The back is a complex structure that consists of;
24 small bones (vertebrae) that support the weight of your upper body and form a protective canal for the spinal cord
shock-absorbing discs (intervertebral discs) that cushion the bones and allow the spine to bend
ligaments that hold the vertebrae and discs together
tendons that connect muscles to vertebrae
the spinal cord, which carries nerve signals from the brain to the rest of the body
nerves
muscles
The lumbar region
The lumbar region is the lower part of the back. It is made up of five vertebrae: L1, L2, L3, L4 and L5.
The lumbar region supports the entire weight of your upper body. It is under constant pressure, particularly when you are bending, twisting and lifting. This is why most cases of back pain develop in the lower back.
Lower back pain is very common and is caused by the structures in the back as noted above. Lower back pain is noted as chronic when it has lasted longer than 6 weeks but less than a year (NICE, 2009). Low back pain is a common disorder. Nearly everyone is affected by it at some time. For most people affected by low back pain substantial pain or disability is short lived and they soon return to normal activities, however the underlying problem will still be present and it could return at any time. A small proportion can develop constant chronic pain and disability.
The lower back is commonly defined as the area bounded by the bottom of the rib cage and the buttock creases. Some people with lower back pain may also feel pain in their legs, but the low back pain usually predominates.
Lower back pain is tension, soreness and/or stiffness in the lower back region. It may or may not be possible to identify a specific cause of the pain using current investigative techniques which have their limitations. Several structures in the back, including joints, discs and connective tissues, may contribute to symptoms. The back pain may be associated with numbness, pins and needles or shooting pain down either or both legs.
There are also Red Flags, which is a phase commonly used by medial professionals, that can be involved when lower back pain arises. These are defined as a clinical sign or symptom that may indicate a certain problem as the source of Lower Back Pain.
The Red Flags that involve lower back pain are;
Numbness or loss of sensation between the legs.
Reproduction of symptoms when coughing or sneezing.
Any differences in the number of times you go to the toilet or a feeling that you need to go but are unable.
Difficulties in walking, feeling like your body not in control of your legs.
In the event of any of the above occurring please consult with either your GP or ourselves for further advice.
Epidemiology of low back pain
Many people suffer with back pain in their lives. 65% of people suffer with back pain for a year and 84% suffer for life (Walker, B. F., 2000) There is no convincing evidence that age affects the prevalence of back pain (Airaksinen, O., Brox, J. I., Cedraschi, C. et al , 2006).
Some people who have chronic lower back pain are strongly advised to keep active. Continue with daily activities and exercise programmes are advised by the NICE guidelines. Staying physically active is likely to be beneficial in many circumstances. Painkillers and NSAID (Non steroid anti-inflammatory drugs) alone have not been proven to treat lower back pain only reduce the inflammation, the underlying cause is still there (NICE,2009).
Pain can lead to a number of things including fear avoidance which then leads to dysfunction and not moving the body as it should be moved. This will then lead again to pain and is how some individuals suffering with back pain can find themselves in a vicious circle. If you see come see us at Arfon physiotherapy we can help you avoid getting into this circle and help with confronting the pain which then leads to recovery.
Our body is very good at coping and as the pain diminishes sometimes these protective and initially helpful patterning of movement are maintained- which can sometimes become the source of further problems at a future date
Physiotherapists can help in many cases of lower back pain by assessing the patients in self management, manual therapy to help restore segmental mobility, exercises to address motor control and loading problems and posture where appropriate. At Arfon Physiotherapy we offer evidence based but specifically an individually tailored approach to each presenting individual. When you are ready or if the problem is not so complex we also offer a back class which helps clients to exercise under the watchful eye of the qualified, chartered physiotherapists. Education and information is given to each client to help you understand the need for the treatment. Lower back pain can be treated for all ages, the earlier we see you the better.