The Low Down on Lower Back Pain
As a chartered physiotherapist, lower back pain is the most common complaint I deal with. In fact, according to the statistics, it’s probably the most common ‘medical’ condition in the developed world, with 80 percent of people suffering back pain at some point. But why is it so common, and is there anything we can do to reduce the risk, or at least relieve the symptoms when they occur? I have a patient, who obviously has to remain anonymous, but for the ease of writing this article, I’ll call him my dad. My dad is a frighteningly healthy 70-year-old man. He wore a moustache and knew about prostate checks long before anyone thought of Movember. He eats more fruit and vegetables than anyone I know, and was once told his cholesterol levels were too low. A farmer for most of his life, he has always been active, and avoids sitting in the office as much as is legally possible. And yet, despite all of this, he has had back problems for at least 30 years. If we were to put a diagnostic label on my dad’s back problems, it would say ‘degenerative disc disease’ or possibly ‘non-specific lower back pain’. But what do those names mean, and what are the connotations of them? Degenerative disc disease refers to wear and tear of the discs of the spine. Discs are like rubber-framed jam doughnuts – a mobile but sturdy casing around a gel substance that act as a shock absorber for the spine. Over time, with repeated incorrect loading, the casing begins to crack, and the gel makes its way through the outer layers and may eventually leak out altogether. In extreme cases, this is called a ‘slipped disc’, but typically it is a gradual process resulting in a stiff, painful back. Non-specific lower back pain, as the name suggests, is due to no specific structure, but rather a bit of everything: some wearing of the discs, mild arthritis in the joints of the spine, muscle tightness or weakness, and hypersensitivity of the nerves in the area. As long as there is no significant referred pain or neurological signs, such as pins and needles, the best way to look after such problems is to keep moving. Regular, short walks are an excellent way of loosening a stiff, sore back. My dad is renowned for walking the paths around his house three or four times a day. Gentle stretches such as the ‘old man’ exercise where you put your hands on your hips and arch your back work a treat if you are stiff after sitting or driving. If you wake with a stiff back and shuffle the first few steps of the day like a 100 year old, lying on your back and rolling your knees from side to side like windscreen wipers before you get out of bed mimics the motion of walking and stretches the muscles of the lower back and hips and makes those first few steps a bit easier. Perhaps the most important thing though, is to keep doing the exercises, not just daily, but several times a day. Our spines are designed to move; keep them moving and, like a rusty hinge, they will gradually move better. If your pain is too severe for the above exercises, or you have referred pain or pins and needles, then you need to see a chartered physiotherapist or your doctor for more investigation and treatment. In most cases, a combination of a few weeks of treatment, combined with regular exercise on your behalf, will result in a significant reduction in your symptoms. If you don’t see improvement within four to six treatment sessions, or if you have neurological signs, then further investigation such as X-ray or MRI might be necessary, but is rarely needed in the first instance. Really, though the best thing for your back, is to get up and move.
Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.
This article first appeared in The Mayo News ( http://www.mayonews.ie/living/nurturing/21622-health-the-lowdown-on-lower-back-pain )