13 Apr Why do I keep suffering from low back pain?
Why do I keep suffering from low back pain?
Low back pain (LBP) is a common source of pain for many adults. LBP has and continues to puzzle most clinicians in pain services and patients complaining of these symptoms. But why does back pain seem to come back and what can we do to prevent it?
Studies have found that approximately 50-80% of adults will experience an episode of LBP at some point in their lives. Of these, about 10% of them will continue to feel pain past three months, or continue to experience bouts of pain throughout their lives.
These 10% represent patients who end up seeking care from physiotherapists, osteopaths, GPs, orthopaedic surgeons and other clinicians for their LBP. So it is believed that there are still many of you out there that cope with the recurrent spells but do not seek help!
So why do we get low back pain in the first place?
Most individuals who seek pain seem to relate the start of their symptoms to an incident. For example; a fall, sporting injury, overdoing something, work-related injury, and road traffic or other types of accidents.
Many others report that the pain came on gradually, for no apparent reason. Research has shown that all of the above reports are possible and probable. It’s expected that the back will heal itself within 3 or a maximum of 6 months (depending on the involved structures).
Why does pain persist beyond 3 to 6 months?
It’s unknown exactly why pain persists beyond 3 to 6 months of injury, and it is expected to vary between individuals depending on their circumstances. A few reasons why are explained below:
1. In the first few months of healing, your body sends pain signals to your brain to stop you from moving to allow you to rest while it tries to heal itself. (This is true for most structures and not just the back!) In some instances, the body becomes so “efficient” in sending these pain signals to get you to slow down, that it continues to send it 3 or 6 months post injury thinking it is doing you a favour when most of the injured structures have possibly healed by then.
2. During your initial healing process, you might have limited your activity, or walked funny to protect your back. In some instances you might have caused muscle imbalances in other parts of your body (for example your sacroiliac joint (pelvis) or hips) that will contribute to pain in your lower back past 3 to 6 months.
3. Brain centres responsible for interpreting pain, stress, fear and other negative emotions lay next to each other in some individuals. When your emotions are triggered by a negative experience; for example stress at work, the chemical activity at your stress centres can overspill to the pain centres and recreate the feeling of physical pain (perhaps in your lower back).
4. Stress and tension from work, or in your personal life can also cause a build-up of tension in your neck and upper back that can contribute to your lower back pain.
So what can I do about the four points above?
It can be difficult to isolate which of the 4 problems above have contributed to your LBP. It could also be a mixture of all of them, and this is best determined after a thorough examination with experts in pain management. However, there are a few things to consider.
1. In the case of issue no. 1: it is best to try and ignore the pain, or try to move and carry on with your life without triggering the pain to its maximum. Eventually, the body can learn to stop sending the pain signals for efficiency. A qualified physiotherapist can help identify safe and pain-free levels of movement / activity to help you start a safe rehabilitation journey.
2. In the case of issue no. 2: a thorough examination of your upper and lower back, your pelvis, hips and knees is required to identify whether any changes have taken place away from your back that keep contributing to more back pain. Specialist physiotherapists and osteopaths can help measure these muscle imbalances and identify which structures need to be targeted. Additionally, our team here at Perfect Balance Clinic includes podiatrists that can help identify specific imbalances from the knees down (foot and ankle) and sports therapists that can help you train weak muscles and stretch tight areas.
3. Issue no. 3 can be one of the hardest issue to uncover. So far, research has shown that this can only be identified through high resolution magnetic imagining (such as specialist MRIs). However, research also shows that trying to control life and work stresses can prevent chemical reactions from over spilling to pain centres in the brain. Although it sounds like a difficult task, physiotherapists specialising in pain management can help identify life and work stresses that can cause these chemical reactions, and help you identify skills and strategies to deal with these situations to prevent them from causing you physical pain.
4. Issue no. 4 is similar to 3 in terms of management. However it is easier to identify through a thorough examination by a qualified physiotherapist, osteopath and sports therapist. They would be able to find areas in your body that carry and store your tension and stress, and provide the appropriate treatment to reduce it.
Perfect Balance Clinics have a team of dedicated experts that can work together to help identify why your LBP has persisted beyond its natural healing period, and how to best deal with it. Give us a call on 0800 0724 012 today to find out more information!
This article was written by our physiotherapist Dana Maki
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