Common Ailments

Back > Mechanical Low Back Pain

 

Back pain is very common.  Almost half the adult population of the UK (49%) will experience back pain lasting for at least 24hours at some time during the year, and an estimated 4 out of 5 adults (80%) experiencing back pain at some stage in their life.  Back pain peaks in adults of 35-55 years of age.  Reassuringly, most cases of back pain are nothing serious and will recover spontaneously.

The most common form of non-specific back pain is sometimes referred to as ‘simple’ back pain, the term simple does not reflect the pain felt by the patient.  The severity of the pain can range from mild to severe.

To understand how to manage you back pain, it is of benefit to understand the anatomy.

When correctly aligned the back has 3 curves; these curves help to distribute the pressure evenly throughout the vertebrae and discs.

 

 

It curves forwards (lordosis) at your neck (cervical)

 

 

It curves backwards (kyphosis) in the mid region (thoracic)

 

 

It curves forward again in the lower back (lumbar)

 

 

 

 

The discs, which are located between the vertebrae, act as shock absorbers.  The discs are made up of a soft jelly like substance (the nucleus) which is held inside a tough, elastic and fibrous outer casing (the annulus).

Besides the boney structure, there are numerous ligaments which attach the vertebrae together.  Overlaying the bones and ligaments are muscles that help to stabilise and move your back.

In most cases it is very difficult to identify a single cause of back pain.  However, the following factors could contribute to back pain;

 

 

  • Sustained poor posture (as shown in the daigram)
  • Previous history of back pain
  • Frequent bending, twisting and lifting, pushing and pulling, repetitive work, static postures and vibrations
  • Heavy physical work involving
  • Direct fall or injury
  • Smoking
  • Obesity
  • Psychosocial factors such as stress, anxiety, depression, job satisfaction and mental stress

and ...

  • Sometimes it can develop for no apparent reason

  • Back pain is usually located in the lower area of the back; it can be either unilateral of spread across the lower lumbar area
  • The pain can spread to one or both buttocks or thighs
  • The pain is usually eased by lying flat and is often made worse if you move your back, cough or sneeze
  • The pain will often improve quickly, usually within a week or so
  • It is not uncommon to have further bouts of pain (recurrences) from time to time in the future

In Summary, non-specific lower back pain is ‘mechanical’ in the sense that it varies with posture or activity.

  •  Identifying the bad habits  that you may have developed and addressing these e.g. poor moving and handling techniques or poor working posture
  • Stay Active.  It is important to keep moving and avoid bed rest from the initial onset of back pain. 
  • Pain control is important to ensure that you continue to stay active and can carry on with daily activities.  Medication in the form of pain killers and anti-inflammatories are the most common form of pain control used: other forms include TENs, heat or ice.

Physiotherapy in the form of;

  • Structured Exercise Program - our resource section has a sheet of basic active range of movement exercises for the back which may be appropriate for you to ensure that your back stays active and importantly your back symptoms stay under control.  Additionally, patients who develop recurrent mechanical back pain are often weak in their core strength and this will need addressing
  • Manual Therapy, including Manipulation
  • Soft Tissue mobilisations
  • Acupuncture
  • Education for prevention of future episodes