Lower back pain is one of the most disabling conditions that affect up to 80% of the population. Most of us would have experienced at least an episode of lower back pain within our lifetime. While it mostly resolves on its own without requiring medical treatment, it can sometimes turn into a persistent debilitating chronic condition.

So why is lower back pain so common?

Let’s understand the structure of your lower back. Your spine has five bones known as the lumbar vertebral bodies (L1-L5) that sit on top of the sacrum. The vertebral bodies wrap around and protect your spinal cord and nerves. Between the vertebral bodies are soft, fibrous structures known as Intervertebral disc. The discs act as a shock absorbers and assist the back with bending and twisting. Muscles attach to the bones, producing movement, and helps with stabilizing our posture. 

Each of these structures can become susceptible to injury. Due to improper posture, normal wear and tear through aging, accidents, sports injuries etc, the vertebral bones can develop arthritis, fracture, or slip on top of each other (Spondylolisthesis). Discs can tear, rupture, bulge, or weaken (prolapse disc). When this occurs, it can compress the nerves, causing severe pain. Muscles can also cause pain if strained, pulled, torn, or overworked.

Mechanical lower back pain is a common affliction which affects many of us because of poor habits (in movement and posture) places excessive stress on the spinal structures. Hence, it is important to correct these poor habits in order to reduce the pain.

How can lower back ache be reduced?

 For temporary relief: Simple Analgesics

   - Taking Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen/Aspirin or muscle relaxants can be considered if the pain is severe. Do seek advice from your pharmacist or doctor prior to taking the medications.

 For short term support: Lumbar support/brace

   - If severe pain on movements is present, consider using a lumbar support/brace

 To strengthen your muscles in the long run: Exercise

   - To prevent your trunk muscle from guarding

      1.  Lie down on your back, with your knee bent, with one hand on your chest and the other hand on your stomach.

2.  Breathe in through your nose, feel your stomach rising up into your hand. The chest should remain fairly still. Hold the breath for 5 seconds

      3.  Breathe out through your mouth, as if you are blowing out a candle.

  Gentle mobility exercises and stretches for the back and hips

     - Reduces trunk muscle guarding

     -  Normalize movement  

Lying on your back, bring one knee to your chest, until you feel a comfortable stretch in your lower back/buttocks. Hold for 15-20s seconds.

                                          Knee to Chest Stretch↑             

       Lying on your back, bend both knees and roll the knees to the side until you feel a comfortable stretch. Roll the knees to the other side and repeat 10 times.

                                           Lumbar Rolls  ↑
                                                       

Some tips to follow:

   Avoid prolonged static positions

    -   Alternate between standing, walking, sitting every 3mins within pain tolerance

   Aerobic exercises (swimming, walking, cycling etc)

   -   Aim for 20-30mins of aerobic activities if it does not exacerbate the pain.

   Do seek medical attention if you have these symptoms:

- Unexplained weight loss

- Severe abdominal pain

- Sudden leg weakness

- Chronic back pain with fever and chills

- Severe pain waking you up from sleep

If your lower back pain persists, physiotherapy treatment consisting of manual therapy (soft tissue release, joint mobilizations) and a combination of exercise therapy can help. 

Article Courtesy of Tay Kai Ling, Physiotherapist

Movinglives Physiotherapy