Low Back Pain: Symptoms & Treatment

INTRODUCTION: This article looks at the causes, symptoms and treatment of low back pain.  It gives people an understanding of how the body reacts to low back pain and how to break the pain cycle. 

Corefulness.com was born out of a passion to provide the tools to break the cycle of pain and re-educate patients’ core muscles. The Corefulness® Foundation programme is designed to proactively maintain strong bodies to help pain occurring in the first place, as well as help those in pain.

OVERVIEW:  80% of the world’s population will experience low back pain during their lives.  One third of the adult population will suffer with back pain each year. 

In the UK, back pain costs the NHS over £4.7 billion each year and indirectly costs the British economy more than £10 billion per annum.  Despite these statistics, preventative treatment of low back pain still remains a low priority.  

In the UK, the financial modelling of the NHS means pain is treated rather than prevented.  The management of lower back pain (and pain in general) is reactive rather than proactive

CAUSES: What causes low back pain?

There are many different reasons why people have low back pain:

1. Trauma:  The most common is following injury or trauma, which can result in a muscle or ligament strain or a joint strain. The trauma may be sudden from a fall, sporting injury or lifting something heavy or it may be more gradual following overloading of the back from repetitive movements or prolonged sitting.
2. Degeneration:  Back pain can also occur due to degenerative conditions of the spine (Spondylosis). Facet joints, which lie between adjacent vertebrae, can become arthritic. 
3. Medical conditions:  Conditions that can cause low back pain include:
   1. A slipped (prolapsed) disc: this occurs when there is a breakdown in the outer layers of the cartilaginous disc that is located between the vertebrae.  This can affect the nerves in the back and cause pain, pins and needles, numbness or weakness in the legs
   2. Sciatica: (irritation of the nerve in the leg) can be caused not only from the disc bulging or being prolapsed but also from joints being inflamed or other problems that cause pressure on the nerves.
   3. Spondylolisthesis: happens when one of the vertebrae slips out of position due to repetitive trauma, a sudden injury or advanced spinal arthritis
4. Pregnancy:  Due to the presence of a hormone called Relaxin, which allows the ligaments of the pelvis to stretch during childbirth, and due to the weight of carrying a baby, some women experience back pain during pregnancy
5. Posture:  Sitting or standing or working manually in the same position for prolonged periods can cause back pain. The ergonomics of the working environment has an impact on people’s backs
6. Serious problems:  Under 1% of those who experience a new episode of back pain will have serious causes. These may include cancer of the spine, cauda equina syndrome, fractures, diseases or infections.

SYMPTOMS:  Types of Pain

Most people’s pain will resolve after six weeks however, for some people it can last considerably longer and this is often determined by the actions taken in the first few weeks.

INTENSITY OF PAIN: Low back pain can be dull or sharp, shooting and stabbing. It may be intermittent or constant. Pain that has been present for a few days is commonly called acute pain. Chronic pain is a pain lasting longer than 3-6 months. 

The pain may be located in a small area of the back or it can affect a large area and cause leg pain.

REACTION TO PAIN: 

1. How do people react to pain:  Everyone reacts to low back pain differently depending upon the type and intensity of pain, the cause of pain, its duration, an individual’s pain threshold and their ability to seek help and resolve their pain.

2. How does the body react to pain:  In the body we have muscles that move us and muscles that stabilise us.  When a person has low back pain, the  body’s natural reaction is to stop movement, as a protective mechanism, and the large movement muscles go into a reactive spasm.  Unfortunately the spasm reduces movement in the joints of the spine (the facet joints) which results in movement becoming more limited. 
   
   Pain inhibits specialised stability muscles that lie deep next to the skeleton, these are switched off, leading to instability around the lumbar spine. 
   
   These ‘compensations’ of joint stiffness and muscle weakness are often the cause of long term or repeated episodes of low back pain, even after the original problem has been resolved.
   
   Patients need ‘mobility and stability’.  They need to move and build muscle strength in order to gain control of their bodies. Patients need to break the pain / spasm / weakness cycle. This approach needs to be logical and provided to patients in a functional way to ensure muscles work correctly.

PAIN CYCLE: Once the PAIN cycle is broken then the compensations associated with low back pain can start to be addressed, there is a reduction in pain and restoration of normal movement and function. 

Whilst there may still be underlying pathologies of a disc prolapse or degenerate joints, the compensations which start to take centre stage, especially in chronic low back pain, will be addressed.

TREATMENT COREFULNESS® FOUNDATION

Corefulness.com provides a foundation programme which teaches people how to strengthen the stability muscles that would be switched off as a consequence of low back pain and exercises to promote body movement.

COREFULNESS® FOUNDATION PROGRAMME: The specific Corefulness® Foundation Exercises focus on four key core muscles of the body.  The exercises progress from lying, sitting, standing to walking and this vital muscle activation strengthens the muscles that had been inhibited by pain.  They also encourage areas of the body that have been held by chronic spasm to move, thereby providing people with the confidence to move again.  

Returning to basics allows time to re-educate and strengthen the deep muscles that hold the skeleton that make up ‘the core’.  

If we can strengthen the deep core muscles then the outer movement muscles do not hold the body rigid in spasm.  They can release and allow the body to move smoothly again. 

Corefulness.com creates a conscious way of thinking, to educate the body and mind about posture, movement and muscle activity.  This approach is known as physical mindfulness, and is adopted in the Corefulness® Foundation Programme. 

Footnote: 

The Corefulness® Foundation programme is the solution for everyone wanting to live their lives to the maximum regardless of their individual needs and ability.