Lower back pain is defined as pain and discomfort localised below the costal margin and above the inferior gluteal folds, with or without leg pain. It is one of the most common musculoskeletal problems and in most cases usually improves within a few weeks or months.
Acute means the pain has lasted less than four to six weeks.
Mechanical means the pain originates from the joint, bone, or soft tissue supporting the spine.
Sometimes, a specific trauma or strenuous activity may cause pain. However, 80% of the time, the specific source of the pain is not found. Mechanical back pain implies the source of pain is in the spine and/or its supporting structure. The surrounding muscles and ligaments may develop reactive spasms and pain. It is sometimes the result of poor posture or lifting something awkwardly and can develop suddenly or gradually. It tends to get better or worse depending on position and often feels worse with movement.
The pain is primarily in the lower back. Pain radiate (spread) to the buttocks and thighs. May also experience spasms with mechanical back pain. Difficulty bending down or lifting things.
A careful evaluation of your medical history and physical examination (ability to sit, stand, walk, lift your legs and specific tests), will help the physiotherapist determine if you have mechanical back pain. The physiotherapist might also ask you to rate your pain and talk about how much it affects your daily activities. If your physiotherapist has determined your back pain is mechanical, additional testing is not usually necessary.
Your physiotherapist will consider referral to your GP for further investigation where deemed necessary.
The treatment involves pain management and exercises. Self-management includes applying an ice pack for the first 48-72 hours to reduce inflammation and then a heat pack for the pain. Heat or Ice packs are to be applied for 15-20 minutes only and wrapped in cloth or towel. Do not maintain one single position such as lying, sitting, or standing for a long time, and keep mobile. Bed rest isn’t recommended. Activities can be painful but encourage yourself to do as much as possible within the pain limit as this will help with recovery.
The physiotherapist will prescribe you simple exercises to build strength and flexibility in your back and leg muscles.
Most back pain gets better within a month of home treatment, especially for people younger than age 60. However, for many, the pain lasts several months.
- 50-80% of adults suffer from LBP at some point in their life;
- 2.5 million people are experiencing back pain every day in the UK;
- increased prevalence with age with a cost for the NHS > £1 billion per year;
- Global Burden of Disease Study showed that low back pain was ranked the highest in terms of causing disability.