Lower back pain is very common and according to the World Confederation of Physical Therapists, it is the number one cause of disability across the globe! But this doesn’t need to be the case. Only 1-5% of all lower back pain is attributed to serious disease or injury. However, this can leave people scratching their heads as to why exactly they are experiencing discomfort in the lower back without having done anything to cause it in the first place.
Let’s consider what may be driving our lower back discomfort. Pain – also known as nociception, is an experience to potential tissue damage. The key word being ‘potential’ because with long term discomfort, our bodies can develop a dysfunctional pattern in which typical movements the body is capable of, are perceived as painful as a way of protecting us. For example, you may bend & twist suddenly which may cause a spasm of the lower back musculature but the muscles going into spasm and becoming painful doesn’t represent damage in that area. A spasm is an over-activity of a muscle of region of a muscle which also become more sensitive. A useful way to describe this is to imagine holding a clenched fist for a while…after several minutes the forearm muscles will begin to ache & this is like what could be taking place in the soft tissue around the area where pain is felt.
Although an initial event may cause what we call ‘acute’ pain – such as surgery, tissue damage, bee sting, stubbing your toe, chronic pain is typically not associated with tissue damage however as explained above, this perception of potential tissue damage may continue.
The WCPT has outlined the key contributors and conditions associated with chronic pain which include lower back pain, cervical and mid back pain, rheumatoid arthritis, shoulder pain, headache disorders and (rarely) cancer. However, once again, Physiotherapists are equipped with the skills and knowledge to empower you to take control of your pain experiences and effectively manage your symptoms to increase your activity levels and ultimately ensure you can live your life to the fullest!