Low back pain (LBP) affects 60-80% of individuals at some point in their lives and makes up a considerable proportion of doctor and physiotherapy appointments.
Low back pain is typically categorised into three subtypes based on duration: acute (less than 6 weeks), sub-acute (between 6 and 12 weeks), and chronic (more than 12 weeks).
Chronic low back pain, lasting longer than three months, accounts for over 80% of healthcare costs associated with LBP. Approximately one-third of individuals seeking treatment for LBP will experience persistent moderate pain one year after an acute episode.
Non-specific low back pain comprises the majority of patients seeking physiotherapy treatment for low back pain. Physiotherapy assessment aims to pinpoint impairments that may have triggered the pain onset or could lead to persistent pain. These factors encompass biological aspects such as weakness and stiffness, psychological factors like depression, fear of movement, and catastrophising, as well as social factors including work and sport environment (e.g. pressure to get back to recover ASAP).
Whilst majority of people we see in the clinic have non specific low back pain, we also see the following injuries at AppliedMotion:
- Disc injuries: A disc prolapse happens when the soft centre of a spinal disc pushes through a crack in the tough exterior. People with this issue often recall a specific event that triggered their pain. Unlike regular back pain, disc pain can feel like burning or stinging and might spread down the leg. In more serious cases, it can lead to weakness or changes in sensation.
- Facet joint injuries: Lumbar facet syndrome is a painful irritation at the back of the lower spine. It happens when there’s swelling in the area around the joints, which can irritate nearby nerves. Muscles around the joint may also tighten up as a protective response, making the pain worse. Over time, these changes can cause scar tissue and the growth of bone spurs. The main cause is usually repetitive small injuries or chronic wear and tear. Activities involving frequent bending backward, like reaching above the head (e.g. tennis, volleyball, cricket), or sports that require a lot of bending backward can also lead to this condition (e.g. dancing, gymnastics).
- Stress fractures: Stress fractures are small cracks that can develop in bones. Unlike complete fractures, where the bone breaks all the way through, stress fractures involve clear but partial cracks. In the lower back, these cracks often occur in two specific areas. When a stress fracture happens at the pars interarticularis, it’s commonly known as spondylolysis. This is an injury we often see in gymnasts, bowlers in cricket and tennis players.
The guidelines explore various strategies for preventing low back pain. Physical exercise is recommended to mitigate the consequences of low back pain, such as work absenteeism and recurrence. Exercises targeting back extensors and trunk flexors, combined with regular aerobic training, are particularly beneficial.