If you have ever suffered from low back pain, you know it can be crippling. What starts as a small twist in the lower back may develop into excruciating back pain and muscle spasms. There are a number of different causes of your lower back pain, or lumbago.
When you visit Shefford Osteopathic Clinic with low back pain, we will give you a thorough examination, find the cause of your back pain, develop your treatment plan and start your treatment. Our aim is to get you quickly returned to your regular activities, with decreased pain and better function.
What is Lumbago / Lower Back Pain?
Low back pain may also be know as Lumbago, and the two terms are often used interchangeably.
Low back pain is one of the most common complaints that GPs are presented with today. It is estimated that up to 85% of the population will suffer from low back pain at some stage in their lives. Although the vast majority make a full recovery over a three-month period, nearly 50% will have at least one recurring episode.
The underlying causes of low back pain can be complex and are not always readily apparent. There are a few things to consider:
The type of low back pain – meaning a description of how the pain feels, what makes it better or worse, when it occurs – and the area of pain distribution – meaning where the pain is felt, if it is confined to the low back, or if the accompanying leg pain is worse than the low back pain, or if the pain radiates elsewhere in the body.
Acute lower back pain is defined as pain that has a rapid onset and lasts for less than three months.
Chronic lower back pain is defined as persistent back pain that lasts for more than three months.
The pain does not always reflect the extent of damage – meaning the severity of pain from low back problems is often unrelated to the extent of physical damage present. For example, a simple pulled muscle in the low back can cause excruciating pain that can limit one’s ability to walk or even stand, whereas a large herniated disc can be completely painless.
The diagnosis is often difficult – meaning there are many anatomical structures in the low back that can cause severe lower back pain and/or pain that radiates into the legs and/or feet. These include:
- Soft tissues, such as muscles, ligaments and tendons
- Bones, which provide the structural building blocks of the spinal column
- Facet joints, which allow the spine to move
- Discs (the outer rim of the disc, the annulus, can be a source of significant low back pain due to its rich nerve supply and tendency towards getting damaged)
- Nerves, which branch out from the spinal cord in the low back and innervate the legs and feet
Finally, it is important to note that – unlike many other medical conditions – different people experience low back pain in different ways. For example, two people can have the exact same condition, but for one it is incapacitating and for the other it is a mere nuisance. In fact, for most people a spinal abnormality (such as a degenerated disc that can be seen on an MRI scan) is painless. In addition, other factors – psychological, emotional, and financial – often contribute to and influence a person’s experience of low back pain.
Symptoms of Lower Back Pain
There are many different symptoms of low back pain from, the types of pain, where you experience pain and what it prevents you from doing. You may have one or some of the following:
- Pain in the lower part of your back, ranging from mild to excruciating
- Numbness in the low back and/or leg and foot
- Muscle tightness or stiffness
- Decreased mobility in one or more directions
- Pain radiating down one or both legs
- Tingling sensation in your back or legs
- Pain when standing or bending
- Pain after activity, sudden movement or lifting a heavy object
- Difficulty moving preventing walking or standing
- Pain that moves around into the groin, buttock or upper thigh
- Pain that is achy and dull
- Local soreness upon touch
- Interrupted sleep as it is painful when turning over
- Pain that is most pronounced first thing in the morning and again toward the end of the day
- Pain aggravated by coughing
Some symptoms can be medical emergencies, and you should contact your GP immediately if you have these symptoms as well as low back pain:
- Loss of bladder or bowel control
- Leg weakness that gets worse
- Fever above 101 degrees Fahrenheit (38.3 Celsius), especially after surgery
- Unusual weight loss
- Severe stomach pain
Causes of Lower Back Pain
Your spine is made up of 24 bones called vertebrae – 7 neck, 12 thorax and 5 lumbar. Each vertebra has a central large hole for the spinal cord. There are spaces for nerves to enter and exit the spinal column. In addition, vertebrae have places where tendons can connect muscles. These muscles help hold your spinal column upright. There are cartilage disks in between the vertebrae.They protect the bones and absorb shock. Problems with any of these structures can cause you to have pain, stiffness, muscle spasms, swelling, inflammation and numbness.
There are many different reasons for back pain, and if prevention and treatment is to be as effective as possible, it is important to have a good understanding of the cause. As well as those episodes when an obvious injury is the cause, some back pain can seem to occur for no reason or as the result of a very minor strain. Back pain in general can often be traced to an accident or trauma, even one that occurred many years previously.
As low back pain is a generic term, it is impossible to name one cause of pain. Often the pain can be the result of several, related factors. However, below are examples of lifestyle factors that can cause low back pain
- bending incorrectly
- lifting, carrying, pushing or pulling incorrectly
- slouching and bad posture
- extended periods of standing or bending down
- driving in a hunched position
- driving for long periods without taking a break
- overuse of the muscles, usually due to sport or repetitive movements (repetitive strain injury)
- women who have given birth more than once
- physical workers whose occupation involves excessive bending, twisting and hard physical labour
- prolonged periods of sitting, such as drivers or office-based workers
You may also suffer back pain due to:
Accumulation of stresses in the body Back pain does not always arise immediately after an injury because the body is very good at adapting to injuries and accommodating strains and stresses. However, the disruption to spinal mechanics brought about by injury can cause strain to build up over a period of time and symptoms begin, often insidiously. Episodes of pain may be triggered by events such as physical exertion, emotional stress or illness. Sometimes a minor strain may give more pain and take longer to heal than expected. This may be because the body has reached the limits of its ability to cope with the combined effects of past injuries and any new demand is ‘the final straw’.
In treatment it is often necessary to release retained stresses from past injuries and trauma in order to relieve the current back pain and reduce the chances of it recurring. Stresses within the body often cause problems in other areas as well as the back. Tension within the back can affect the shoulders and the pelvis, and upset the normal functioning of the arms, elbows, hips, knees and ankles. For example, “sciatica” is not a condition but a description of symptoms, which can have a number of different causes. Some of these are directly related to tensions within the back and pelvis.
Occupational strain Habitual bad posture such as poor seating at computers, can place strain on areas of the spine and lead to back pain. The seating position should be improved, as well as using osteopathic treatment to release ingrained spinal stresses. Karen is a trained Display Screen Equipment and ergonomic assessor and can work with you ensuring your workstation is set up correctly.
Lifting strains Lifting heavy or awkward weights including babies, children and shopping, can cause back strain, especially if not done correctly. If the spine is already under stress from another cause, it may only take lifting a small weight to cause strain, usually at the weakest point in the spine.
Car accidents, whiplash. In any car accident, even at relatively low speed, the body is subjected to sudden deceleration forces and can be thrown around violently in many different directions. Osteopaths are often able to feel the effects of these stresses locked into the body tissues as tensions. The whole body can be affected, not just the neck, and unless these strains are treated, they can be present for life.
Osteopaths commonly find the following after car accidents:
- Neck: Overstrain of the neck muscles and ligaments. This often causes persistent neck pain and headaches.
- Low Back: The sacrum or the tail bone at the base of the spine often becomes wedged down into the pelvis, leaving it rigid and immobile. This is one of the most important effects to release in the treatment of any whiplash, because it can disturb the function of the whole spine.
- Rib Cage: Twisting and compression through the rib cage from the seat belt restraint. This can leave pain in the ribs, shoulder and sternum (breastbone).
Falls. The spine is often jerked or twisted during falls and parts can become quite impacted or compressed. Sit-down falls such as falling on ice or a slippery surface are particularly damaging because in addition to the direct impact on the base of the spine, the impact of the head onto the top of the spine can cause strain at the top of the neck. Headaches and neck problems are very common after this type of injury.
Direct injury. Any direct injury, for example kicks or blows to the spine, can create a local area of disruption of normal spinal mechanics. Problems may gradually develop over a period of time, even if the back seemed uninjured at the time.
Blows to the head. Blows to the head can disrupt the normal minute flexibility of the bones of the skull, a situation that has far reaching effects on the whole of the rest of the body. Posture can also be modified by blows to the head as the spine adapts to the injury.
Childbirth strains. During childbirth the mother’s pelvis can become distorted as the baby’s head descends. In many cases the distortion corrects itself, but if severe it can remain for many years and disrupt spinal and pelvic mechanics. This can cause very diverse symptoms including backache, constipation, stress incontinence, headaches, disruption of periods when they start again and even postnatal depression.
Some medical causes of back pain are:
A back muscle strain or ligament strain is one of the most common causes of acute lower back pain. Lifting a heavy object, twisting or a sudden movement can cause muscles or ligaments to stretch or develop microscopic tears. With a lower back strain, the severity of the pain ranges from mild discomfort to severe, disabling pain depending on the extent of strain and the lower back muscle spasms that result from the injury.
Osteoarthritis – causing the bones to change shape, leading to abnormal function
Herniated or bulging disk pressing on the spinal cord or nerves
Abnormal curvature of the spine, such as scoliosis
Spinal stenosis or narrowing of the holes in the vertebra which compress your nerves
Pinched nerves leading to numbness, tingling, pain and sciatica symptoms
Facet joint impingement where a surface of your vertebra presses on your nerve
Other causes of low back pain are very rare but quite serious. These conditions may include fractures, cancer or ankylosing spondylitis.
How will osteopathy help?
Back pain is very common, and can be severe and debilitating either in acute episodes, or as chronic pain suffered over a long period of time that is both uncomfortable and fatiguing. Here at Shefford Osteopathic Clinic we spend much of our time assessing, treating and managing low back pain due to its high incidence.
When you see us for your low back pain, we will do a number of things to diagnose and treat you. We will ask you a lot of questions about your general and back health, medications, supplements, and lifestyle. If you have had any previous X-rays or MRI studies, we will evaluate those too.
We will then examine you (so please wear appropriate clothing so that we can see your low back) and work out what is and what is not working correctly. Once we understand what is happening in your body, we will tell you what we think and then treat. We use gentle hands-on techniques to stretch muscles, rebalance your body mechanics, improve back mobility, reduce spasms, and decrease inflammation.
Many people find at least some relief after their first visit with us. For short term pain, you may only need two or three visits to us. However, if you have long term chronic pain or degenerative conditions, you may need a course of treatments to address the problem.
We may show you exercises to do at home to strengthen your back and abdomen muscles to help reduce pain, and stretches to increase your flexibility.
If you need anti-inflammatory or pain medications, we’ll refer you to your GP for a prescription.
Manual therapy has been recognised by The National Institute for Health and Care Excellence (NICE) and the NHS as an effective treatment for low back pain. NICE recommends “Consider manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) for managing low back pain with or without sciatica, but only as part of a treatment package including exercise, with or without psychological therapy.”.
The report can be found here:
At Shefford Osteopathic Clinic, we are trained to diagnose your low back pain and provide you with a complete treatment plan to help you feel better and return to your normal activities. Don’t forget: a healthy low back can be maintained with a combination of exercise, postural advice and being aware of individual limitations.
What to do now ……
If you’ve come to this website looking for help, then don’t in silence suffer any longer.
Contact us immediately on 01462 811006 for a consultation and let’s assess your condition.
At the assessment, we’ll take some details from you and build your case history. We’ll discuss why you’ve come to see us and where you have any aches and pains. Then we’ll examine you with the aim of giving you the appropriate treatment.
This will take a little while to complete, but it’s a necessary part of the ethical guidelines we work to. The guidelines are there to make sure everything is done professionally and to a high standard of patient care. I’m sure you agree that’s a good thing!
If you have any questions about what we do and how we do it, call us on 01462 811006 or use the contact form below – and we’ll be happy to help.