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Lower back pain is very common especially amongst middle aged adults and is often caused by over straining of the back muscles or injury. Also called the lumbar region, it is the area of the back that starts below the ribcage. The symptoms might range from a dull ache to a stabbing or shooting sensation.
The numbing pain can make it difficult to move or stand up straight. The lower back pain that comes on suddenly is termed as “acute.” It might be related to playing some sports or lifting heavy articles or postural issues. If the pain lasts for more than three months it is considered as “chronic.” Ruptured discs which act as cushions between the vertebrae in the spine, arthritis, osteoporosis and various other reasons can result in chronic back pain.
Lower back pain may be linked to the bony lumbar spinal cord, discs between the vertebrae, ligaments around the spine and discs, the spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area.
Immediate attention is required if any of the following symptoms are seen:
- Sudden spike in pain, discomfort, weakness or numbness
- Loss of bladder function
- High fever
- Severe stomach pain
- Unexplainable weight loss
- The pain results from a fall or severe blow to your back, amongst various other reasons
The following factors are linked to developing lower back pain:
- occupational activities
- pregnancy
- a sedentary lifestyle
- poor physical fitness
- older age
- excess weight and obesity
- smoking
- strenuous physical exercise or work, especially if done incorrectly
- genetic factors
- medical conditions, example, cancer of the spinal cord, kidneys, or arthritis
Lower back pain also is seen more often in women than in men, and could be related to hormonal factors. Mental conditions resulting from stress, anxiety and mood disorders can accentuate lower back pain.
On the basis of various assessments, a physical therapist can help you recover from lower back pain. Physical therapy can help you stay as active as possible. Post the assessment of the back pain the physical therapist also helps you realize that some continued or repeated back pain is not surprising or dangerous.
It is observed that:
- Most low back pain can improve if you stay active, avoid postures and activities that may increase or cause back pain
- When you no longer have acute pain, you may be ready for gentle strengthening exercises for your stomach, back, and legs, and perhaps for some stretching exercises
- Regular and disciplined exercises may not only help decrease low back pain, but it can also help you recover faster, prevent reinjure to your back, and reduce the risk of disability from back pain
- Exercises to reduce low back pain are not complicated and can be done at home without any special equipment
- It is important that you don’t let fear of pain keep you from trying gentle activity. Too little activity can lead to loss of flexibility, strength, and endurance and that can result in more pain
Physical therapy is one of the most widely used treatments 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 of treatments is found useful.
Owing to the complex structure of the human back consisting of a highly complex system of series of interlocking elements including the vertebrae, discs, facet joints, ligaments and muscles a back pain needs a strong and prolonged physiotherapy-based rehabilitation program.
In this section, we have briefly listed the key aspects of the role of physiotherapy in management of lower back pain.
The main aspects of physical therapy in case of lower back pain includes the following:
- Assessment and early intervention
- Mobilization or Manipulative physiotherapy
- Specific stabilization exercises
- General exercises and stretches
- Ergonomic advice
- Postural guidelines
The two basic types of physical therapies used for curing lower back pain includes:
Active physical therapy: this becomes critical to rehabilitate the spine. In order to obtain optimum results a personalized back exercise program should follow:
- Stretching exercises
- Strengthening exercises, for dynamic lumbar stabilization or other prescribed exercises
- Certain aerobic exercises based on the assessment of the physical therapist
Passive physical therapy is used where exercise is either too painful or not possible, the therapist may include:
- Heat/ice packs
- TENS units
- Iontophoresis
- Ultrasound
The physical therapist can combine various exercises involving stretching, weight-training and miscellaneous exercises like the ones mentioned below to help alleviate lower back pain.
- Ankle Pumps
- Heel Slides
- Wall Squats
- Straight Leg Raises
- Single Knee to Chest Stretch
- Hip Flexor Stretch
- Pisiforms Stretch
- Lumbar stabilization exercises
