80% of us will have low back pain in our lifetimes. It is the most common musculoskeletal pain that patients will talk to their family doctor about. Most of us will recover within a few days but if this isn’t happening, having a physiotherapy assessment will help identify the source of your pain and start moving you in the right direction to getting rid of your pain.
One of the most common reasons clients present to a physiotherapist with low back pain is because they have overstretched or torn a portion of one of their intervertebral discs. This can happen when we slightly stretch the back part of the disc, doing simple things like:
- Anytime we sit
- Bend forward
- Lift something
Repetitive movements (gardening, shovelling snow … etc) or doing activities for long periods of time (sitting in the car on a long drive, computer work… etc) can cause a tear or disrupt some of the fibres of the disc. As a tear progresses, some of the material in the centre of the disc can be forced toward the back corners of the disc and exert pressure on the nerve root. Depending on the extent of this pressure, the pain may remain in the low back or it may start to radiate or spread toward one side, into the buttock or groin area, or even down the leg.
When this occurs it is important to have a physiotherapist assess your pain and possible movement loss to identify what directions or positions you need to move in to help take the pressure off and let the disc heal.
“When low back pain occurs, from any source, it makes many of the activities we do everyday difficult. Your physiotherapist can guide you toward activities and positions that are less likely to aggravate your pain while your body gets busy healing.”
The McKenzie method looks at mechanical diagnosis and therapy for spinal and peripheral pain and mobility. It was developed in the 1950’s by Robin McKenzie and has been wonderfully successful in reducing pain and improving range of motion. McKenzie trained therapists are specifically taught to identify an individual’s “direction of preference” (movement patterns) and to educate patients on how to utilize these movement patterns throughout their day to help manage their pain while they are healing.
Other sources of low back pain
Other sources of low back pain include nerve root irritation, facet joint sprain/ dysfunction and the sacroiliac joint (SIJ) to name a few.
Nerve root irritation can occur after being in a prolonged, possibly awkward posture or if a small spur or scar tissue has developed in your spine.
The facet joints are found on either side of the spine at each level. They can be “sprained” just like any other joint in your body by moving them too fast, too far or too many times. They can also undergo a degenerative process like osteoarthritis (OA) and become stiff and painful.
Low back pain can also occur if you injure your sacroiliac joint (SIJ).
This joint is found on either side, between the outflare of the pelvis and the sacrum (the large flat bone at the bottom of the spine at the back). This joint can become painful during pregnancy or after delivery, with sports that involve impact through the legs like soccer, running, jumping or after a fall onto the buttocks.
Depending on the mechanism of injury your physiotherapist will assess many things such as the ability of the SIJ to bear weight (as in standing on one leg), the interaction between your lumbar spine/ SIJ and hips and how your muscles work. Your therapist will then work with you to improve the mobility in this region and help you re-train any muscle patterns necessary.