What is back pain?

Back pain is pain that is felt in the lower part of the spine. It is a sign that the joints, muscles or other parts of the back are injured, strained or not working properly. Back pain is very common with four out of five people experiencing it at some time in their lives. Most bouts of back pain get better in several weeks.

What are the symptoms?

Back pain can be felt in the back, as a sharp pain, ache or spasm. It can be felt in the middle of the back or on either side. Your back may feel stiff, making it difficult to turn or bend in certain directions. Occasionally pain may be felt down one or both legs, this symptom is known generally as sciatica, although it doesn’t always involve the sciatica nerve, as other structures will often refer the pain.

What causes it?

There are many joints, muscles and other structures in the back that can cause pain. In many cases, even with images such as CT and MRI, it is not even possible to find the cause of the pain. It can be worrying not knowing exactly what is wrong, however the good news is that research shows you do not need to know the exact cause of the pain to be able to deal with it successfully. It is rare for back pain to be caused by a serious medical problem.

What can a physiotherapist do?

The physiotherapist will discuss the history of your back injury, assess contributing factors and complete a biomechanical assessment. Your physiotherapist can provide education and advice regarding the optimal management of lower back pain. Further imaging is generally not required for lower back pain unless the pain has been present for greater than six weeks or there is significant leg pain.

The physiotherapist may employ treatments such as mobilization, electrotherapy modalities, soft tissue massage, taping and advice regarding exercise and activity. Exercises to regain normal range of motion will be given. Core stability exercises and stretches may be provided in the later stages of recovery.

Return to activity

It is important to start light activities such as walking from the time you are injured. In many cases people can resume their activities rapidly but may have to modify movements or tasks for a short time. See your physiotherapist for advice regarding return to normal activity including safe return to work and sport.

Outcome

For most people back pain is mild and short-lived (acute back pain) and responds very well to physiotherapy.
This usually takes several weeks but can be different for different people. After two months, nine out of 10 people will have recovered from episodic back pain. About half of the people who get back pain will have it again within a couple of years. Unfortunately, some episodes are more difficult or protracted, extending for months or years (chronic back pain). In the medical literature, exercise in conjunction with medical management provides the best long-term outcome for chronic back pain.