Back pain, lumbar spine pain, lumbago, mechanical back pain, non-specific back pain, simple back ache and slipped discs are all terms that can be used to describe painful symptoms emanating from the lower back or top of the buttocks. Often the pain experienced is moderate to severe restricting normal movement and function. Sitting, driving, rising to standing, putting on shoes & socks, washing up, brushing teeth and sitting on the loo are regularly reported as aggravating factors whilst heat, a change of position, walking and medication help manage the pain.
Patients regularly report taking time off work and reducing participation in hobbies due to symptoms or fear of further harm. Disturbed or broken sleep is non-restorative, reducing resilience leading to further frustration, negative thoughts and mood disturbance.
Back Ache is extremely common with 80-90% of the population likely to experience symptoms at least once in their lifetime. It may feel serious in the midst of it all as you experience spikes of pain with most normal movements, however this is likely because the spine and surrounding muscles are central to all movements of the body and you are simply moving those structures; for example, you may have pulled/sprained the muscles of you lower spine, you may have aggravated a ligament, irritated a nerve, developed stiff spinal joints or most likely a combination of all. When rising from sitting the spinal muscles, ligaments and tendons will tighten and spinal joints extend. Despite this being a completely normal movement, the series of movements required at each structure can be enough to aggravate pain. Sitting down involves lengthening the spinal muscles, tendons and ligaments, flexing the lumbar spinal joints which again could cause pain.
It’s important to remember that despite the levels of pain and distress often associated with back ache, the majority are not serious and are likely to ease off within a day or up to eight weeks. To reassure yourself take time to consider why you are experiencing back ache in the first place; for example, could it be due to:-
- Long hours
- Repetitive nature
- Desk set-up or hot desking
- Physically and mentally demanding
Have you had an accident, slip, trip or fall?
- Sedentary office work
- Awkward angles and postures of boat building
- Constantly changing stability of a sea trawler, yacht or ferry
- Repetitive loading of assembly line jobs, building, plumbing etc
- Standing all day in retail and hairdressing
- weight training
- boot camps
- Martial arts
Trauma – road traffic accident
Chartered Physiotherapists are expertly placed to collect a detailed medical history and provide a thorough spinal assessment to be able to safely diagnose lumbar spine pain. Medical history forms the foundation of the assessment which will include your current presenting symptoms, when and how symptoms began, levels/types/frequency of any pain, medication, previous trauma/surgery/spine problems. More in depth questioning regarding bladder and bowel function, bedroom performance difficulties, sleep pattern and weight will provide plenty of clues to the underlying cause of the problem and eventual diagnosis.
A physical examination will be required to assess the ranges of spinal motion available. A loss of expected range will help identify the underlying cause. To enable a thorough examination you should prepare to undress to your underwear or have a pair of shorts and loose T-shirt available. Muscle power, sensation and reflexes will be tested and compared to normal values. The sciatic and femoral nerves will be tested for any signs of tension. Hips and pelvic joints will be assessed as will the muscles in the thigh for any increase in tension. The spine will be palpated/mobilised systematically assessing the mobility of each spinal segment and any underlying muscle spasm or guarding. At this point a diagnosis will be established and fully discussed with you so you are reassured and knowledgeable regarding your Lumbar spine pain.
Remember 90% of lumbar spine pain is not serious and is likely to settle within a couple of days to eight weeks. If you are worried please get in touch.