Introduction:

Pain in the lower back that persists for three months or longer is classified as chronic. The exact cause of chronic low back pain is unknown.

The lower back comprises five vertebrae (L1-L5). The lower back has an inward curve, commonly referred to as lordosis. It is the L5-S1 and L4-L5 segments that carry the most weight and have the most movement in the lumbar spine, which makes them more vulnerable to injury. There are spinal discs between each vertebra, which provide support. When the discs in the lower spine herniate or degenerate, pain may radiate to the legs and feet as well as the lower back. A spinal cord runs from the base of the skull until it reaches the joint at T12-L1, at which the thoracic spine meets the lumbar spine. The cauda equina is formed by nerve roots branching off from the spinal cord at this segment. Radiculopathy arises when these nerve roots are compressed in the lower back, causing pain to radiate down the legs.

Clinical Feature of Chronic Low Back Pain:

Pain is usually felt in the lower back (lumbar and sacroiliac region), and patients with chronic low back pain have limited mobility. You may also experience pain in your lower extremities, or generalized pain can be present. In addition, patients with CLBP may experience impaired coordination and movements. Patients may have difficulty controlling their voluntary movements.

Patients may have difficulty maintaining neutral posture, which can lead to body misalignment. The ability to stand, sit, or lie down can also prove difficult, especially in cases of radiating pain to the lower extremities. It might also be painful to carry things with the arms or bend. For those with CLBP, daily activities can become difficult, such as cleaning, playing sports, and other recreational occupations.

Physiotherapy Treatment:

  • Core strengthening exercises:
    • They are used to improve control of the lumbar spine and pelvis by restoring coordination and control of the trunk muscles. Exercises like these are designed to improve the endurance and strength of the trunk muscles so that they can meet the demands of control. For patients with CLBP, core exercise is more likely to relieve pain and improve function compared to general exercise in the short term.
  • Motor control exercise:
    • This method can be effectively treating chronic low back pain. Among the muscles targeted are the transversus abdominis, multifidus, the diaphragm, and the pelvic floor. The goal of motor control exercises is to improve neuromuscular control over the segments of the trunk that are involved in the spinal movement.
  • Spinal Manual Therapy:
    • Such as Chiropractic adjustment,& osteopathic treatment.
  • Traction:
    • Mechanical lumbar traction is very effective for treating acute or chronic nonspecific Low back pain. It is also effective for the treatments of radicular low back pain.
  • Mckenzie Method:
    • These methods are as effective as other exercise therapies. And helpful in reducing low back pain.
  • Soft tissue Massage:
    • Back pain can now be treated with massage both in the acute and chronic stages.
  • Dry needling/acupuncture
    • Dry-needling can help alleviate low back pain.
  • Therapeutic Modalities:
    • for example Electrical nerve stimulation, High-intensity laser therapy, Shortwave diathermy, therapeutic ultrasonography, extracorporeal shockwave therapy,& TR therapy, etc.
  • In addition, Pilates.
  • Also, Yoga.