Back pain is something most of us will experience at some stage during our lives and is the most common reason for missed days at work. Back pain affects primarily the lower back and the good news is, that in most cases, the cause of pain is not serious and can be resolved in a few days or weeks. However, some symptoms can be more serious requiring a full assessment and diagnosis by an experienced Physiotherapist.

Understanding Your Back

Your spine is made up 24 separate bones called vertebrae which are connected together by a series of ligaments and soft tissue. The lower part of your spine is joined to the sacrum which is part of your pelvis. The curves, shapes and various sizes of the vertebrae (along with the discs found in between them), help to evenly distribute the weight of your body on the spine and creating the flexibility necessary to bend or rotate your back.A complex group of muscles are attached to the spine which allows you to move your back. There are also postural muscles which help to maintain the shape and curves of your spine, keeping them in the correct position, as well as help to keep you upright.The spinal cord passes through the centre of each vertebra. The cord ends in your lower back where it becomes a series of strands called the “cauda equina” (horses tail). Either side of each vertebra are spinal nerve exits from the spinal cord which pass sensory and motor signals between your brain and a certain part of your body which the nerve innervates.

Back Pain and Poor Posture

Poor posture is normally the result of weak or imbalanced core muscles which help maintain the spine in the correct position – like guidelines of a tent. When these muscles are weak it is very difficult to keep your spine in the correct or neutral position, especially when sitting for long periods. Eventually, the soft tissue structures around the spine become overloaded, initially manifesting as a dull ache across your lower back, but if the overload is not reduced, and eventually pain and stiffness will develop. Other muscles may also be contributing to developing poor posture and back pain. For example, your main leg muscles (hamstrings and quadriceps) can become tight from inactivity, sitting or driving for long periods. As a result, the increased tension from either of these muscles can pull your pelvis out of position and increase the tension on your lower back.Then further sitting will exacerbate the overload to your lower back, resulting in pain.

It is almost a daily occurrence to have a patient attend one of our clinics suffering from lower back pain, to explain they have, for example, been stretching their back every day for a month and it has made no difference to their back pain.With typical posture related back pain, the soft tissue structures in the lower back are overloaded i.e. they have been at full stretch for hours on end until pain starts to develop. Therefore, it won’t be a surprise to know that further stretching is unlikely to help. What is required is gentle movement, not stretching. However, stretching of other muscle groups like hamstrings, quadriceps and glutes can help to relieve the tension on the lower back muscles.

Treatment for Back Pain

Physiotherapy is an ideal choice for the treatment of back pain.

Your experienced physiotherapy will firstly diagnose the cause of your back pain and then combine manual therapy, which is hands-on treatment including techniques like myofascial release, mobilisation along with specific exercises (similar to the exercise plan at the end of this article).They also use different modalities like Ultrasound, IFT, and Laser etc. to release the pain.

Self-treatment for Back Pain

1. Staying active is the key to reducing postural back pain. 30 minutes a day of gentle exercises like walking, swimming or cross-trainer are ideal. Joining an exercise class is a great way to keep fit and healthy and reduce postural back pain. Even 2 x15 minutes of daily exercise can be really effective.

2. If you sit for long periods, stand up and move around every 20 minutes or so. Introducing simple pelvic and lower back movements will really help.

3. If you work daily in an office, establishing a suitable desk and chair position is essential to avoid back pain. If you are not sure what position is right for you, arrange for one of our Occupational Physiotherapists to help you. Here is a useful article to read Getting the right position at your desk.

4.  If you are not a gym goer, a daily routine of home movement exercises for your lower back  and stretching any tight leg muscles like quadriceps, hamstring and glutes will really help reduce your back pain. Again, you should always consider to get customized exercise from a physiotherapist.

It is always advisable that you always get your exercise plan customized by an experienced Physiotherapist only. They can understand your body condition and strength of your muscle and prescribe appropriate exercise.Following incorrect exercise pattern will worsen the back pain.