Low Back Pain & Bothwell Physiotherapy

Almost everyone will experience low back pain at some point in their lives.
Back pain is the most common cause of work-related disability and absence from work and back pain can interfere with daily living activities and recreation.

For most people back pain is brief and self limiting and lasts for anything between a few days and a few weeks.


Symptoms can range from aching muscles to severe shooting pain, limited movement, deformity or radiating pain into the limbs or elsewhere in the body.

When to Seek Help with Low Back Pain

Some low back pain can take much longer to settle or can signal a more serious condition.
If symptoms persist for more  than 3 days it is wise to get it assessed by your doctor or physiotherapist as it can lead to more significant problems or be a symptom of a serious medical problem (see below).

PHONE BOTHWELL PHYSIOTHERAPY ON 01698 85 44 74 NOW for your assessment.

Low back pain that lasts for more than 3 months is classed as chronic and can often become progressively worse over time especially without intervention.

Low Back Anatomy

To better understand the causes of low back pain some knowledge about the anatomy is helpful.
The spine is made up of bones called vertebrae which stack on top of each other to make up the spinal column. All the vertebrae are in contact with one above and below it in the form of joints (Blue Line).
Between each of these bones are the discs (Green) which are there to absorb shock and allow movement of the spine.
Through the holes in the vertebrae runs the spinal cord which extends down from the brain. Branches of nerves run from the spinal cord and through a tunnel (Red) between the vertebrae at every level supplying power to the muscles and sensation to the back, buttocks and legs.

Lumbar Facet Joints

Each Lumbar Vertebra joins on to the bone above and the bone below. As you can see in the diagram there are two protuberances which point up (A) and two which point down (B). These two “facets” come together to form a joint. Each joint has a joint capsule with a lining inside to provide lubrication for the joint. If you sprain the joint it becomes swollen and painful in exactly the same way as an ankle sprain does.

‘Slipped Disc’

In simple terms I want you to think of a lumbar disc as an ‘onion with a toothpaste centre’. This allows for movement between the two verterae and for shock absorption.
If there is degeneration or damage to the ‘onion rings’ then the ‘toothpaste’ moves from the centre (Red arrow) and causes the outer rings to bulge. This can put pressure on the nerve root (Yellow) and cause pain in the back or down the leg – sciatica.
It can also cause your standing posture to become very bent or twisted.

Muscle Spasm

As you can see in the diagram opposite there is a very complicated arrangement of muscles in the lumbar area. The more superficial layers of muscles (removed in the diagram) are large and spread from the low back up to attach to the arms. In the deepest layers (not shown) the muscles are short and only pass between one or two vertebra. In between these layers there are long thin muscles and short thick muscles (shown).
These muscles can be very sensitive to a local change in the soft tissues, or to problems affecting the inter-vertebral disc or facet joints, and can produce ‘spasm’ in these muscles. The ‘spasm’ can affect anything from a few fibres up to large muscles tightening up to protect the underlying structures. Spasm can be thought of as an uncontrollable contraction of muscle fibres. The ‘spasm’ itself can cause pain either locally in the back or referred pain to the buttocks and thighs.

Medical Causes of Low Back Pain

Medical conditions that can cause low back pain include:

• Abdominal Aneurysm
• Pelvic Inflammatory Disease
• Acute Appendicitis
• Perirectal Abscess
• Ectopic Pregnancy
• Prostatitis
• Endometriosis
• Renal Calculi (Kidney Stones)
• Spinal Cord Lesions
• Urinary Tract Infection
• Ovarian Cysts
• Pancreatitis
• Large bowel obstruction
• Perforations to any of stomach, appendix, intestines, spleen, gallbladder, and urinary bladder

Summary

I have only scratched the surface and discussed the more common causes of mechanical low back pain.
There are many more localised problems – that is why I would recommend getting a full professional assessment of your whole spine, hips and pelvis and let us provide a solution to your low back problems.

Phone Now for an appointment on 01698 85 44 74.