Lower Back Pain – what is lower back pain and the likely causes?
By Carin Penberthy, Physiotherapist
The lower back is a complex structure made up of interconnecting bones, discs, joints,nerves, ligaments, discs and muscles working together to provide a base of support for the body. This complex structure is susceptible to injury and pain and needs to be stable, flexible and strong.
Lower back pain (lumbar pain) may present in a number of ways depending on the underlying cause. Symptoms of the pain may include a dull ache, shooting or piercing pain, or a burning sensation. Pain may be localised in the back or radiate into the buttock, groin, legs or feet. The individual may also experience pins and needles, numbness or paraesthesia in the buttock, legs or feet. The pain may also worsen by certain postures such as prolonged sitting or prolonged standing, or when moving such as walking, or from sit to stand.
Lower back pain is often categorised by type of onset and duration. Episodes of back pain may be classified as acute (0-6 weeks), subacute (6-12weeks), and if pain persists for more than 12 weeks is considered chronic.
Types of low back pain commonly classified into:
- Mechanical back pain is primarily from muscles, ligaments, joints (facet joints) and is often associated with pain localised in the lower back, buttocks and groin.
- Radicular pain (sciatica) involves nerve tissue that is either impinged or inflamed. This pain will often radiate into the buttock or down the leg. This pain is often described as a burning sensation, shooting pain and can be also be associated with pins and needles/numbness and sometime weakness in the leg.
Pain can also be classified as traumatic or sustained overload injuries. Traumatic may be when a person bends awkwardly to lift a heavy load, that tears or damages structures, or sustained overload injuries are more related to positional stress or postural fatigue that overloads the back structures over an extended period of time causing injury, dysfunction and resulting in lower back pain
The source of lower back pain is commonly:
- Muscle – muscle tissue pain may be a result of muscle strains, muscle spasm, and muscle imbalances
- Ligament sprains
- Joint pain is often a result of facet joint irritation, stiffness or dysfunction.
- Bulging discs, herniated discs or degenerate disc disease can all contribute commonly to radicular pain where nerve tissue is irritated or impinged. Discogenic pain can also cause muscle spasm and associated facet joint irritation.
Other sources of lower back pain may include lumbar spinal stenosis, osteoarthritis, infection, tumours, deformity/fractures, osteoporosis, inflammatory conditions such as ankylosing spondylitis or rheumatoid arthritis. Lower back pain may also be a secondary pain related to medical conditions in organs of the body such as kidney or pancreas.
Consulting with a Physiotherapist for a professional assessment and diagnosis, followed by early intervention, is the best way to recover from lower back pain. At Wisdom Physiotherapy Nedlands we treat the cause of your pain and also help to prevent recurrent episodes.