Getting BACK to Action: Managing Your Low Back Pain
If you are struggling with low back pain, you are not alone. It is one of the most common reasons people seek medical care and can significantly impact your daily life, making simple tasks like sitting, standing, or walking painful and difficult.
At any given time, approximately 18% of the population is experiencing some form of back pain, making it the single greatest contributor to global disability.
Once you've had an episode, you are likely to experience it again, with about 1 out of every 3 people having a flare-up within one year after recovery.
Given how common it is, it is important that people learn how to manage it so it has less of an overall impact on daily life.
Common contributors to low back pain:
- Poor lifting mechanics (twisting and lifting at the same time)
- Repetitive movements and prolonged work with insufficient rest (such as shoveling)
- Trauma such as slip and falls or motor vehicle accident
- Sitting for prolonged or standing for periods of time with no breaks. There is no “perfect posture”, the issue is more about staying in one position too long.
- Muscle weakness from little activity or a previous injury
Lifestyle factors also play a role in back pain. Sedentary lifestyle, excess body weight, smoking, and aging can all increase the risk of developing low back pain.
Categories of Low Back Pain
While many people worry that their back pain is due to a severe injury, it's important to know that low back pain can be categorized in different ways, and the vast majority of cases are not serious.
Most back pain is non-specific, meaning a specific underlying cause (like a fracture or tumour) cannot be identified.
The "low back" is comprised of a number of different anatomical structures - muscles, joints, discs, ligaments, fascia, nerves (just to name a few!). Low back pain isn't typically caused by just one thing, or one anatomical structure.
In some instances, structures may be putting pressure on the nerve roots exiting the spine, which can cause pain into the buttock, thigh and sometimes extending down into the ankle.
Whatever the issue may be, the piece of anatomy causing the pain does not determine the treatment. The treatment is determined by the specific symptoms and mobility limitations that someone is presenting with and not necessarily the condition that is causing the symptoms.
An appropriate treatment plan will be guided by a physiotherapy assessment.
What to Expect During an Assessment
When you come in for an assessment for low back pain, your physiotherapist will begin with asking you questions regarding your low back pain, focused on understanding your specific experience and limitations.
These questions may include:
- What pain and limitation you are currently experiencing
- History with low back pain
- Aggravating and easing movements
- Medical history
- What your current limitations are
- Your goals
Next the physiotherapist will look at:
- Your overall posture and general movement such as walking
- How you get up from a chair, move around the bed, etc.
- How your back moves and your low back range of motion
- How you respond to specific movements
- Test lower extremity strength and may look at the flexibility of specific joints and muscles
- If needed, they will also do a neurological scan, assessing if any nerves are impacted from your back injury
Back Pain & Imaging |
A common misconception is that imaging results, whether being from an MRI or Xray, are required before beginning physiotherapy. This is however not the case.
The treatment you receive will be based on the results of the physical assessment done by your physiotherapist, as well as your health history, symptoms and aggravating factors.
Imaging results are often not a reliable way to identify sources of pain.
The graph below shows the percentage of people who do not have any low back pain but have some sort of finding show up on their imaging report.
These things are incredibly common and are really not as scary as they sound. At age 30, about 50% of people show degenerative changes in their spine without even feeling any symptoms. This becomes nearly 100% of people at age 80.
Imaging is only recommended if someone is presenting with "red flags."
These are signs and symptoms that may indicate a more serious underlying issue (such as severe trauma, unexplained weight loss, or changes in bowel/bladder function).
Your therapist will screen for these during your initial assessment.
Imaging may be recommended if treatment is not progressing as expected.
Treatment for Low Back Pain
Treatment for low back pain is never “one size fits all”. It is always individualized to each person’s specific needs and goals.
Treatment for the low back will always include some form of exercise therapy. Most focusing on the mobility of the spine, hip mobility and strength, core strength, nerve mobility and specific activity focused exercises.
There will also be education provided on activity modifications, things to avoid if any specific movements exacerbate your pain, and strategies to safely return to your normal daily activities.
In addition to the exercises and activity modification, some manual therapy may also be provided as well as modalities such as acupuncture or laser therapy.
It is common for people experiencing low back pain to develop a fear of movement and begin to avoid certain activities that they worry it will cause re-injury.
This can often make things worse as prolonged avoidance can lead to increased muscle stiffness, further muscle atrophy, increased overall sensitivity to pain which can all delay recovery or make re-injury more likely.
Remember, Your Spine is Incredibly Resilient!
Staying active and gradually returning to normal activity is very important and pain intensity does not mean that there is tissue damage.
Physiotherapy can help you navigate a gradual return to activity, help you to understand your pain, manage your symptoms, and safely get back to the activities you love, while reducing this fear of movement.
Don’t let the back pain hold you back! If you are struggling with low back pain, come and see one of our physiotherapists. Book here or call 905-333-3488.
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Ally Ferguson is a Registered Physiotherapist who is passionate about exercise and helping her clients address pain and limitation so they can do the things they love! Ready to say goodbye to low back pain? Book with Ally! |