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Did you know that lower back pain is the 5th most common reason for people to visit their doctor! This always strikes me as weird as generally speaking your Physio is a better bet when you have musculoskeletal pain than your GP. Did you also know that lower back pain will affect around 70% of people throughout their lifetime. That a lot!
Low back pain is usually categorized into 3 categories: acute, sub-acute and chronic. Acute low back pain is an episode of back pain that is less than 6 weeks, sub-acute is between 6-12 weeks and chronic is anything more than 3 months. However it is often not so clear cut as this. Many episodes of lower back pain feel as though they might run together, or 'flare up' at different points throughout the year. Its important to understand your body - your back and what factors are contributing to your symptoms, in order to best prevent forte episodes.
The prognosis for anyone with an acute episode is fairly good, with most resolving in 8 weeks, with around 50% of people resolving spontaneously in the first two weeks.
The exact cause of low back pain is often very difficult to identify, in fact there are numerous possible causes of back pain from muscles, soft connective tissues, joints, ligaments, cartilage and even blood vessels. Depending on the circumstances chronic stress, depression and obesity has been linked with the onset of acute and even chronic back pain. However, just because it is difficult, doesn't mean it should be overlooked. It's important you work with your Physio / healthcare professional to ensure a clear picture of what is causing your back pain is established.
Managing back pain:
The best advice for the treatment of acute back pain is to continue to remain active as tolerated. Continuing everyday activities may sound counterintuitive but if we stay at home and cooped up in bed we tend to get more stiff. By being active we can promote blood flow and nutrients flowing to the area and reducing muscular tension. Here are some things we can do to manage an acute episode:
1. Stretches – There is no reason not to completely avoid stretches. All stretches if done correctly are good. However stretching should not cause more severe pain.
2. Heat or ice – Local application of heat or ice can reduce pain. Neither is better or worse for the situation, all dependent on your preference
3. Medication – Paracetemol or anti-inflammation drugs can be used to help ease the pain. These classification of drugs are known as analgesics which dampen the central nervous systems ability to pick up pain signals. These medications should be used only as prescribed by your doctors since some anti-inflammatory drugs can have some side effects.
4. Physical therapy – Physical therapy can give you great relief and advice on how to further manage your pain. A good physio will diagnose the pain generating structure. Possibly use some manual therapy early on to help relieve symptoms. They can cater a specific stretch and exercise program to help you get through it. They can also identify possible triggers and help devise a plan to prevent another episode from occurring.
If you or someone you know is suffering with lower back pain, encourage them to seek help. It doesn't have to be a debilitating injury and with the right advice it can be overcome!
I’ve suffered from chronic and sometimes acute lower back pain since I was 14 years old. That was until I found Pilates!
I remember skipping Thursday afternoon High School sports because if I ran, jumped or turned my body, my back would seize up with pain. Instead, every Thursday afternoon was spent in a Physiotherapist office where they would treat me with Ultrasound and tell me to do sit ups to improve my core strength. Needless to say it was a waste of time and money, my back pain only worsened.
I had scans, which revealed bulging discs. I tried Acupuncture and Osteopathy, they later left me unable to stand or walk for three days. Doctors suggested I consider surgery, which seemed like a drastic solution for a skinny 17 year old.
Mostly, I simply got used to it and thought it was just going to be a part of my life. Eventually I became active again, moving through the pain and going home to aspirin and heat packs. I would get regular massages, which gave me some short-lived relief.
I remember a holiday to Costa Rica spent drowning my sorrows with a bottle of wine, as I couldn’t even enjoy a swim in the ocean without gut wrenching agony.
In my twenties my passion was Yoga. I was attending up to five classes a week. I loved the first part of the classes but hated when we would get to backbend section. I was naturally flexible and back extension came easily, but no amount of Child's Pose would relieve the back spasms that inevitably came afterwards. At the time I assumed Yoga teachers had extensive training and would take their advice about postures, it’s only now after completing my own Yoga Teacher Training that I realize how generally ill equipped Yoga Instructors are to give advice about pain or anatomy.
A few years ago I returned to Australia after almost 20 years in the United States and again my back pain flared its ugly head. I thought maybe I’d irritated it with the 16-hour flight or packing and lifting boxes. Regardless of how, it was impossible to get through daily life. I couldn’t lift anything at work, avoided yoga completely as it was too painful to stand up after a class. It would come on randomly, while cooking dinner or brushing my teeth. Pain so bad I’d find myself in tears in a heap on the floor. It was so frustrating being an otherwise healthy young woman with a pain that wasn’t visible. Pain affects your mental health as well as your lifestyle.
I decided I couldn’t live like this any longer and was determined to find a solution. I had several more scans and X-rays and varying diagnosis and treatment plans. Every Physiotherapist I spoke to gave me a different opinion. How was I, a laymen, supposed to know which was correct? Who to trust?
One Physio suggested I try Pilates, which I knew nothing about.
My initial consultation with my Pilates instructor was fascinating. She walked me though the basics or core control and several basic mat exercises. During the next few weeks I learned about my pelvic floor, my Transverse Abdominus muscle and my posture. I used all the bizarre looking studio equipment including the Reformer and Wunda Chair. The whole time I was attending sessions, two times a week, I wasn’t convinced. I was used to high intensity exercise that made you sweat, and couldn’t see how these small, controlled movements were doing anything! That was until a few months in I realized my pain was gone. For the first time I could run, and jump and backbend to my hearts content without pain! It was incredible.
So convinced was I of the power of Pilates, I signed up to undertake my Diploma of Professional Pilates Instruction. Today I love helping people with chronic Back Pain, as I personally understand how horrible it can be.
Back pain is an increasingly 'common' symptom in a wide variety of the populations. From adults to kids, male to female, active to sedentary it seems this insidious and costly symptom is increasingly creeping into our daily lives and very few people actually know what to do to get rid of it!
Rest & Panadol for Back Pain?
Back pain has long been treated with 'rest and panadol' by our friendly GP, however many people who have tried this approach will tell you, it is not all that effective and certainly in the long run it does nothing to prevent the pain returning often with vengeance!
At the other end of the spectrum is the surgical approach which, worryingly, is increasing at an alarming rate. While both these options have their merits in certain subsections of the population, the best cure (and yes I mean real cure) is to improve the quality of the structures which are causing the pain in the first place. That's right, I mean fix the problem from the source!
The frustrating part for many back pain suffers is the frequency and unpredictability of when their next episode will occur. The continual increase in frequency and severity after someone has their first back pain episode is commonly due to the adaptive behaviours they begin to adopt. By starting to worry about when and how they might 'injure' their back again, they often subconsciously make choices which eliminate certain movements and activities from their lives. The negative impact of this is that by reducing the frequency and variability of their movement's they are actually increasingly the likelihood of re-injury and the back pain cycle carries on.
Alleviating Back Pain
The only true way to stop back pain from coming back is to work at improving it. Work on your movement patterns, understand your pain generating structures, your weaknesses and your strengths and then get to work on optimising them! It is not the quick fix path, but trust us, it's the path that is proven and long lasting. True resolution of your symptoms and the return of the freedom to your life!