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Chronic Low Back Pain Physiotherapy

Chronic low back pain is defined as low back pain that continues for 12 weeks or longer…even after the original injury has been treated. About 5-10% of people who has back pain develops chronic back pain which lasts at least one year.

To make things worse, 20% of doctor visits are related to back pain!

Back pain anatomy

Low back pain happens in the lumbar area (area in orange), and is located between the thoracic and pelvic area.

The lumbar has five vertebrae (L1- L5) and has a slight inward curve known as lordosis. The last 5th lumbar vertabrae is connected to the 1st vertabrae of the pelvic, which allows

  1. forward extension
  2. backward extension
  3. twisting movements

The two lowest segments in the lumbar spine, L4-L5 and L5-S1, carry the most load AND have the most movement, and  that makes it prone to injury.

Between every vertabrae are shock-absorbing spinal discs, and these disc has their own risks and problems too, they can

  1. “slip” or medically termed as herniate
  2. degenerate, leading to degenerative disc disease

they can cause pain in the lower back, which can travel to the legs and feet.

The spinal cord starts from the brain, travels down the neck (cervical), and extend downwards to the joint at T12-L1 where the thoracic meets the lumbar area. In the lumbar area, the nerve root branches out like roots, forming the cauda equina. Some lower back injuries or conditions may compress these nerve roots, that may cause lumbar radiculopathy that radiates downwards to the legs and even toes.

To add to that, the lower back area also has large muscles that support / carries weight plus allows movement in the body – if these muscles get injured or strained, that too can cause lower back pain.

Low back pain studies show that

5-10% of all low back pain patients will develop chronic (long term) low back pain). This number is staggering already, but when you find out that up to 20% of all doctor visits are spine related, you’d see how the math quickly add up:

There’s gonna be many, many chronic low back pain patients =(

Prevalence of chronic low back pain by age

  • less prevalent in patients below 30 years old
  • more prevalent between 31-49 years old
  • most prevalent between 50-60 years old

70 years onwards, everyone’s the same at that point.

Higher chronic low back pain occurrence in

  • ladies
  • people of lower economic status
  • people with less education
  • people who smoke
  • people who are obese

Chronic low back pain factors

  • family history of disabling back pain
  • radiating pain
  • advice to rest upon back pain consultation
  • occupational LBP or
  • LBP caused by traffic injury
  • job satisfaction

Chronic low back pain characteristics

Most patients who suffer from chronic low back pain experience

  • lumbar and sacroiliac pain that may travel to the legs and feet
  • difficulty moving around

Patient may have difficulty maining neutral position, causing body malalignments; as well as difficulty maintaining

  • standing
  • sitting
  • lying
  • walking

In fact, carrying load even in the arms, or movements including bending (even slight) can cause their low back pain to trigger. It’s no wonder that back activities that we take for granted, such as brushing teeth, toileting, changing clothing, cooking, groceries and more — all these can trigger low back pain flare ups in patients who suffer long term low back pain issues.

Some low back pain episodes can be short bursts of acute pain; whereas some others it’s “background” pain lasting weeks and months. Some intensity is very high, some is very low, but the common consensus that it affects the patients emotional, mental, social, work – everything’s affected negatively.

What physiotherapists can do for you

The most important thing to note is that patients with chronic low back pain generally do not need any forms of invasive or corrective spinal surgery and tends to respond well to spinal (back, neck, pelvic) physiotherapy.

Some of the spinal physiotherapy treatments includes:

Where To Next?

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