Some Causes of Low Back Pain

Low back pain can be quite debilitating for people if it becomes chronic or if brought about by an immediate injury mechanism. Many times though, acute low back pain will settle within several days with gentle activity and simple analgesia. The International Association for the Study of Pain (2021) reported that low back pain is the leading cause of global disability. Clearly, this warrants ongoing community education and awareness.

Again according to The International Association for the Study of Pain (2021), “low back pain is not usually associated with a specific identifiable pathoanatomical cause” and “85-95% of people presenting to primary care providers do not have a specific identifiable pathoanatomical origin for their pain.” This may correlate with the strong link between psychological factors such as anxiety and depression and low back pain, plus other central nervous system mechanisms such as sensitisation over time and personal beliefs. As you can see, low back pain gets complicated!

However, whilst Physiotherapists are highly trained to acknowledge such factors, and treat the whole person, they are also trained to look for more specific indicators such as mechanical and inflammatory patterns of pain.

Below is a summary of just a few diferent pain patterns that Physios are trained to detect.

Muscle tears – are often caused by heavy lifting or quick / heavy / sudden jolting. Muscle tears usually feel ‘sharp,’ are very localised to one specific area, and are aggravated with movement and less painful when resting.

A muscle tear may feel sharp and localised.

Intervertebral disc pain – may be dull, aching, diffuse, towards the midline. May be aggravated by prolonged sitting or bending forward, lifting. May be constant and unrelenting.

Disc pain may be central and feel like a strong general ache.

Facet joint pain – may be sharp, stabbing, towards one side only, worse at the end of the day. May be aggravated with arching backwards, twisting or prolonged standing.

Facet joint pain may be one sided.

Nerve root irritation – may be sharp, intermittent, ‘electric’, aggravated with bending, lifting, prolonged sitting. May send pain or a feeling of ‘numbness’ down the lower limb.

A dorsal root ganglion of the lumbar spine.

Nerve root compression – often associated with ‘hard neurological findings’ such as reduced lower limb reflexes / sensation / muscular activation. Often associated with a feeling of lower limb numbness, burning or freezing, and ‘electric shocks’ into the lower limb. Often wake people at night and may not respond to simple analgesia.

The pain from a lumbar nerve root compression is often excruciating.

At Destiny Health, we take a view of the whole client when writing our exercise programs and providing hands on treatment. We review your symptoms, medical history and social circumstances. We communicate with your doctors and specialists as needed, and aim to keep you moving as freely as possible.

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International Association for the Study of Pain.

Images from Elsevier’s Complete Anatomy