Are You Tired of Your Aching Lower Back?

 If you feel like you are done with your aching back, we may have the solution to your problem!

Low back pain is the most significant cause of disability globally. Every 9 out of 10 people you meet daily suffer from LBP- Low Back Pain. Women generally suffer more from this condition than men. Almost everyone has experienced LBP at least once in their life.

What is Low Back Pain?

As the low back, also known as the Lumbar region, is the area of the spine just below the ribcage so this pain may be defined as;

"Any pain or discomfort in the lumbar region of the spine associated with muscular tension or stiffness in the low back area with or without leg pain."

LBP can be a result of injury to a muscle or tendon in your back, falls, diseases, bad posture, or some other health conditions.

Is My Back Pain Acute or Chronic?

 If your pain lasts up to or less than 4 weeks and comes on suddenly then it is Acute LBP. If it lasts from 4 to 12 weeks then it is Sub-acute.

 While chronic LBP usually lasts more than 3 months and it comes and goes. 

What Are The Symptoms Associated With Lower Back Pain?

Symptoms can be ranging from mild to severe when you are experiencing Lower Back Pain. Pain can be characterized as sharp or stabbing or is generally dull and aching. Sometimes it may appear when you change your posture for example bending your back to pick something up from the ground. It may or may not radiate to the legs. 

Other symptoms may include;

• Muscular Spasm.
• Tightness or tension in hips, legs low back, and pelvic region.
• Disturbed sleep.
• Pain when you stand up from sitting or when you sit up from lying - Postural Pain.
• Pain while walking.
• Recent weight loss without dietary or lifestyle changes.

Some red flag symptoms may arise with Low Back Pain. These include;

•  Loss of bladder and bowel control
•  Progressive leg weakness
•  Aching back with fever 
• Numbness in the groin or anal area 
• Disturbed sleeping due to back pain. 

If these symptoms persist, consult your physician or physiotherapist immediately. 

Causes of LBP:

• Ankylosing Spondylitis - The arthritis of the spine. 
  
• Herniated disc compressing nerves. This can result in loss of bladder and bowel functions as well as weakness in the legs.
• Spinal stenosis (Nerve compression) - Cauda Equina Syndrome.
• Vertebral Fracture. This may be a result of a fall. Pain may be severe, localized, and disabling. This may result in Urinary incontinence and numbness in the legs.
• Bacterial Infection - Discitis (disc infection), Osteomyelitis (bone infection), and infectious arthritis of facet joints. 
• Spondylolisthesis - Disc slip.
• Spinal Cancer
• Sprain (injury to ligaments)
• Strain (Injury to Muscle or tendons)

Who Is At Risk For LBP?

Individual risk factors include Long sitting, Inappropriate posture, obesity, smoking, nicotine or drug abuse, age, and muscular weakness. While psychosocial and socioeconomic factors include stress, manual material handling at the job, monotonous tasks, etc. 

Diagnosis:

1. Take proper medical history for duration and intensity of pain. 
2. Check if the pain radiates down the legs causing numbness and tingling sensation as well as ache. (Look for the symptoms of Sciatica)
3. Ask the patient about personal history such as smoking, recent weight loss, cancer, age, and family history of LBP.
4. Ask the patient about his job and if he has anything to do with manual material handling involving loads or long sitting.

Treatment:

For mild back pain, over-the-counter medications (OTC) are commonly used. These include Acetominophen and certain NSAIDS to cure inflammation and reduce pain. 

Severe back pain requires medical attention and prescription. Your doctor may use a combination of drugs or corticosteroid injections. There may be several surgical options too for severe low back pain

Beyond Drug Pain Management: 

The above-mentioned drugs for pain management may have adverse effects. To counter the pain without facing the consequences of drugs, people opt for Physiotherapy management to control LBP.

Physiotherapy Management includes;

Hot Pack

• Thermotherapy 

If the pain is due to an injury such as a fall immediate application of cold packs can numb the pain and hence inflammation can be reduced. While hot packs should be applied 48 hours after the onset of pain.

• Exercise Therapy 

The sooner you get up and start moving the quickly you will heal. Keep in mind that exercise is meant to help, to prevent further injury, it shouldn't hurt so start slow. 

Stretching

• Stretching Exercise 

 Stretch your back muscles. Hold the stretch for 30 seconds.

• Aerobic conditioning such as Walking, Cycling, Swimming, etc

• Strength Training for lower back muscles.

• Ultrasound Therapy

• Modalities such as; Transcutaneous Electrical Nerve Stimulation - TENS

• Bed Rest BUT too much bed rest can worsen the pain.

Some specific exercises for low back pain relief are Straight leg Raises (SLR), Ankle pumps, lumbar stabilization exercises, and Knee to chest stretch. 

Taking proper precautions and avoiding risk factors can help people with low back pain to carry out their activities of daily life - ADL. 

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