Low back pain

Around 50 – 80% of people will experience low back pain at some point during their lives, according to research, and every year around 40% of Australians will experience or have low back pain. Low back pain is the number one reason a worker will have a day off, resulting in huge economic losses.

 

Low back pain can lead to discomfort and stress. However, only 25 – 40% of Australians with low back pain will receive treatment to help relieve the problem.

 

Most people who get low back pain will recover, however recovery times vary, especially without appropriate treatment. If low back pain is left untreated or not treated properly, recurrent and persistent low back pain symptoms will continue and increase.

 

Risk factors

Risk factors for low back pain include:

  • Previous back pain problems
  • Frequent lifting, or heavy lifting
  • Whole body vibration (lots of driving)
  • Prolonged and sustained bending (lots of sitting)
  • Frequent bending (lots of bending down loaded or unloaded)
  • Frequent twisting (everything from a fast bowler to getting kids in and out of the cot)
  • Postural stresses such as bad postures, especially when frequent and often.

 

Who is less likely to get better quickly?

A number of variables have been shown to predict poor prognosis in recovery of low back pain. These include:

 

  • A range of psychological factors
  • Continued heavy manual work
  • Occupation that involves prolonged sitting
  • Low job satisfaction
  • Back pain with leg pain (sciatica)
  • History of back pain (in the first place)
  • Poor progress clinical tests your chiropractor or physiotherapist will conduct.

 

Who is more likely to get low back pain?

Predisposing and predictive factors for low back pain are identified as:

 

  • Poor sitting posture
  • Increased bending forward (spinal flexion) sustained (sitting) or frequent (lifting etc).

 

Which structures in the back can be a source of pain?

The parts of the back that feel pain include:

 

  • The covering (capsules) of our facets joints and sacroiliac joints
  • The outer part of intervertebral joints
  • Ligaments (interspinous and longitudinal)
  • Bodies of vertebra
  • The dura mater
  • Nerve root sleeves
  • Connective tissue of nerves
  • Blood vessels in the spinal canal
  • Muscles around the spine.

 

What are the categories (types) of pain that affect the low back?

 

  1. Somatic pain – comes from a muscle or joint usually vague and hard to localise. Feels deep and like a ache at times.
  2. Radicular pain – Comes from a nerve in the back. Described in a variety of ways and is experienced in the leg with or without back pain.
  3. Central pain – the nervous system can become sensitised to pain even after the injury has healed. Referred to as central sensitisation.
  4. Visceral pain – pain from organs can be referred to the back region, such as kidney pain, liver pain and heart pain.

 

What gives you pain in the first place?

Chemical pain

When an injury or pain related problem occurs, we experience an inflammatory response. Our body knows its been hurt and sends chemicals to help protect the area. It then communications what has happened through pain and begin providing the substances to start to repair process. This is the pain that occurs with a swollen ankle after a sprain. This process occurs in our back after we hurt it too, we just cant see or feel the swelling, redness and heat as much because the back structures are a lot deeper and less conspicuous.

Chemical pain is generally:

 

  • Constant pain
  • Caused by a recent event
  • Caused by lots of little things that build to a big thing (insidious)
  • Presented with swelling, redness, hotness and tenderness
  • Made worse with movements (e.g. sitting, bending, walking, lying etc).

 

Mechanical pain

Mechanical pain comes from one of the mechanical or structural parts of the back, including muscles, tendons, joints, intervertebral discs and many more. Mechanical pain is irritated when the mechanics are used through bending, twisting and loading the back.

Mechanical pain is generally:

 

  • Constant, variable or intermittent
  • inconsistent – it can come and go
  • Made worse through certain movements – while some movement may also make it better
  • Improved when pain reduces.

 

Find out how Chris treats low back pain and what you can expect in his chiropractic care.

Dr Chris Knee (chiropractor) is the owner and director at Sydney Spine & Sports Centre and Balmain Chiropractic Centre

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