The lower back region is also called your Lumbar Spine. It is made up of 5 vertebrae and functions to support high forces, provide protection to the spinal cord, and attachment points for muscles/tendons and ligaments.
What is the injury/condition?
Low back pain is one of the most common causes of missed work, resulting in more global disability than any other condition [1,2]. It is also the fifth most common reason for physician visits .
Low back pain can be quite debilitating but can be self-limiting. It can resolve with minimal intervention within a couple weeks to a few months. However, 5-10% of people with low back pain will require conservative care, such as Physiotherapy .
There are many causes of low back pain. It can result from a strain to the muscles or tendons in the lower back, injury to the intervertebral discs, degenerative or traumatic stress to the joints, just to name a few.
What are the characteristics/clinical presentation of low back pain?
During the acute phase, you may have pain in your lower back that is more constant in nature. It can also refer pain into your buttocks and/or down your leg. Pain is usually aggravated with certain movements (ie: forward bending, lifting). During the subacute to chronic phase, the pain may be less intense, but you may feel more stiffness and limited range of motion in your lower back. The pain may still be reproduceable with certain movements and/or prolonged immobility.
How can Physiotherapy help with injury/condition?
A Physiotherapist can help you with pain relief, re-gain range of motion, and develop a specific exercise program tailored to your specific needs.
Recent studies have shown the effectiveness of manual therapy (spinal mobilization and/or manipulation) and exercise, along with self management strategies and modifications in lowering pain levels and improving overall function in individuals with low back pain [5,6].
A tailored exercise program with graded progressions targeting your core stability and muscle strengthening is essential to regaining proper function. This will also help to prevent recurring episodes of low back pain.
What should be avoided with injury/condition?
It is important to remain active in the presence of low back pain . However, activities need to be modified in order to prevent excessive pain. During the acute phase, you may be limited to walking short distances, avoiding prolonged immobility and focusing on maintaining proper posture. It is also important to avoid movements that aggravate your pain. During the subacute/chronic phase, there is a greater emphasis on rebuilding strength, cardiovascular endurance and increasing your activity level. Be sure to consult a Physiotherapist when resuming activity to ensure you are doing the right exercises.
- Burton AK, Tillotson KM, Main CJ, Hollis S. Psychosocial predictors of outcome in acute and subchronic low back trouble. Spine (Phila Pa 1976). 1995 Mar 15;20(6):722-8. Level of evidence 3C
- Truchon M. Determinants of chronic disability related to low back pain: towards an integrative biopsychosocial model. Disabil Rehabil. 2001 Nov 20;23(17):758-67.Level of evidence 2B
- Damian Hoy, Lyn March, Peter Brooks, Fiona Blyth, Anthony Woolf, Christopher Bain, Gail Williams, Emma Smith, Theo Vos, Jan Barendregt, Chris Murray11, Roy Burstein11, Rachelle Buchbinder. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014;73:968-974. Level of evidence 2A
- Gatchel RJ, Polatin PB, Mayer TG. The dominant role of psychosocial risk factors in the development of chronic low back pain disability. Spine (Phila Pa 1976). 1995 Dec 15;20(24):2702-9.
- Anthony Delitto, Steven Z. George, Linda Van Dillen, Julie M. Whitman, Gwendolyn Sowa, Paul Shekelle, Thomas R. Denninger, Joseph J. Godges. Low Back Pain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association. Journal of Orthopaedic and Sports Physical Therapy, 2012, 42(4) level of evidence 1A
- Quentin C, Bagheri R, Ugbolue UC, Coudeyre E, Pélissier C, Descatha A, Menini T, Bouillon-Minois JB, Dutheil F. Effect of Home Exercise Training in Patients with Nonspecific Low-Back Pain: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2021 Jan;18(16):8430.