Managing back pain, what’s the good news?

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By Editor

 

Back pain is something many of us will experience at some stage during our lives and the most common reason for seeking physiotherapy management. 

 

In this article we explore the reasons behind back pain with physiotherapist Nutnarinee Lerdsatittroong, better known as Khun Prahn.  She’s the founder of Hua Hin’s ‘The Movement Clinic’, offering a range of services all about improving mobility, and that often means managing back pain. 

 

 

Your spine is made up of separate bones called vertebrae which are connected together by a series of ligaments and soft tissue. The lower part of your spine is joined to the sacrum which is part of your pelvis.

 

The curves, shapes and various sizes of the vertebrae (along with the discs found in between them), help to evenly distribute the weight of your body on the spine and create the flexibility necessary to bend or rotate your back.

 

A complex group of muscles are attached to the spine which allows you to move your back.  There are also postural muscles which help to maintain the shape and curves of your spine, keeping them in the correct position, as well as help to keep you upright.

 

 

The spinal cord passes through the centre of each vertebra.  The cord ends in your lower back where it becomes a series of strands called the “cauda equina” (horses tail).  Either side of each vertebra are spinal nerve exits from the spinal cord which pass sensory and motor signals between your brain and a certain part of your body which the nerve innervates.

 

Khun Prahn says the most common cause of back pain, especially lower back pain, is a combination of poor posture, including when lifting heavy objects, and lack of movement, typically seen with people who sit for long periods.  

 

This is known as mechanical back pain and is not a serious condition.  However, it can be uncomfortable and frustrating to experience a constant ache or pain in your back.

 

Physiotherapy is ideal for treating mechanical back pain. Along with advice on correcting your posture, appropriate exercises and self-treatment techniques, your back pain should quickly be resolved.

 

When you first start to develop postural back pain, it often manifests itself as a low-grade ache normally combined with stiffness in your lower back.  Symptoms tend to be relieved with light exercise or by avoiding long periods of sitting, for example not so much computer time.  But if symptoms are ignored, the pain will become constant, just varying in degrees. The level of stiffness may also increase as well as your golf handicap!

 

 

Poor posture is often the result of weak or imbalanced core muscles which help maintain the spine in the correct position – like guidelines of a tent.  When these muscles are weak it is very difficult to keep your spine in the correct or neutral position, especially when sitting for long periods.

 

Eventually, the soft tissue structures around the spine become overloaded, initially manifesting as a dull ache across your lower back, but if the overload is not reduced, eventually pain and stiffness will develop.

 

 

Other muscles may also be contributing to developing poor posture and back pain. For example, your main leg muscles (hamstrings and quadriceps) can become tight from inactivity, sitting or driving for long periods.  As a result, the increased tension from either of these muscles can pull your pelvis out of position and increase the tension on your lower back.  Then further sitting will exacerbate the overload to your lower back, resulting in pain.

 

Lower back pain which develops from running is normally due to poor running technique.  Your back pain when running may also be caused by poor posture due to weak core muscles.  This is where carrying out a proper warm-up prior to running is essential.

 

The cause of lower back pain whilst road cycling and mountain biking is generally caused by an incorrect bike position set-up.  For example, the saddle to handlebar distance is too short or too long.  The end result is the same, and back pain and stiffness may develop.

 

However, there are more complex causes of back pain, with symptoms related to conditions other than poor posture. 

 

For example, disc prolapse, joint impingement, spondylitis, osteoporosis, arthritis or fractures all require a more detailed assessment.  

 

Some symptoms need to be properly assessed to diagnose the cause of your back pain and provide appropriate treatment, management and advice, especially the following:

 

Pins and needles or numbness in the buttocks, lower limbs or feet

Pain going down the back or front of your leg

More severe back pain, especially when bending forward

Excessive levels of stiffness in your lower back

Unsteadiness when standing or walking

Difficulties passing or controlling bladder or bowels or numbness in either area

If you have a previous history of cancer or osteoporosis

Back pain accompanied by unexplained weight loss or fever

 

Back pain affects primarily the lower back and the good news is, that in most cases, the cause of pain is not serious and can be resolved.

 

Source: https://royalcoastreview.com/2022/05/managing-back-pain-whats-the-good-news/

 

-- © Copyright Royal Coast Review 2022-05-27

 

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