The spine is made up of many bones called vertebrae. These are roughly circular and between each vertebra is a disc. The discs are made of strong rubber-like tissue which allows the spine to be fairly flexible. A disc has a stronger fibrous outer part and a softer jelly-like middle part called the nucleus pulposus.
The spinal cord, which contains the nerves that come from the brain, is protected by the spine. Nerves from the spinal cord come out from between the vertebrae to relay messages to and from various parts of the body.
Strong ligaments attach to the vertebrae. These give extra support and strength to the spine. Various muscles also surround, and are attached to, various parts of the spine.
Symptoms of lumbar back pain
- Lower Back Pain: Initially occurs only during certain activities but as the conditions gets worse it back pain may persists for longer periods of time.
- Muscle Spasm: Feeling of muscle spasm while sitting down or standing up.
- Radiating Pain: If the condition has led to compression of the spinal nerve, causing radiating pain from the spine and down to the leg (Sciatica).
- Numbness in leg
- Swelling of para spinal muscles
- Tender spots
What Is Back Pain?
Back pain can range from a dull, constant ache to a sudden, sharp pain that makes it hard to move. It can start quickly if you fall or lift something too heavy, or it can get worse slowly.
Who Gets Back Pain?
Anyone can have back pain, but some things that increase your risk are:
- Getting older. Back pain is more common the older you get. You may first have back pain when you are 30 to 40 years old.
- Poor physical fitness. Back pain is more common in people who are not fit.
- Being overweight. A diet high in calories and fat can make you gain weight. Too much weight can stress the back and cause pain.
- Heredity. Some causes of back pain, such as ankylosing spondylitis, a form of arthritis that affects the spine, can have a genetic component.
- Other diseases. Some types of arthritis and cancer can cause back pain.
- Your job. If you have to lift, push, or pull while twisting your spine, you may get back pain. If you work at a desk all day and do not sit up straight, you may also get back pain.
- Smoking. Your body may not be able to get enough nutrients to the disks in your back if you smoke. Smoker’s cough may also cause back pain. People who smoke are slow to heal, so back pain may last longer.
Another factor is race. For example, black women are two to three times more likely than white women to have part of the lower spine slip out of place.
Can Back Pain Be Prevented?
The best things you can do to prevent back pain are:
- Exercise often and keep your back muscles strong.
- Maintain a healthy weight or lose weight if you weigh too much. To have strong bones, you need to get enough calcium and vitamin D every day.
- Try to stand up straight and avoid heavy lifting when you can. If you do lift something heavy, bend your legs and keep your back straight.
When Should I See a Doctor/therapist for Pain?
You should see a doctor if you have:
- Numbness or tingling
- Severe pain that does not improve with rest
- Pain after a fall or an injury
- Pain plus any of these problems:
- Trouble urinating
- Numbness in your legs
- Weight loss when not on a diet.
How Is Back Pain Diagnosed?
To diagnose back pain, your doctor will take your medical history and do a physical exam. Your doctor may order other tests, such as:
- X rays
- Magnetic resonance imaging (MRI)
- Computed tomography (CT) scan
- Blood tests.
Medical tests may not show the cause of your back pain. Many times, the cause of back pain is never known. Back pain can get better even if you do not know the cause.
What Is the Difference Between Acute and Chronic Pain?
Acute pain starts quickly and lasts less than 6 weeks. It is the most common type of back pain. Acute pain may be caused by things like falling, being tackled in football, or lifting something heavy. Chronic pain lasts for more than 3 months and is much less common than acute pain.
Role of physiotherapist on treating back pain:
Lower back pain is one of the leading causes of physical disability, especially at the workplace. Research indicates that almost 80% of the population is likely to suffer from lower back pain in their lifetime.
Physiotherapy and Low Back Pain:
Physiotherapy is one of the most widely used forms of treatment adopted for gaining relief from low back pain. It is used in both modes, as a single line of treatment as well as in combination with other treatments such as massage, heat, traction, ultrasound or short wave diathermy.
The human back is basically a highly complex system of series of interlocking elements including the vertebrae, discs, facet joints, ligaments and muscles. Owing to such a complex structure, an episode of back pain needs a strong physiotherapy-based rehabilitation program, once the basic medication course has been undertaken.
In this section, we have briefly listed the key aspects of the role of physiotherapy in management of lower back pain.
- Advice and early activity – There is significant evidence to prove that encouraging early movement in case of lower back pain is one of the most significant aspects of treatment in this condition.
- Mobilization or Manipulative physiotherapy – This aspect concentrates on promoting mobilization of the specific affected area. The approach of manipulative physiotherapy is used to target the specific point of pain for the purpose.
- Specific stabilization exercises – In this aspect of physiotherapy, stress is laid on improving the strength and stability of the muscles which have been weakened due to the lower back pain.
- General exercises and stretches – A series of properly structured exercises and stretches are usually carried out in context of the patient’s individual condition and cause of the lower back pain.
- Ergonomic advice – Since work-related hazards account for more than 65% of lower back problems, physiotherapists also concentrate on providing accurate ergonomic device, guiding the patient on using the appropriate infrastructure at work to avoid and cure lower back pain.
- Postural guidelines – This aspect of physiotherapy focuses on guiding the patient about the correct postural habits and ways to maintain accurate posture to avoid lower back pain.