Do you suffer from lower back pain? If so, you aren’t alone. Back pain affects 80% of the population at some point in their lives. It is also the second leading cause of work-related disability and a major cause of missed work.
Most back pain occurs in the lower back, and physical therapy can provide tremendous relief. In this article, we will discuss topics such as the anatomy of the spine, symptoms of lower back problems, tips to reduce back pain, and how physical therapy can help lower back pain.
Anatomy of Your Spine
Understanding your spine’s anatomy and function can help inform you as you decide on a treatment plan to manage pain.
Your spine is made up of thirty-three interlocking bones consisting of seven cervical (neck), twelve thoracic (middle back), and five lumbar (low back) vertebrae. Additionally, there are five fused vertebrae in the sacral region (near the bottom of the spine), and four fused coccygeal (at the base) vertebrae.
Gel-filled discs (intervertebral discs) are positioned between the individual vertebrae and function as shock absorbers that protect as your body moves. Ligaments are fibrous bands that connect bone to bone, help keep vertebrae secure, and stabilize joints. Tendons are similar to ligaments but attach muscle to the bones of the spinal column.
When any of these spinal structures are disrupted, it can result in lower back problems and pain.
Symptoms of Lower Back Problems
Describing your symptoms helps pinpoint the source of the problem and develop an effective treatment plan to alleviate pain. The following symptoms are characteristic of lower back problems:
- Dull, aching pain
- Sharp pain that travels down the leg
- Pain that increases with sitting
- Pain that improves when you shift position
- Pain that is worse in the morning and improves after moving around
- Tingling or numbness in leg or foot
- Weakness in leg or foot
If you experience lower back pain together with loss of bladder or bowel control, numbness in the groin, unintended weight loss, fever, chills, or severe abdominal pain, seek immediate medical attention.
Types of Lower Back Pain and Their Causes
The most common cause of lower back pain is a torn or pulled muscle or ligament. Types of lower back pain include acute, subacute, chronic, and neuropathic, and each of them can cause significant or debilitating pain.
1. Acute: Acute pain is pain that lasts six weeks or less. Acute pain is often caused by a sudden injury such as an accident, fall, or heavy lifting resulting in a disruption in the way the spine, muscle, discs, and nerves work together. Most acute lower back pain is caused by injury to the muscles, ligaments, joints, or discs.
2. Subacute: Subacute pain is pain that lasts between six weeks and three months. It is a category of acute pain.
3. Chronic: Chronic pain in the low back lasts more than three months. 90% of the time, people can’t pinpoint the cause, but the pain source can be from problems such as degenerative disc disease, herniated disc, spinal stenosis, osteoarthritis, and scoliosis.
4. Neuropathic: Neuropathic pain in the lower back is usually chronic. Patients experience neuropathic pain as a sharp, electric-like, stabbing pain often accompanied by numbness, tingling, or weakness down the legs to the feet.
Tips to Prevent or Reduce Lower Back Pain
The best way to reduce lower back pain is to reduce the risk of falls and injuries, keep your back muscles strong, and maintain normal spine curvature. Cleveland Clinic offers helpful tips to ease low back pain, which include:
- Resist the temptation to get too much bed-rest, and stay active. At least two days each week, do stretching and strengthening exercises.
- Limit the length of time you sit, and maintain good posture when you are sitting. A footstool can help keep your hips and knees at a right angle. Keep your feet flat without crossing your legs, sit up straight without slouching, and use back support (i.e., a rolled-up towel) at the curve of your back. Keep health-promoting workplace ergonomics a priority!
- Avoid lifting heavy objects. Keep your back straight and bend your knees, keeping a wide stance if you need to lift something heavy.
- Do your best to maintain a healthy weight. There is debate about whether being overweight causes lower back pain or exacerbates it. However, research reveals a strong correlation between low back pain and obesity or being overweight.
- Wear supportive, quality, low-heeled shoes, and walk with your back straight, keeping your weight balanced on both feet.
- Sleep on your side on a medium, supportive mattress, and place a pillow between your knees. If you sleep on your back, choose a firm mattress, and put a pillow under your knees. Don’t sleep on your stomach.
If you continue to experience lower back pain despite these preventive measures, physical therapy can be just the solution to help.
How Can Physical Therapy Help Lower Back Pain?
Physical therapists are highly trained healthcare professionals that use physical therapy treatment modalities to strengthen core muscle groups that support the lower back.
After ruling out serious conditions needing medical intervention, a physical therapist will work together with you to set therapy goals, which usually include:
- Relieving or reducing pain
- Improving structural strength and stability in your lower back
- Increasing your ability to function and return to normal activities
- Education, including exercises and stretches you can do at home
Through active and passive physical therapy, you can enhance flexibility and increase your strength, which improves mobility and restores function that was lost due to pain.
1. Active Physical Therapy:
Active physical therapy consists of exercises to strengthen muscle groups that support your lower back and core. Stretching is incorporated to help keep you flexible. Another pain-reducing active treatment is soft tissue work and joint mobilization/ manipulation provided by manual therapy.
2. Passive Physical Therapy:
Passive physical therapy is used in conjunction with active physical therapy for pain modulation. Passive physical therapy can include treatments such as cold and heat packs to reduce inflammation and dry-needling trigger points.