Did you know that 80% of people will experience lower back pain at some stage of their life? Back pain is a symptom caused by numerous conditions and it is one of the most common reasons for people missing out on work and enjoying life. Fortunately, most back pain is caused by musculoskeletal conditions and can be readily treated with great success. Generally lower back pain is something you can also avoid with some back education, back care strategies and even simple back exercises.
Lower Back Pain is categorised into the following categories:
1. Specific Spinal Pathologies
2. Radicular Syndromes
▪ Radicular Pain eg Sciatica
▪ Spinal Stenosis
3. Non-Specific Lower Back Pain
Specific Spinal Pathologies
Some conditions that cause back pain do require urgent and specific referral and treatment. These can include spinal infections, malignancy, spinal arthropathies (eg rheumatoid arthritis) CES or spinal fractures. These conditions do require early diagnosis and prompt referral onto the appropriate medical specialist. Luckily these conditions only account for less than 1% of back pain sufferers, but it is important to determine the case of your pain.
Lower back pain can result from structural damage that can irritate or even pinch a nerve. Researchers believe that radicular syndrome causes 5-10% of the presentations of back pain to GP’s. The most common nerve that can be pinched in the lower back is usually your sciatic nerve. We’re sure you’ve heard of it before. You may be diagnosed with sciatica if you are suffering radicular pain down your leg due to a back injury. While the sciatic nerve is the most common nerve that can be affected by a spinal injury, any nerve can be affected.
Back injuries such as a herniated disc (slipped disc), facet joint sprain, degenerative disc disease, spondylosis, and back ligament sprain can all contribute to or cause radicular pain syndrome due to swelling or space occupying material adjacent to the spinal nerve. Ouch! The nerve is either irritated (radicular pain) or pinched/compressed (radiculopathy).
Spinal stenosis is slightly different condition and relates to compression within the spinal canal. Spinal stenosis is usually more prevalent as you age.
Non-Specific Lower Back Pain
Non-Specific Lower Back Pain (NSLBP) is the term used to classify sufferers of lower back pain where no specific structure has been injured. It is really a diagnosis of exclusion. In other words, your spinal health care practitioner has excluded specific spinal pathologies and any of the radicular syndromes mentioned above as the cause of your back pain or symptoms. Fortunately, these conditions account for approximately 90-95% of the lower back pain causes and they can nearly always be successfully managed conservatively and without the need for surgery! Most improve within two to six weeks. They can be fast-tracked with pain relief and physiotherapy techniques such as manual therapy and back exercises.
Causes of Non-Specific Lower Back Pain
The causes of this common lower back pain are numerous but roughly fall into either a sudden (traumatic) or sustained overstress injuries.
Most people can relate to traumatic injury such as bending awkwardly to lift a heavy load that tears or damages structures. However, sustained overstress injuries (eg poor posture) are probably more common but also easier to prevent. In these cases, normally positional stress or postural fatigue creates an accumulated microtrauma that overloads your lower back structures over an extended period of time to cause injury and back pain.
Most commonly, NSLBP is caused by back muscle strain, back ligament sprain. Other chronic back conditions such as degenerative disc disease may underly the acute conditions and predispose you to the acute pain.
The good news is that you can take measures to prevent or lessen most back pain episodes. Early diagnosis and specific individualised treatment is the easiest way to recover quickly from lower back pain and to prevent a recurrence.
What Should You Do If You are Suffering Lower Back pain?
As you can see while lower back pain is common, the diagnosis of the cause of your back pain is specific to you and therefore the treatment or investigation pathway does vary from case to case. A GP is a good place to start but visiting a top notch Physio like those at Medwest will get you back on the mend in a heartbeat!