Low Back Pain

Low back pain (sometimes called lumbago or mistakenly sciatica) is a common musculoskeletal problem which affects the lumbar spine (the low or lower back). 80% of people suffer from low back pain over their lifetime. Thankfully most attacks are not serious and clear up with the appropriate care. Unfortunately 50% have multiple attacks and low back pain accounts for more sick leave and disability than any other single medical condition.

Acute Low Back Pain

Acute lower back pain is usually severe pain with a sudden onset and the sufferer can often pinpoint exactly how and when it happened. Usually the damage is limited to 'soft-tissue' ie ligaments, muscles, tendons although it can be hard to know exactly which tissues are causing the pain. . The lumbo sacral joint (the connection between the spine and the pelvis) is often implicated when the small joints (facet joints) behind the spinal discs can 'lock' leading to a facet lock, apophysitis or zygoapophyseal joint inflammation). The pain can occur around the tail bone known as coccyx pain or coccydinia. The pelvis or pelvic ring is composed of the sacrum, and two innominate bones (in turn formed by the fusion of the pubis, ischium and iliac bones). The joint between the sacrum and ilium (sacroiliac joint) can be a source of pain often in pregnancy when the ligaments softened due to the action of relaxin - a hormone produced in the third trimester as the body prepares itself for the birth process. Most cases clear up quickly but can recur in which case a consultation with an osteopath would be helpful. Often low back stretches are prescribed especially if the suffer is desk bound or sedentary

Chronic Low Back Pain

Chronic lower back pain usually has a slower, more insidious onset, occurring over a long period of time. The lumbo sacral facet joints or sacroiliac joints can be effected but one commonest causes is a herniated lumbar spine intervertebral disc often mistakenly called a 'slipped disc'. The disc doesn't actually move but the jelly like substance within the disc can bulge (protrusion of intervertebral disc) or burst out (prolapsed intervertebral disc) irritating the pain sensitive structures around it. Most cases will respond to conservative osteopathic treatment with prescribed rehabilitation exercises but some may need other measures like injections or sometime surgery.

Osteoarthritis (degenerative or 'wear and tear' changes) can often cause chronic lower back pain especially in the elderly. The discs may thin (spondylosis), the facet joints may degenerate (apophyseal arthritis) and small spikes of bone (osteophytes) may develop which can press on the local nerves or ligaments producing pain. Osteoporosis may affect any part of the spine leading to 'crush fractures'. Rarer causes include infection, rheumatoid arthritis or tumours. Back pain that doesn't follow a 'normal' course should be investigated by a physician to exclude these more serious causes.

Sometimes low back pain may be caused by non musculoskeletal structures (viscera) like the ovaries or kidneys or maybe due to psychological/emotional causes.