Help, have I slipped a disc?
Hands up how many of you have suffered from low back pain? Almost everybody will experience low back pain at some point in their lives (similar to a common cold). For some people, it can become a recurrent problem where it follows a pattern of coming and going. Low back pain is rarely a serious cause for concern so try not to panic.
What causes Lower Back Pain?
As physiotherapists, we have undergone training to be able to question and recognise when your symptoms may suggest a more serious condition. But remember this accounts for a small percentage of low back pain sufferers. As I explain to my clients the spine is a strong, robust structure designed for movement. It is not made out of glass and it is unlikely you will “damage” it by following some of our tips for recovery.
One of the main questions we get asked is “what causes low back pain?” It is often difficult to pinpoint an exact structure due to the number of joints, ligaments and muscles in the back which can often all become sore initially. We know that discs do not “slip” and bones or joints do not move out of place. The discs sit between the vertebra in the spine and are firmly attached. Discs and joints cannot be put back into place with any sort of treatment.
As we age (and I am also the wrong side of 40!) our skin becomes wrinkly and our hair turns grey. It is normal for these changes to occur inside our body too and this can result in disc bulges and degenerative changes (like internal wrinkles!). These changes can be seen on 80% of people over the age of 50. However, only a small percentage of these people may have symptoms. After all, we do not see everyone over a certain age walking about with low back pain!
A number of clients ask us about the need for an x-ray or MRI scan. Rarely are these indicated or helpful. The majority will probably show us some age-related changes but that doesn’t mean they are responsible for your pain. A bit like trying to fit a round peg in a square hole they can often give you a misdiagnosis and cause you anxiety. Surgery is rarely indicated for low back pain and an x-ray or scan is not necessarily going to change the treatment you are undergoing.
Treatment For Lower Back Pain
So rather than focusing on the exact cause of low back pain and exploring quick fixes (gadgets and devices that sound too good to be true probably are!) trying to figure out what triggers your low back pain and how to manage it is far more useful. Try to think of treating or managing low back pain as like having a first aid kit. Rather than being a bag full of plasters and bandages, it is a physiotherapy tool kit consisting of advice to:
- Remaining active and avoiding bed rest
Years ago you may have been unlucky enough to have been given the advice of spending 6 weeks in bed sleeping on a piece of wood! Although previously popular we now know that this approach is unhelpful and can prolong the pain, disability, and recovery. If you have ever broken a bone and had it in a cast you may remember how your arm or leg felt when it was first removed? Stiff, sore and weak. However by keeping your limb moving and gently doing more (in the same way as you can do with your back) the pain will settle. Pain and muscle spasm is a normal part of experiencing low back pain and pain is not always damaging. A bit like limping for a few days after a sprained ankle.
- Returning to your usual activities
It is normal when you have low back pain to feel anxious about returning to your normal leisure and daily activities. However, in order to aid recovery, it is important to do so – even if your jobs involve bending. Remember our backs are designed to bend and twist and are safe activities to do (even if sore initially).
Do not wrap your back in cotton wool and avoid activities – try and imagine a new runner training for a marathon. They wouldn’t just pop on a brand new pair of trainers and run 26 miles! They would start with a sensible training programme to increase their mileage gradually and allow their body to adapt. The same way you can help with low back pain by setting small realistic, and importantly, achievable goals.
- Exercise helps to reduce pain and prevent future episodes.
We know that exercise is safe and very good for low back pain. Choose the one that you enjoy and know that you will stick to – Pilates, swimming, running, walking (free and plentiful!) or cycling. Some new activities may feel sore when you first start them, but that’s normal as your back gets stronger and healthier. (contrary to some popular beliefs running will not wear your back out!).
- Stay at work or go back to work as quickly as you can.
It has been shown that the longer people with low back pain are off working the harder it is for them to go back and can delay recovery. We would encourage our clients to stay at work as so far as possible – even if that means modifying your routine initially. Backs like movement so break up prolonged periods of sitting with activities like trips to the photocopier or taking the stairs instead of the lift.
- Look after yourself
Back pain is always real and not imagined but these days we know that other non-physical factors can play a part in triggering or prolonging your symptoms. These can include feeling tired or having poor sleeping patterns, being overweight, smoking, worrying about not getting better, depression and stressful events can all contribute to pain. Our bodies are not like car engines – our feelings and emotions play a huge (and very real) part of how we perceive pain. No two people have the same experience of low back pain and considering some of these triggers may help you to manage your low back pain and reduce the risk of further episodes.
As physiotherapists, we offer a range of treatment options in combination with exercise and advice to help you manage an episode of low back pain. Some of our exercises are featured in our download section. For further advice or to book an appointment with one of our Barnsley physiotherapists call us on (01226) 282560 or book online via the link on the home page.