Lower back pain is common, with 40-80% of people experiencing it in their lifetime. Back pain can be extremely painful and debilitating and is rated 6th in the world for burden of disease, contributing towards 25-30% of medical costs.
Back pain is unfortunately re-occurring, meaning if you have had it before, you will probably experience it again in future. As physiotherapists, it is important that we equip our patients with the skills, strategies, and education for managing their back pain and preventing it from getting worse.
Back pain can refer pain to areas above and below the knee. It is essential when you present pain that occurs away from the lower back region, that the back is cleared as being the cause of your pain. Pain from the back can cause central, unilateral, or referred pain. The referred pain that one may experience can occur as gluteal, hip, groin, hamstring, shin, calf and even foot pain. Back pain can be associated with numbness and loss of muscle power of structures below the knee or above the knee. This is usually associated with a nerve root being pinched or compromised.
As a physiotherapist, when treating a patient with referred pain, numbness and/or muscle power loss, the aim is to try get the pain to 'centralise' i.e. move the pain away from the legs and bring it towards the back. We want the pain to stay in the back as this tells us that the nerve root is not being compromised anymore and we are on the right track to resolving the referred pain. Often when the pain centralises, the pain in the back worsens, although it may not feel nice, it is a good sign, and it is what we want to restore your full function and reduce your pain eventually.
It is important that if you are presenting with back pain or your level of function has been compromised at all such as weakness in the legs, unable to have control over or bowel and bladder or numbness in a saddle shape distribution by your hips that you see a physiotherapist or a doctor for an assessment.
It is also important that if you have persistent night pain, night sweats, unexplained weight loss, or a history of cancer that you get assessed by your doctor or physiotherapist to ensure that there is no serious pathology going on such as cancer.
Things that you can do to reduce the re-occurrence of back pain:
- Exercise or move frequently.
- Avoid sitting or standing too long in ONE position.
- Ensure you are sitting with good posture at work, avoid slouching.
- Ensure you are getting up regularly from your desk chair.
- Ensure your work setup is ergonomically correct.
- Ensure you implement correct lifting techniques if your job is physical.
- Repeat your prescribed back exercises as maintenance or more often if you feel your back pain starting.
- Get your gluteal muscles strong and working properly so that you protect your back if working with heavy equipment.
- Balance the amount of time you spend sitting/ bending forward with standing and walking.
- Ensure you have a comfortable pillow and mattress so you are able to sleep comfortably.
If you have any questions or concerns regarding any back pain you may have, please contact us to talk a qualified Physiotherapist
Written by Dunia Mouneimne - Senior Physiotherapist