Low back pain is one of the most common reasons that people visit their doctor or have to take time off work. As many as 4 out of 5 of us will experience an episode of back pain in our lifetime. The good news is that the overwhelming majority of people with low back pain will recover within a few months and half of those with low back pain will recover in 2 weeks with no treatment at all.
Why should I see a Physiotherapist?
So, if most people recover on their own, why see a physiotherapist? The first and most obvious reason is that it can be quite difficult and painful to move while you're experiencing back pain. The role of the physiotherapist is to provide both treatment and self-care methods to help you move and feel better while you recover. The second reason is that most people who experience low back pain will have a reoccurrence and often this can happen within 6 months or sooner. Following a thorough examination, a physiotherapist can help identify some of the factors that contribute to your pain and put you at risk of further episodes or developing persistent pain. A third reason for seeing your physiotherapist is that while most people with back pain don't require any tests such as an x-ray or an MRI, your physiotherapist will screen you to make sure that your particular situation doesn't fall into one of these categories or may be a rare situation that requires medical treatment such as surgery.
What is Non-Specific Low Back Pain?
The most common type of back pain is something called 'non-specific low back pain' with 19 out of 20 cases falling into this category. What this simply means is that it's not clear what the actual underlying source or cause of the pain is. With many other areas of the body, it's often easier to attribute pain to a specific ligament, muscle or tendon that was injured but this simply isn't possible with many cases of low back pain. This doesn't mean that something specific like a muscle, one of the many joints in your back or a disc isn’t irritated. It simply means that there is often no way to definitively identify the pain generator. Often the source of the pain is multi-factorial and there is almost always some element of pain originating from sensitivity of the muscles surrounding your back. In some cases, especially if your pain has endured for a very long time, your physiotherapist may even determine that your symptoms are due to an overly sensitive nervous system. This is referred to as 'central sensitization' and we hope to cover this type of pain and treatment in a future blog post. At other times, your physiotherapist might identify a specific nerve in your lower back that runs to your leg that’s irritated. This is often accompanied by burning pain in the leg, numbness or pins and needles.
What are my Treatment Options?
When it comes to non-specific low back pain, it’s easy to assume that the treatment is also non-specific and that the problem can be managed by watching exercise videos on YouTube right? In actuality, the exact opposite is true. What might be good for some people with low back pain might actually aggravate another person’s symptoms. A good example is core exercises. We’ve all heard that having a strong core and abdominal muscles are good for our back but there’s a right time and a wrong time to be doing these exercises and some of the most popular exercises can be aggravating if done too early in the recovery process. Likewise, for some people, any movement can be therapeutic while for others certain directions of movement like forward or backward bending may need to be avoided, especially early on. The job of your physiotherapist is to partner with you and develop a personalized treatment plan based on your examination as well as your own activity goals. Treatment often includes some manual (hands-on) therapy, pain relieving modalities such as electrical stimulation, medical acupuncture, dry needling, as well as therapeutic exercise and self-care techniques that you can perform at home. Education on body-mechanics, modifying activities and more optimal work postures and habits are often also necessary.
If you have low back pain and are looking for 1-on-1 care, Striowski & Associates Physiotherapy clinic in North York has a team of dedicated physiotherapists experienced in treating various types of back pain.
Watch this video to see one of our expert physiotherapists, Dino Bertani, PT, FCAMPT, discuss some common sources of low back pain and how physiotherapy can help!