What Causes Lower Back Pain?

Up to 80% of people suffer from low back pain at some point in their lives. Thankfully, most low back pain resolves within 6 weeks with simple, conservative treatments and advice.

Low back pain has recently been found to be the leading cause of disability worldwide. Low back pain is more disabling than any other medical condition and this begs the question: why is LBP so common?

Well….the short answer is that modern life has resulted in humans becoming more sedentary and more deconditioned. Our muscles help to support our spine and, if our muscles get weak or “de-activated” we can begin to feel pain. This may even occur in the absence of any pathology. A good example of this is sitting too much. Prolonged sitting is not very good for our low back as it causes your gluteal (or butt muscles) to become stretched around the back of the hip. If left in this position long enough, it appears that the brain simply allows these muscles to “switch off”. Indeed, these muscles don’t necessarily activate when you next need them (perhaps when lifting or playing sport).

So get moving! All exercise is good for your low back – from walking, swimming, cycling, lifting weights and playing golf. It’s so important to get moving and perform activities which you enjoy!

Should I get a scan to see what’s inside my back?

In the case where you have hurt your back, it’s tempting to ask your doctor or physiotherapist for a scan to have a look at what is causing your pain. As most low back pain is caused by things such as weakness or mild joint irritations, nothing of any clinical importance will show up in your scan. Depending on your age, the scan will most likely find some “degeneration” of some sort, but us physio’s consider these to be the “kisses of time”.

What this beautiful saying means is that over time, our tissues age with everyday loads of normal activities and these little bits and bobs found in scans are just normal.

So the answer to the questions is “No”. In most cases, you will not need a scan in the case of low back pain.

What’s the best treatment?

Your doctor may prescribe you some pain relief if your low back pain is very strong and these might help you in the short term. However, to gain a better understanding of what has lead to your low back hurting, your doctor may also ask you to see a physiotherapist.

This is the best option for an enduring relief of pain and return to full function.

Your physio will take a history to understand what has happened to you in the past. Then your physio will perform a full examination of your spine, hips, pelvis and body to see how well your joints are moving. They will also test how well you can perform simple tasks like squatting to see how well your muscles are firing. Your physio may touch certain muscles and joints to see if they move well or are sore.

You will be given a diagnosis of your problem and a plan for rehabilitation will be described to you, as you will be a part of the solution. Your physio will use gentle techniques designed to reduce your pain as soon as possible. A simple effective exercise and postural regimen will be implemented to get your muscles, joints and nerves moving well again. Depending on your goals (playing golf or running marathons for example) your exercises will be tailored to get you back doing what you love best!

Until next time,

Dr. John