Low back pain is among the common reasons for consultation with the physician. It affects about 80% of people throughout their lifetime and it is among the leading causes of days off work. It is costly not only to the individual but also to the society and the nation’s health service.
Low back pain can be described as an unpleasant experience localised between the lower rib cage and the buttocks. In some individuals, the pain may radiate down the thighs and legs.
Causes: Multiple body structures that contribute to low back pain include the following:
- Problem with the lower bones of the back, called lumbar vertebrae and sacral vertebrae.
- Problem with the intervertebral (IV) discs which separate the vertebral bones from each other. These IV discs help provide cushion.
- The problem may be located in the surrounding muscles of the lower back.
- The ligaments joining the muscles to the bones may be the source of pain.
- Spinal nerves which help in our perception of touch and control of movement may be the source of pain.
- The various joints of the lower back may be diseased, hence, causing pain.
Some individuals may have pain as a result of problem in two or more of the above structures. The diagrams below describe the various distribution patterns of low back pain.
Forms of low back pain: There are basically 2 forms.
- Specific: This is attributed to recognisable or known specific pathology e.g. infection, tumour, trauma, osteoporosis etc.
- Non Specific: This is not attributed to any recognisable or known specific pathology (cause). This is the more common form of low back pain.
Duration of pain: Some individuals experience low back pain of few days duration while others experience theirs for 12 weeks or more. Irrespective of the duration, the intensity of pain may be severe enough to affect the activities of daily living.
The following are tips for low back pain management:
- Bed rest: 3 – 5 days of bed rest may suffice.
- Medicine: Use of pain relieving medications and muscle relaxants etc.
- Physiotherapy: Core Stabilisation and Strengthening exercises, Manipulations, Electrotherapy (TENS), Thermotherapy (Shortwave/Microwave Diathermy, Ultrasound Therapy, Infra-Red Radiation etc), Cryotherapy, Hydrotherapy, Massage Therapy, Traction, Acupuncture etc, are beneficial.
- Surgery: In some severe cases of specific low back pain, surgery may be required.
PREVENTION (See recommended postural habits in the pictures)
- Regular exercises (Strengthening exercises, Stretching exercises and Aerobic exercises).
- Maintain good back posture in all positions (see above pictures).
- Avoid high impact activities.
- Do not sit for a long period of time without back support.
- Sit upright with your back well supported (avoid slouched sitting).
- Lift objects safely (avoid lifting heavy load, if you must lift a heavy load, get one or more people to join you).
- Sleep on firm mattress (avoid saggy or soft mattress).
- Good sleeping position is recommended.
- Maintain a healthy body weight.
Adewumi Adeagbo is a Physiotherapist, researcher and specialist in rehabilitation of neurological conditions in adults and children. He is an expert in identification and maximisation of individual functional ability and potential. He is a Lecturer at Department of Physiotherapy, College of Medicine of the University of Lagos. He can be contacted via firstname.lastname@example.org