At Body Logic Physiotherapy, we have world-leading clinical researchers in the back pain and lower back pain treatment right here at our Perth clinics: Professor Peter O’Sullivan and Dr JP Caneiro. They are also supported by a team of expert physiotherapists.
The lower back is a very important part of the body. It’s very clever in that it can move in all directions and it can generate big forces and bear huge loads, as it has a specialised set of muscles that control it.
It’s very important to understand that pain usually improves with the right treatment, even if you have had it for many years. Physiotherapists at Body Logic Physiotherapy play a very important role in this treatment.
At Body Logic Physiotherapy, we aim to coach people to get back in charge of their back. Get in touch with our Perth team with any concerns you might have.
- How common is it?
- Back pain risk factors
- Myths & facts about back pain
- Approaching back pain
- Assessing back pain
- Treating back pain
Is back pain common?
Back pain is a term that relates to a pain problem that occurs anywhere between the rib-cage and the buttocks. It may also be associated with pain referring down the buttocks, legs and to the groin region. Common labels used to describe it are:
- Disc degeneration
- Disc bulges
- Disc prolapses
- Facet joint arthropathy or osteoarthritis
- Annular tears
- Sacroiliac joint pain
Pain in the back is very common. It rarely presents below the age of 10; however, it is common during adolescence and becomes even more prevalent through life.
It often occurs with other pain problems such as hip pain, pelvic pain, neck pain and headaches. Problems such as incontinence are also common with it.
Up to 80% of the population will experience this type of pain in their life, and most people (70%) who get back pain will recover to a large degree, although recurrences are common.
For a smaller group of people (up to 30%) it may become distressing, persistent (lasting beyond 6-12 weeks), disrupt many aspects of a person’s life and need treatment.
This can include limitations in the ability to do activities of daily living, exercise, work and participate in social activities. This can be very scary and lead to anxiety and depressed mood in many people. This is why back pain is the leading cause of disability. It is important to know that it is very rare (1-2%) for this pain to be caused by a serious health problem such as cancer, fracture, infection or inflammatory disorder.
The below videos summarise a research paper co-authored by Body Logic Physiotherapists Professor Peter O’Sullivan, and Dr JP Caneiro.
10 facts every person should know about back pain. Presented by patients
Patient stories behind the facts.
Back pain risk factors – what makes it serious?
Pain in the back is usually linked to things like: being stressed and tense, run-down, carrying too much weight around the belly, sleeping poorly, low mood, inactivity, smoking, poor conditioning, overdoing it and doing things we are not fit for.
This can make your spine’s structures very sensitive. The good thing is that many of these things can be modified and you can seek effective back pain treatment.
Your pain may be serious if:
- you have had a traumatic injury like a fall off of a ladder, seek medical advice and treatment to ensure you don’t have a fracture.
- you are over 50, have had a previous history of cancer, aren’t feeling well, and have developed pain for no apparent reason and it isn’t settling, then get checked by your doctor.
- you have back and leg pain, a loss of sensation and power in the legs and have trouble passing urine, get checked by your doctor.
Worried about your pain? The team at Body Logic can help.
Myths about back pain
- It’s always a sign of tissue damage and needs urgent medical attention
- Scans are always needed to diagnose the pain
- Activities that provoke pain should always be avoided and rest is needed
- Loading your back and participating in activities like running, lifting and twisting are dangerous and can injure the back
- Experiencing this pain means your core is weak
- Your back pain is caused by poor posture
- It means something is out of place and needs to be put back in
- There is nothing you can do for it as you get older
- Surgery, injections and strong drugs are important for pain treatment
Approaching back pain
Acute back pain can be really scary and painful. This can occur with awkward or unaccustomed movements of the back. Usually, it is associated with muscle spasm where the back gets locked up making it very difficult to move. This usually settles within a few days. Although it’s scary, it’s important to try and stay mobile and active as possible.
Our team can provide guidance in dealing with your pain.
When your pain persists beyond 6-12 weeks, it is important to identify the factors that are keeping the spine sensitive in order to address them.
These factors can include: having a negative mindset about the back (“my back is damaged and can’t be trusted”), high levels of stress, worries or anxiety, low mood, fear of pain and or movement, avoidance of movement and activity, resting too much, carrying excessive weight (especially around the belly).
These factors can cause changes to the nervous system making the spine’s structures very sensitive. Over-tensing the ‘core’ muscles and over-protecting or stiffening the spine can also be unhelpful, leading to more pain – a bit like clenching the fist all the time.
Whether associated with inactivity, feeling tired or run-down, poor or limited sleep, tensing, protecting the back and avoiding movement, there are many things you can do for back pain treatment. Avoiding work, social engagements and fearing pain will usually heighten it.
The best treatment is understanding the pain, staying active, having good sleeping habits and developing a positive mindset.
Assessment of back pain
At Body Logic, we provide an in-depth assessment of your pain.
The first and most important thing for us is to take time to hear your story and pain experience in your own words. We want to know how your pain feels to you and how it impacts on all aspects of your life so we can help you get back doing what you like. We will also screen you to ensure your pain isn’t caused by serious health problems.
Following this, we will conduct a comprehensive examination.
This will usually involve looking at where you hurt, how your posture and spine move, your ability to relax your back and core muscles, as well as screening for your strength and fitness. We may also check things like your sensation and reflexes and do tests to check if your nerves are sensitive.
Based on all this information, we will then explain to you in simple language the factors that are contributing to your back pain, and discuss the best treatments options available to you.
Facts about back pain
- Back pain is the leading cause of disability – it can ruin lives, but it doesn’t need to if you seek the right back pain treatment
- It is rarely linked to serious tissue damage or life threatening disease
- Scans often can’t identify the cause
- So-called ‘abnormal findings’ on scans like disc bulges, disc degeneration and arthritis are common and normal in most people without pain especially as they get older
- Backs don’t go out of place … ever
- There is no perfect posture … a variety of postures is good for the back … even slouching is OK
- Backs become healthier with movement and physical activity
- Gradually loading the back is safe and makes the spine stronger
- There are lots of different methods of back pain treatment, even when you are elderly … so don’t give up, get a good plan and stick to it
- 30% of people that have back surgery are no better. Benefits from injections as a back pain treatment option are often short lived and strong drugs such as opioids are not effective for persistent back pain and have many negative side effects.
Treatment of back pain
If your pain is acute (sudden onset), the key to your back pain treatment is to help you to get comfortable and moving as this helps with recovery. We will also identify the factors that caused the pain in your back and make a treatment plan to prevent it in the future.
If your pain is persistent (longer than 6-12 weeks), we will work out a plan with you to help you take control of your pain, obtain treatment, and get back to living based on your goals.
Back pain treatment may involve some hands-on techniques to relax you and get you moving, coaching you in body relaxation, training you to restore relaxed spinal movement, help you get strong and confident, resumption of physical activity and where relevant sleep rehabilitation.
A long-term plan is the key to prevent pain from recurring and stop it interfering in your life. We also work with your doctor and/or psychologist if additional care is needed.
At Body Logic Physiotherapy, we are not interested in ongoing band-aid treatments for your pain. We know that the best approach to management is to help you understand why you have pain, and get you back in control, moving, active and living again.
For some people this may take 2-3 sessions; however, for long term problems, this may take up to 7-10 sessions over a 3-4 month period. We also offer supervised exercise rehabilitation classes and one-to-one sessions to support this process if needed.
To find out more about back pain treatment, check out All You Ever Wanted To Know About Back Pain by Dr Mary O’Keeffe and Dr Kieran O’Sullivan.
David Hanscom is a prominent spinal surgeon on a mission for change. In this article on avoiding spinal surgery, he discusses how to know whether you need spinal surgery for low back pain.
Professor Ian Harris features on the Body Logic ‘Empowered Beyond Pain’ podcast discussing whether surgery is necessary.
Professor Peter O’Sullivan separates fact from fiction when it comes to back pain: https://www.youtube.com/watch?v=dlSQLUE4brQ
‘Core stability’: A discussion with Peter O’Sullivan on core stability and the myth of how it affects chronic low back pain: https://youtu.be/YezBG_NdLgs