Causes of lower back pain are varied. Most cases are believed to be due to a sprain or strain in the muscles and soft tissues of the back.
Overactivity of the muscles of the back can lead to an injured or torn ligament in the back which in turn leads to pain. An injury can also occur to one of the intervertebral discs (these are shock absorbers which sit between the bones). As the body ages, the spine does too, discs begin to deteriorate resulting in vertebrae rubbing against one another. Ligament and joints deteriorate as one ages which sometimes causes the vertebrae to move much more than they should. Pain is also generated through spinal stenosis, sciatica and scoliosis. At the lowest end of the spine, some patients may have tailbone pain (coccydynia). Others may have pain from their sacroiliac joint, where the spinal column attaches to the pelvis, called sacroiliac joint dysfunction. Physical causes may include osteoarthritis, rheumatoid arthritis, degeneration of the discs between the vertebrae or a spinal disc herniation, a vertebral fracture or rarely, an infection or tumor.
Case Studies: Simple Low Back Pain
A 54-year-old gentleman attended my clinic as he had been suffering from low back pain for about 3 months and now it was starting to affect his ability to work normally. He worked within an office and wasn’t happily taking any time off work. He usually played Golf at weekends but this had stopped due to his low back pain. The pain was affecting his sleep pattern as he was finding it difficult to get comfortable at night.
Once he was assessed, we found that he had restricted movement bending forward and to the left and right due to pain on the right side of his lower back. The level of pain restricted how much he could move which affected the muscles around the spine especially his right side. He didn’t experience any symptoms down his leg, just an aching sensation around the top of his right thigh.
Rehabilitation Program
1). Four sessions of Treatment helped to reduce his level of pain & advice was given to see the GP for adequate pain relief.
2). A personalized program involved working on improving the length of the tight muscles with muscle-specific stretches and a detailed strengthening program addressing his muscle imbalance.
3). Posture re-education program to encourage normal posture in sitting at his office and in normal daily life.
4). One Pilates progressing onto a full spinal rehabilitation program which consists of strengthening exercises combined with flexibility exercises and a gym program.
5). Evidence-based advice on walking about 15 minutes a day which could then gradually increase this or gentle swimming (no backstroke).
Response to the Treatment
1). Pain score reduced from what was 8/10 to 4/10 after 4 sessions of treatment.
2). He was sleeping better, which helped him stay focused at work.
3). The movement from his spine had improved and he was walking better and longer distances.
4). He felt stronger and confident by the 3rd week after doing his pilates exercises and combining this with going swimming.
5). He was back to playing Golf within a month of starting his personalized rehabilitation program.