LOW BACK PAIN
How serious is my back pain?
About 85% of adults experience low back pain at some time in their lives. It is the most common cause of job-related disability and a leading contributor to missed work days. However, only around 10% of people with low back pain have a specific diagnosis. In most of cases, there is no specific disease or spinal abnormality that can be attributed to the pain, we call this non-specific low back pain.
Do I need to know what’s causing my pain?
Research actually suggests it is not always possible or necessary to identify the specific tissue source of pain for effective management non-specific back pain. Over 90% of back pain is mechanical in nature, meaning that there is simply a disruption in the way the components of the back (the spine, muscles, intervertebral discs and nerves) fit together and move.
But why does this cause pain?
It is important to remember that pain does not always equal damage. In the case of back pain, the structures of the spine are sensitised, causing increased pain. Imagine stubbing your toe on the wall, our first reaction is ouch and then a bruise develops. This bruise can become very sensitive and quite sore to touch. We know touching the bruise is not causing further damage, but it is causing increased pain. Why? Increased sensitivity causes protective responses by the body, which increases pain. Following this sensitisation, it is easier for your pain to increase with various activities due to changes in the brain. Even expecting pain may increase pain.
So when should I see my doctor?
Most low back pain is acute, or short term, and lasts only a few days or weeks. The most important thing to remember is to keep moving. Strong evidence shows that people who continue their normal activities following onset of low back pain have better outcomes than those who rested in bed for a week.
However, you should consult your doctor after a week if your pain has not improved, or if your pain:
Is constant or intense, especially at night or when you lie down
Spreads down one or both legs, especially if the pain extends below your knee
Causes weakness, numbness or tingling in one or both legs
Occurs with unintended weight loss
Occurs with swelling or redness on your back
Should I be taking pain medication?
Painkillers are not recommended as a stand alone treatment for back pain, and are only recommended in addition to active treatments such as exercise and movement to relieve severe pain or to help you start moving more again. The most common medications prescribed are anti-inflammatories, or if other medications don’t work or you’re unable to take anti-inflammatories, you may be prescribed stronger painkillers known as opioids. It is important to remember that anti-inflammatories shouldn't be taken over a long period of time due to the associated health risks, such as stomach irritation, ulcers, heartburn, diarrhoea and flu retention. Opioids can also have negative side effects such as constipation, nausea, dizziness and tiredness, affecting your ability to drive vehicles. Opioids should be used with care as dependence can also occur with long term use.
For many years, the advice given to people with back pain was bed rest. However, current evidence shows that bed rest may actually delay recovery further. Prolonged periods of rest increase stiffness which can actually increase pain. Studies suggest that bed rest alone may make back pain worse and can also lead to secondary complications such as depression, decreased muscle tone, and blood clots in the legs.
The most effective way to control your pain is by staying active and moderating your activities. Exercise and movement helps to reduce stiffness, which in turn helps to prevent further injury and pain by stretching and strengthening the muscles that work to support the back.
If you have any further questions, you are more than welcome to come and see us. We will
be able to conduct a full assessment, and prescribe an
individually tailored exercise program specifically targeting your needs.
Give us a call on 9875 3760
NINDS Low Back Pain Fact Sheet. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet.