Lower Back Pain

Low back pain is a common complaint that patients suffer from at some point throughout their lives. A survey conducted by the American Physical Therapy Association (APTA) found that 61% of Americans experience low back pain however; only 4 out of 10 pursue treatment. Whether the pain is aching or more severe, short or long lasting – low back pain can alter the way you carry out day-to-day activities. There are multiple causes of low back pain and these causes can differ slightly for each patient.

 

 

 

 

 

 

 

Causes

  • Aging: The natural aging process can contribute to different degenerative changes in your spine. These changes may include decreased space between your vertebrae leading to possible pain in the future. Changes in your spine can begin at age 30 or less and can be more prevalent if high-intensity activities are performed.  Aging alone is not a negative factor for the health of your lower back however it can contribute to the various pathologies listed below.
     
  • Muscle Strain or Ligamentous Sprain: Muscle soreness from over-activity is a common cause of low back pain. Muscle and ligament damage can occur from lifting, bending or various activities. These injuries can vary from small tears to larger more painful tears that can last an extended period of time. This type of pain usually resolves within a few days. Trauma can also be associated with these pathologies. These can include motor vehicle accidents or falls. After ruling out fracture via x-ray, muscular or ligamentous issues can be associated with these traumatic experiences.

  • Disc Herniation: This type of back pain does not resolve within days. Disc herniation can occur which you may have heard of as a “slipped disc”. This injury may occur as a result of lifting, pulling, bending or twisting. It can even take place without specific injury. This process occurs when the disc is degenerated to the point where the inside nucleus pushes through the outer annular covering putting pressure on the ligaments, spinal cord or nerves causing pain. This type of injury can also lead to burning or tingling in you buttock and leg region. This pain usually is the most painful in the morning and may improve somewhat throughout the day.

  • Degenerative Disc Disease (DDD: DDD is a common cause of back pain that occurs because of age. The discs in your spine begin to wear away and shrink down. Due to the fact that intervertebral discs act as shock absorbers between the bones in your spine, the lack of shock absorption can lead to back pain. This pain can also travel into your buttocks and upper thighs if it causes compression on the nerve or spinal cord. In severe cases this can cause bone on bone contact leading to both pain and stiffness. The aforementioned symptoms can worsen with bending or twisting movements that originate in your lower back region.

  • Spondylolisthesis: This occurs when the bones in your spine do not line up correctly. There are multiples types of spondylolisthesis including, congenital, isthmic and degenerative. Congenital spondylolisthesis is associated with abnormal bone formation causing an increased risk of slipping. Isthmic spondylolisthesis is a condition that leads to small fractures in the vertebrae leading to slipping of a vertebral segment. Lastly, degenerative spondylolisthesis is known as the most common form that is associated with aging of the discs leading to movement of the vertebrae. There is also a genetic component associated with spondylolisthesis. Oftentimes this condition is not diagnosed until back pain develops. This can cause spinal instability in which the bones move more than they should and can compress nerves or spinal cord causing pain. From a physical therapy standpoint, this condition is oftentimes treated with stabilization exercises on the trunk to strengthen the abdominal musculature.

  • Spinal Stenosis: This takes place as a result of the narrowing of the hole that your spinal cord fits into. This will cause pain due to the compression on the blood supply to the spinal cord or the spinal cord itself causing pain, numbness or weakness in your low back or legs. It’s characteristic sign is increasing pain in the legs with walking that is quickly relieved by sitting and resting. This diagnosis can be associated with the normal aging process. Physical therapy treatment may include strengthening exercises for the abdominals, selected manual therapy techniques and stretching to improve mobility of the joints and muscles of your lower back.

Physical Therapy Treatment 

Many patients feel that surgery is the best option to relieve their symptoms of pain however; according to recent studies this may not be true. Whether the pain is described as a stabbing, burning, tingling or aching sensation, physical therapy treatment can alleviate your symptoms. A recent study that was conducted at Thomas Jefferson University Hospital in Philadelphia found that non-operative treatments including appropriate care by a physical therapist is just as effective at decreasing your pain and disability as a surgical spinal fusion is for treating patients with DDD! The study measured outcomes based on pain, health status, disability and overall satisfaction. Your physical therapist will guide you through what research shows to be the most effective treatment which includes specific stretches, strengthening exercises and manual therapy in order to decrease your pain and increase your strength. Get relief for your low back pain and call us today! 

Contact Sacred Heart University Physical Therapy Specialists today to schedule your appointment:  (203) 396-8181. 

 

References:

Smith JS, Sidhu G, Bode K; et al. Operative and Nonoperative Treatment Approaches for Lumbar Degenerative Disc Disease have Similar Long-Term Clinical Outcomes Among Patients with Positive Discography. World Neurosurg. 2013: