What Causes Low Back Pain?
Jennifer Cushing PT
First we need to cover some introductory information about the back. The back is made up of the spine, ligaments (join bone to bone), muscles, and nerves. The spine is made up of a number of small bones called vertebrae. The vertebrae make a bony tube where the spinal cord sits. Between each vertebrae a set of nerves exit the spinal cord. These nerves control the muscles and provide sensation. Between each vertebrae there is a disc. The disc acts as a shock absorber and evenly distributes the load through the bones. There are many layers of muscle in the back. The deeper muscles lie closer to the spine and act as stabilizers. The muscles closer to the surface work to move your body.
Low back pain can affect people of any age. However, it is more common in people age 25 to 65. On average more men compared to women experience low back pain. Approximately 80% of all people will experience back pain at some point in their life and 60 to 80% of those will have a repeat episode.
There are many different causes of low back pain and it is difficult to tease out the real cause. Some causes of low back pain are: 1. Injury to the ligaments or muscles of the back (a sprain or a strain). 2. Damage to one or more discs. 3. Arthritis that leads to decreased space for the nerves. 4. Osteoporosis which can lead to fractures of the bones. 5. Fractures due to trauma. 6. Poor posture leading to uneven loading on the discs.
How Can I Prevent Low Back Pain?
Most back pain will return if not treated correctly. You can prevent your back pain from returning by strengthening the core, increasing overall fitness, using proper lifting technique and fixing poor posture
Chronic Pain & Fear Avoidant Behaviour
After an injury it is important to return to your usual daily activity as soon as possible to avoid developing chronic pain. Chronic pain can occur after any injury. With chronic pain the nervous system becomes hyperactive sending pain messages to the brain. The nerves can send pain messages even after the tissue has healed and the original biological reason for pain has resolved. There is a cognitive component to pain, meaning how you feel about pain or respond to it can intensify or reduce your pain. The pain felt with chronic pain is real, however, how you cope, or choose to deal with the pain will influence your recovery.
Not everyone develops chronic pain. To avoid developing chronic pain it is important to prevent Fear Avoidant Behaviour (FAB). FAB is when an individual avoids an activity or task because they are afraid it will cause pain. This is a protective reaction, however, avoiding activities due to fear can lead to a longer recovery and more pain. Not all types of pain are harmful. For example the burning pain associated with exercising a muscle is actually beneficial and necessary to improve strength. Speak with your physiotherapist if you are having difficulty returning to your usual activities.
I believe using more than one method to treat your back pain. Our philosophy is to use manual therapy, exercise and pain control strategies to decrease your pain. We also believe in giving you the tools and education so you can manage your condition independently. Treatment will be geared to towards your individual needs. Your physiotherapist will provide you with exercises appropriate to your condition.
What does research support?
Research has shown it is the following are effective in treating low back pain:
- Stay active. Research has shown “rest makes rusty.”
- Core stability exercises.
- Exercise and heat.
- Spinal manipulation and mobilization.
In our next blog, we will discuss Core Stability, Posture, Positioning for Pain Relief, and Exercises for your lower back. If you have any questions, please contact our physiotherapists at (905)849-4576