES IT AFFECT?
SYMPTOMS
- Low back pain - can be localised or a band like referral to the groin and upper thigh region
- Limited range of movement - which can result in pain when the joint is moved in a particular direction (for example: bending over, leaning back), twisting or turning, rolling in bed, or prolonged sitting or standing
- Pain can be described as a sharp, dull aching sensation in the lower back
- Pain can be worse in the morning
- Generalised tenderness over the affected area
TREATMENT FOR LOWER BACK PAIN
The team at Excel Body & Health are highly skilled practitioners that will assist in determining the cause, treatment and management of your lower back pain. Your treatment plan will be tailored to you and will focus on reducing pain, restoring normal function and preventing re-injury of your lower back pain.
Treatment may include soft tissue massage, muscle energy techniques, stretching, joint mobilisation, articulation, manipulation, dry needling, taping and/or exercise prescription.
A personalised treatment plan will aid in managing the injury and associated pain in the short and long term.