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Lower Back Pain

Updated: Nov 7, 2020


Did you know that 80% of the population experience at least one episode of lower back pain during their lives? (1) Lower back pain is something that Osteopathic Practitioners treat on a daily basis, with patients reporting a high-level of satisfaction (5). The current guidelines from the national institute for health and care excellence (NICE) advise manual therapy as part of a treatment package including exercise, with or without psychological therapy for the management of lower back pain (with or without sciatica).


Pain can express itself in a number of qualities including a: dull ache, sharp, burning or cramping sensation. The distribution of lower back pain can be localised to a specific area or refer pain into the buttocks, hips or into the legs. Additionally, pressure on the local nerves can cause pain, pins and needles, numbness and or weakness in the legs.


Back pain can be painful and inconvenient, however, the vast majority of back pain is due to mechanical dysfunction and will often resolve on its own within a few weeks or months. However, many people seek osteopathic treatment to address it quickly (4); and osteopaths are skilled at helping prevent back pain from becoming a chronic, long-term condition (5).


Who gets lower back pain?

Men and women are equally affected by low back pain (7). People of any age, ethnicity and morphology may experience back pain. Back pain is usually due to a combination of different factors.


What causes lower back pain?

Pain can commence abruptly as a result of an accident or by lifting something heavy, or it can develop gradually over time due to age-related changes of the spine (7). However, there are factors which can increase the likelihood of someone developing back pain, including: fitness level, occupation, smoking, pregnancy, age, obesity, genetics and state of mental health.


As previously mentioned, the pain experience is usually due to a number of reasons but can often be the result of a sprain or a strain of the structures of the back such as the muscles, ligaments, joints or discs. Sedentary lifestyles also can make someone more vulnerable to experiencing low back pain, especially when a weekday routine of getting too little exercise is followed by strenuous weekend workout.


A complete medical history and physical exam can usually identify any serious conditions that may be causing the pain. During the consultation, an Osteopathic Practitioner asks about the onset, site, and severity of the pain, duration of symptoms and any limitations in movement; and history of previous episodes or any health conditions that might be related to the pain. Along with a thorough back examination, neurologic tests are conducted to determine the cause of pain and appropriate treatment.


Here is a list of some of the back conditions that patients see Osteopathic Practitioner for (5):

  • Simple mechanical back pain

  • Acute back pain

  • Chronic back pain

  • Scoliosis

  • Osteoarthritis

  • Ankylosing Spondylitis

  • Sciatica


Treatment:

Osteopathic treatment usually involves a range of techniques, specifically adapted to each individual. Osteopaths have an armamentarium of techniques in their tool box, most of which are very gentle. Techniques include massage, joint mobilisations, cranio-sacral and visceral techniques.


To supplement the hands-on treatment, Osteopathic Practitioner provide the patient with suitable exercises, stretches and lifestyle modifications, enabling each individual to manage their symptoms to their best ability.


In some cases where the cause of the symptoms may not be so obvious, the osteopathic practitioner may write to the patient's doctor (with the patient's consent) for further tests, scans or previous medical history. Once the cause has been determined, a suitable management plan can be devised.


References:

  1. Palmer KT, Walsh K, et al. Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years BMJ 2000;320:1577-1578

  2. www.backcare.org.uk/factsandfigures

  3. www.nhs.uk/Livewell/workplacehealth/Pages/backpainatwork.aspx

  4. Gurry et al. (2004) looked at a multidisciplinary setting within Plymouth Primary Care Trust (PCT)46. It found that the return to work time was quicker using this service which included osteopaths than GP and physiotherapy services alone.

  5. http://www.iosteopathy.org/what-we-treat/back-pain/

  6. https://www.nice.org.uk/guidance/NG59/chapter/Recommendations#non-invasive-treatments-for-low-back-pain-and-sciatica

  7. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

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