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Back pain, whether it is located in the mid or lower part of the back, is a very common complaint in populations across the world. Approximately 3.7 million Australians suffer or have suffered with back problems. Statistically approx. 60 – 90% of the population will have experienced back pain at some point in their life.
Often the back pain is short lived, and it settles itself without treatment but what we know as Chiropractors and Physiotherapists is that the chances of it developing into a chronic problem are considerably high, especially if you have a long episode (longer than 3 weeks) or if you have had more than one episode in your lifetime.
Aside from the rare, sinister causes of back pain, the two most common causes to your pain are related to either the disc or the lumbar facet. The pelvic joints (SIJ, Sacrum and pubic symphysis) can also be very similar to lumbar pain, and this is something that Chiropractors and Physiotherapists are highly skilled in assessing, identifying/diagnosing and treating.
Approximately 31% of back pain presentations are related to the lumbar facet joints alone. These joints can become dysfunctional in their movement due to repetitive rotation and bending backwards, eventually this loss of motion causes the joints to degenerate and the discs themselves to lose their viscosity and they also begin to degenerate.
Some discs will bulge or herniate and compress on the sciatic nerve causes pain down the leg. In severe cases there is also sensation loss and weakness in one leg, depending on which side the bulge has compressed.
Not all back-pain presentations correlate with an MRI scan, and we are learning that actually sending patients for scans early in their back pain can worsen their prognosis. Therefore the current recommendation (Choosing Wisely) for new onset back pain is to undergo conservative care for 4 weeks before sending patients for an MRI of their back.
An interesting study on healthy individuals, who had no complaints of low back pain demonstrated: ‘Imaging findings are weakly related to symptoms. In one cross sectional study of asymptomatic persons aged 60 years or older, 36% had a herniated disc, 21% had spinal stenosis and more than 90% had a degenerated, bulging disc’. This is pivotal in a person’s recovery from their back pain and surgeons are now being so much more conservative based on this evidence as this means that even though your scan may demonstrate a disc bulge, it is not necessarily the cause of your low back pain.
Our Physiotherapists and Chiropractors are trained in the orthopaedic assessment of your low back pain. They will assess your range of motion along with orthopaedic testing to work out a diagnosis. Sometimes you may also be referred for further imaging of your shoulder by our allied health team, such as an MRI or Xray to rule out any underlying pathology or injury.
If you would like to discuss your low back complaint but not sure who to book in with, why not book our FREE health discussion with one of our allied health practitioners.
1. Adams, M. and P. Roughley (2006).“What is intervertebral disc degeneration, and what causes it?” Spine 31(18): 2151-2161
2. http://www.aihw.gov.au/back-problems/what-are-back-problems/
