Lower Back Pain – Physiotherapy Treatment
Acute lower back pain is one of the most common conditions that we as physiotherapists see.
Why do I have lower back pain?
Back pain can occur from even the most minor of events, such as leaning over to pick something small off the floor, or sneezing.
The experience of lower back pain can range from being reasonably mild to the point of being unable to move. The area in which the pain is felt can also vary – from being concentrated in the lower back to being felt into the leg.
Major structures of the spine
Lower back pain affects what is otherwise known as the Lumbar Spine. This area has a number of structures in it that can be affected when an injury is sustained.
- Intervertebral Discs,
- Facet joints (the joints joining vertebrae together),
- Muscles in the lower back.
In many cases, there will be a combination of the above.
So what does my diagnosis actually mean?
At your first physiotherapy consult, you will be asked to perform a series of movements and tests that will help the therapist get a better idea of where the pain is actually coming from.
When the disc is involved, it usually means that the outer fibrous ring, the Annulus Fibrosis, is damaged, and could be causing a “disc bulge”. In severe cases, the disc can tear right through, causing what is known as a Disc Herniation or more commonly known (but incorrectly) as a “slipped disc”.
When the facet joints are involved, the pain may be more concentrated on one side of the lower back, with accompanying restriction in movement. The joints in the lower back can be injured in the same way as other joints in the body, such as the ankle. This means that they can also suffer from sprains, and cartilage dysfunction.
Commonly with injuries to the facet joints the inflammatory process is set off, as with any other joint injuries. This means that swelling will occur, which puts pressure on the surrounding structures in the lower back, and increases the intensity and area of the pain felt. In many conditions, there will be an element of neural or ‘nerve’ involvement, with either tightness or a loss of sensation being felt in your extremities. Although indicative of a more serious problem, this does not mean that the problem cannot be resolved reasonably quickly.
Remember, each individual is different. Almost all patients will progress at different paces, and will have different end goals, meaning that rehabilitation programmes will differ substantially between individuals. Each stage will have certain goals that your Physiotherapist will look for you to achieve before moving onto the next stage. Working together with your Physiotherapist, you will achieve the best outcome for your injury. If you have any queries about the rehabilitation programme that you are given, please discuss this with your treating Physiotherapist.