About the condition: Dr Alex talks about low back pain, “Low back pain is by far the most common condition I see and treat; a huge number of people seek my services after suffering for a very long time. After a treatment course many say they wish they had come earlier.”
A survey found that at any one time 33% of the population is suffering with back pain and up to 80% of the adult population will suffer significant back pain at some time in their life. Repetitive activities such as bending, lifting or twisting, as well as poor posture or injury may lead to back pain.
Common causes: Most mechanical spine disorders that cause neck or back pain involve a nonspecific mechanical derangement:
Muscle strain, ligament sprain, spasm, or a combination is most common.
Only about 15% involve specific structural lesions that clearly cause the symptoms, primarily the following:
Disk herniation/Slipped disc
Compression fracture
Lumbar spinal stenosis/Trapped nerve
Osteoarthritis/Wear and tear in the joints
Spondylolisthesis
Non-specific low back pain means that the pain is not due to any specific or underlying disease that can be found. It is thought that in some cases the cause may be a sprain (an over-stretch) of a ligament or muscle. In other cases the cause may be a minor problem with a disc between two vertebrae, or a minor problem with a small ‘facet’ joint between two vertebrae.
Symptoms: Sometimes a pain may develop immediately after you lift something heavy, or after an awkward twisting movement. Sometimes it can develop for no apparent reason. Some people just wake up one day with low back pain.
The severity of the pain can range from mild to severe. Typically, the pain is in one area of the lower back, but sometimes it spreads to one or both buttocks or thighs. Once the pain has eased or gone it is common to have further bouts of pain (recurrences) from time to time in the future. Also, it is common to have minor pains ‘on and off’ for quite some time after an initial bad bout of pain.
Treatment: A national guideline (from NICE) recommends the following treatments should be considered. Each of these treatments has evidence from research trials to suggest that they will help to ease low back pain:
Manual therapy including chiropractic. Typically this includes sessions of massage, spinal mobilisation and/or spinal manipulation. With
spinal mobilisation the therapist moves the joints of the spine around in their normal movement range. In spinal manipulation, the therapist
moves joints beyond the usual range of movement.
Structured exercise programme. This means a programme of exercise supervised by a professional. Exercises may include aerobic activity,
movement instruction, muscle strengthening, posture control and stretching.
In general the sooner you seek treatment and have the underlying problem resolved the quicker the episode will clear and then the focus is on rehabilitating the spine to prevent recurrences.
Chiropractic is also very effective for chronic or long term back pain but treatment normally takes longer to be effective as it will take time to retrain and re-educate the joints and muscles in your body. So don’t hesitate to get your spine back to health.
