Low Back Pain: Definition, Causes, Prevention & Treatment.

(Versione Italiana: https://spark.adobe.com/page/mt7msWTQh1tuB/)

What is Low Back Pain?

Low Back Pain (LBP) is a very common issue involving the lower back (lumbar region) that can sometimes extend to the leg (a.k.a. sciatica).

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Low Back Pain is one of the main reasons why people go see a doctor: it has, indeed, been estimated that 80% of the population experiences Low Back Pain at least once in their lifetime.

Low Back Pain in usually divided into 3 categories, according to how long the person has been living with the pain:

Acute: when Low Back Pain has been present for 1.5 months (6 weeks);
Subacute: when Low Back Pain has been present up to 3 months (12 weeks)
Chronic: when Low Back Pain has been present for more than 3 months.

But what is Low Back Pain caused by?

Let’s find out!

What Causes Low Back Pain?

90% of Low Back Pain is “Non-Specific”: this means it is (almost certainly) caused by mechanical factors.

Other causes of Low Back Pain are very rare, and can be classified as follows:

–Serious causes, including Fracture, Infection, Ankylosis Spondylitis and Cancer; these account only for 1-2% of all Low Back Pain cases.

–Specific causes, associated with neurological deficits (when nerves and related structures are involved), such as Radiculopathy and Cauda Equina Syndrome; these account for 5-10% of all Low Back Pain cases.

As you can see, Low Back Pain, despite being very annoying and at times even disabling, should not make you worry too much.

Being Non-Specific Low Back Pain the most common type of LBP, we are now going to dive deep into it!

Non-Specific Low Back Pain

When you go see a Physiotherapist because of your Non-Specific Low Back Pain, he/she should try to identify factors that may have contributed to the developing of your Low Back Pain, rather then looking for the exact anatomical structure that might be the source of your pain.

This is because, as many studies and guidelines suggest, it is not possible neither necessary to do so.

Low Back Pain is, indeed, a multifaceted issue, which means it can be caused and influenced by many factors. These include biological, psychological and social factors, for example: muscle weakness (biological), depression (psychological) and work environment (social).

For this very reason, diagnostic imaging (especially within the first few weeks), is not recommended: what these images can show, in fact, very often does not correlate with the actual entity of the problem.

Now that you have a better idea of what Low Back Pain is, I am going to reveal you some strategies that can be implemented to prevent it from happening to you, and then also to manage and treat it if you are already experiencing it!

Ready? Let’s go!

Preventing Low Back Pain

There are 3 types of prevention:

Primary prevention: it aims to avoid the onset of the Low Back Pain;
Secondary prevention: its purpose is to avoid the recurrence or worsening of an already diagnosed Low Back Pain;
Tertiary prevention: this is used to maximize the quality of life of an individual with a long-term and very disabling Low Back Pain.

Now that we have specified this, let’s look at something more practical.

It is very important to point out that individually tailored intervention can get better results than standardized programs, as each person is unique and different from everybody else.

That said, there is one thing that you can (and should!) do to prevent Low Back Pain: Physical Exercise.

A combination of strength training and regular aerobic training can do wonders.

Inactivity is, indeed, one of the worst you can do for your body, as it one of the biggest factors that can contribute to Low Back Pain (and many other health problems).

External supports (e.g. back belts and shoe insoles) to prevent Low Back Pain are not recommended either, as they have a negative effect on Low Back Pain beliefs (psychological factors are important, remember?).

On the other hand, as far as the work environment is concerned, ergonomic adjustments can actually be very useful. I wrote a whole article on this topic: you can find it here.

So, to prevent Low Back Pain, try to at least walk 30 minutes/day and implement the ergonomic strategies I outline in this article.

But what if you already have Low Back Pain?

Don’t worry, I have some strategies for you too!

Managing & Treating Low Back Pain

As I explained before, many studies and international guidelines suggest that to effectively address and manage Low Back Pain it is not possible nor useful to identify the specific anatomical structure responsible for the pain.

Instead, it is recommended that the individual with Low Back Pain receives education from his/her healthcare provider, in order to correct false beliefs, and that he/she does not get treated with drugs, but rather with physiotherapy interventions, in particular exercise therapy.

Clearly, some interventions rely in the hands of your physiotherapist, but there are definitely some things you can actively do to manage your Low Back Pain!

Remember: do NOT stop moving! Inactivity will only make your Low Back Pain worse, so go for a walk everyday.

Here I listed some exercise you can do to manage your Low Back Pain (clic the links for the video!):

1.Diaphragmatic Breathing.

2.Prone Press Up (or Cobra Pose)

3.Pelvic Tilts

4.Cat-Cow

5.Pigeon Stretch

6.Hip Flexors Stretch

7.QL Release and QL Stretch

8.Glute Bridge

9.Dead Bug

10.Hip Hinge