FAQs: Lower back pain
Written by Joanne Huynh - Physiotherapist
As a physiotherapist, I have seen many cases of lower back pain, from a niggle through to the client who cannot even get up from the seat. Here are the most common questions I get asked, and these are the answers that I will usually provide:
Why am I getting lower back pain?
Lower back pain is determined by multiple factors. Many may consider that age related changes, which you may hear is ‘degenerative’, of the spine can be a factor. There are certain inflammatory conditions, such as rheumatoid arthritis, that can impact on spinal health and lead to lower back pain. Trauma, such as a fall or a car accident, can also lead to lower back pain. There is a small percentage (less than 5%) of cases that are more serious pathologies, such as cancer, fractures or medically driven conditions that can also contribute to lower back pain.
For the most part though (pretty much 95% of cases), lower back pain is usually due to a combination in varying amounts of:
Lack of movement or exercise
Disrupted sleep or increase in fatigue
Prolonged and/or awkward postures
High levels of mental, emotional or personal stress leading to high levels of cortisol and adrenaline which increases soft tissue sensitivity
Sudden and unexpected load on the lower back that was more than it could handle
But how will I know if I have that serious pathology? Shouldn’t I just get an x-ray,CT scan or MRI, just in case?
If you seek guidance from a physiotherapist, GP or a qualified health professional, they will have the knowledge to ask you the right questions that will help them determine if you are suspected of having a serious pathology. Outside of this, imaging should not be considered until at least six weeks after your pain started.
Routine scans or imaging is not as helpful as you think. Many changes that show up on a scan are usually age related changes (like your skin will usually wrinkle with advancing age) and are more common as you get older. Imaging can increase a lot of stress and anxiety over findings that can be seen even in pain free individuals, which means they are not as important as you think. It also can expose you to unnecessary radiation, and cost your time and money, without increasing your chances of recovery compared to those who do not get a scan.
Will my lower back pain improve on it’s own?
Usually most non-specific (meaning not due to a serious or specific cause) cases of lower back pain will resolve on their own eventually - however some may take more time than others, but usually not longer than 6 weeks, especially if you are taking the right steps to facilitate healing. It is usually then worth seeking advice from a physiotherapist to determine what action you need to take.
Should I be resting so that my lower back can get better?
It is actually better for you to MOVE WITHIN YOUR PAIN FREE LIMITS if you have low back pain, and as your back feels better, you can start to increase your activity levels. Depending on your job, it is not always necessary to skip work or take days off - simply modify the tasks at your job, or even cut down your hours for a short period of time whilst you are healing.
Do physiotherapists know exactly which structure, tissue or muscle is affected with my lower back pain?
It is quite difficult to pinpoint the exact structure that is injured or affected with lower back pain. It is more likely that multiple structures in the lower back are affected (the fascia, the muscles, the vertebrae, the discs etc), maybe some more than others.
Would taking pain medication help me with my pain?
It is usually not required for you to take anything stronger than over the counter pain medication, such as Panadol for management of lower back pain. You can seek advice from your GP or pharmacist to discuss if you need anything different to this.
Why would I need to see a physiotherapist if my back pain will go away on it’s own?
Every lower back pain case is different; it may require an individualised plan of action, with some cases of lower back pain benefitting from a short course of hands on treatment. There may be a need to discuss your occupation and home duties with implementing self management strategies and modifications whilst you are recovering. The exercises may also vary between different types of lower back pain, as well as the dosage or timing of the exercises administered can influence your comfort during your recovery. Sometimes, it is also quite a scary ordeal when your lower back hurts, especially if it stops you from doing the activities that matter to you. It is important for you to receive some knowledge and improve your understanding of what is happening, what to expect with recovery and how to actively manage your pain. This can help to settle a lot of unknowns about your pain and should then help you sleep better at night, which is also fantastic for healing!
Do you have any other questions?
Feel free to drop me an email at joanne@thephysioalliance.com.au, or comment on this diary entry and I am happy to answer more questions!
Do you need to get that lower back pain looked at?
Feel free to click the link below to book an appointment with me, your happy physiotherapist at The Physio Alliance!
