What Causes Lower Back Pain?

Introduction

Lower back pain is a widespread issue in Australia, stemming from diverse conditions. As physiotherapists, we often encounter various causes of this pain. This guide aims to shed light on these causes and provide valuable insights for effective management.

Muscle-Related Injuries

Muscle injuries are a predominant cause of lower back pain, including:

• Back Cramps and Muscle Pain: Typically resulting from overuse or strain.
• Core Stability Deficiency: Weak core muscles can lead to increased back strain.
• DOMS (Delayed Onset Muscle Soreness): Soreness affecting back muscles post-exercise.

Recent research underscores the importance of regular exercise and core strengthening in preventing these injuries.

Bone-Related Injuries

Bone health is crucial in lower back pain, encompassing conditions like:

• Spondylosis: Degenerative spine conditions.
• Spondylolysis or Stress Fracture: Common in athletes, such as cricket bowlers.
• Spondylolisthesis: Occurs when a vertebra slips over another.
• Osteoporosis: Causes bones to weaken, increasing fracture risk. Advancements in bone density scanning have improved early detection and management.
• Scheuermann’s Disease: Affects spinal bone growth in teenagers.
• Scoliosis: An abnormal curvature of the spine causing pain.
• Spinal Stenosis: A narrowing of the spinal canal leading to nerve compression.

Disc-Related Injuries

Spinal discs are vital for spinal health:

• Bulging and Disc Protrusions: These discs protrude  or "slip" and can press on nerves.
• Herniated Disc: A more severe form of disc protrusion.
• Degenerative Disc Disease: Age-related disc wear and tear.

Minimally invasive surgical techniques have transformed the treatment of severe disc-related injuries where physiotherapy and other non-operative options fail to improve.

Back Joint Injuries

• Facet Joint Pain: Arises from arthritis or stress on these spinal joints.

Nerve-Related Injuries

Nerve issues can lead to:

• Nerve Pain and Pinched Nerves: Caused by spinal nerve compression from disc bulging or arthritic changes.
• Sciatica: Irritation of the sciatic nerve.

Physiotherapy and newer medications have been effective in managing these conditions. Some will require injection therapies or surgery.

Pelvis-Related Injuries

Pelvic issues also contribute to lower back pain:

• Sacroiliac Joint Pain: Involving joints connecting the spine to the pelvis.
• Piriformis Syndrome: Where the piriformis muscle irritates the sciatic nerve.

Pregnancy-Related Pain

• Pregnancy Back Pain: Often due to increased back strain during pregnancy. Prenatal physiotherapy programs are beneficial.

Systemic Diseases

Systemic diseases like Ankylosing Spondylitis, Fibromyalgia and Rheumatoid Arthritis can cause back pain.

Recent Research and Advancements

Current research emphasises a holistic approach to treating lower back pain. Techniques like yoga and Pilates, alongside traditional physiotherapy, and conservatively progressed gym programs show significant relief. The role of diet in managing weight and  inflammation is increasingly recognised.

Best Treatments for Lower Back Pain

Treatment varies but often includes:

• Physiotherapy
• Pain management
• Strength and flexibility exercise programs
• Ergonomic adjustments
• Surgical interventions for severe cases

Conclusion

Lower back pain is a significant health concern in Australia. Understanding its causes and seeking professional physiotherapy advice can greatly improve life quality. Remember, early intervention is key for an effective recovery.

What to Do?

If you're experiencing lower back pain, it's vital to consult a physiotherapist or doctor. They can provide an assessment and customised treatment plan based on your specific condition.