Low Back Ache (LBA)
Most of adults may experience significant low back pain sometime during their lifetime.
Low back pain usually involves muscle spasm of the supportive muscles along the spine. Also, pain, numbness and tingling in the buttocks or lower extremity can be related to the back. There are multiple causes of low back pain. Prevention of low back pain is extremely important, as symptoms can recur on more than one occasion. Common causes of LBA are:
Muscle strain: The muscles of the low back provide the strength and mobility for all activities of daily living. Strains occur when a muscle is overworked or weak.
Ligament sprain: Ligaments connect the spinal vertebrae and provide stability for the low back. They can be injured with a sudden, forceful movement or prolonged stress.
Poor posture: Poor postural alignment (such as slouching in front of the TV or sitting hunched over a desk) creates muscular fatigue, joint compression, and stresses the discs that cushion your vertebrae. Years of abuse can cause muscular imbalances such as tightness and weakness, which also cause pain.
Age. “Wear and tear” and inherited factors may cause degenerative changes in the discs (called degenerative disc disease), and joint degeneration of the facet joints of the spine (called degenerative joint disease). Normal aging causes decreased bone density, strength and elasticity of muscles and ligaments. These effects can be minimized by regular exercise, proper lifting and moving techniques, proper nutrition and body composition, and avoidance of smoking.
Disc bulge. or herniation, can cause pressure on a nerve, which can radiate pain down the leg. This generally responds well to a strengthening and stretching program and rarely requires surgery.
Other causes of low back pain include bladder/kidney infection, endometriosis, cancer, or ovarian problems
Role of Physiotherapy in the Management of LBA: Physiotherapy has a primary role in the management of and recovery from LBA. Interventions focus on pain relief and the prevention of future occurrence of pain and injury, as well return to function.
Physiotherapy management of LBA includes assessment and diagnosis, exercise prescription, education, self-management strategies, workplace intervention, manual therapy and modalities.
Physiotherapists may also triage LBA patients to ensure they receive the most appropriate treatment, conservative or surgical management. Physiotherapist-led spinal triage clinics reduce wait times to outpatient orthopedic departments, reduce the ordering of unnecessary diagnostics and enable early access to physiotherapy by directing patients to conservative management treatment options in a timely manner.