Introduction to Low Back Pain
Low back pain is the leading cause of activity and limitation in many parts of the world. It is usually defined as pain, muscle tension, or stiffness localised below the costal margin and above the inferior gluteal folds, with or without leg pain (sciatica). Although it is clear that most individuals in the society commonly experience low back pain, its prevalence varies depending on factors such as gender, age, education and occupation. For example, studies show that low back pain is more common in women than men. Low back pain increases with age. Low educational attainment is associated with increased low back pain.
What are the Causes of Low Back Pain?
Most people experience low back pain at some point in their life. Mechanical low back pain constitutes 80% of these low back pains. These pains respond positively to conservative treatment. Low back pain caused by other causes does not fully recover unless the main cause is eliminated. We can list the common causes of low back pain as follows:
- Muscle, tendon, ligament injuries
- Deformation and bulging of intervertebral discs
- Unequal leg length
- Pes planus (flat feet)
- Strength inequalities in the lower back and abdominal muscles
- Excessive weight gain
- Angular changes, loss of normal shape of the pelvis and spinal column
Interventions in Low Back Pain
- Early physical therapy in acute low back pain reduces the risk of chronic low back pain.
Manipulative procedures can be used to reduce pain and disability in patients with limited range of motion and acute low back and back-related hip or thigh pain.
Trunk Coordination, Strengthening, and Endurance Exercises:
Lumbar coordination, strengthening, and endurance exercises are another commonly utilized treatment for patients with low back pain. These exercises are also described as motor control exercises, transversus abdominis training, lumbar multifidus training, and dynamic lumbar stabilization exercises.
In older patients with chronic low back pain with radiating pain, flexion exercises can be applied in conjunction with other interventions such as manual therapy, strengthening exercises, nerve mobilization procedures, and progressive walking to reduce pain and disability.
Lower-Quarter Nerve Mobilization Procedures:
Clinicians can consider utilizing lower-quarter nerve mobilization procedures to reduce pain and disability in patients with subacute and chronic low back pain and radiating pain.
Patient Education and Counseling:
Research in patient education and counseling strategies has focused on 3 main approaches: general education and advice in acute and subacute populations; behavioral education, including cognitive-behavioral theory, graded activity, and graded exposure, in a variety of populations; and education of patients on the physiology of pain.
Progressive Endurance Exercise and Fitness Activities:
Moderate to high-intensity exercise for patients with chronic low back pain without general pain and progressive, low-intensity, submaximal fitness and endurance activities for patients can be incorporated into pain management and health promotion strategies.
This article has been written for informational purposes only, please consult your doctor for definitive diagnosis and treatment. The causes of low back pain can be very different. Therefore, treatments are specific to the cause. The same approach cannot be applied to every low back pain.
Low Back Pain, Journal of Orthopaedic & Sports Physical Therapy, 2012