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July 16, 2021


The 3 Main Causes of Lower Back Pain, & How to Start to Manage Your Pain  


Back pain, what is it? What are the different types? How common is lower back pain (LBP)? How does LBP occur? Just some of the questions we will be exploring. The main takeaway is if you do have LBP, how can you either get moving again or if you are already moving, how can you keep moving well. 


What is Chronic Lower Back Pain?

Chronic lower back pain is defined as any type of LBP that lasts for longer than 12 weeks.  It is expected that up to 25% of Australians will experience chronic LBP at some stage in their life.  The lumbar spine you might know has five vertebrae running from L1 to L5 and is the main location on LBP. 

What are the different types of Lower Back Pain?

We might be here all day if we go through every single type of lower back pain, so for today's purpose we will just break it into three main categories. 


Mechanical Lower Back Pain
The first type of LBP is defined as mechanical LBP and basically mechanical LBP refers to when there is an actual distinct change in the anatomical structures of your lumbar spine or within those five vertebrae. A couple of major types of LBP that fit into this category are things such as a disc herniation or disc bulge. It also encompasses osteoarthritis and osteoporosis within your lumbar spine.  

Non-specific Lower Back Pain
The last category is non-specific lower back pain, and this is basically pain that is idiopathic, so there is no actual change to the anatomical structure, there is no nerve pain involved, but for some reason you are still experiencing pain throughout your lower back. That's determined as nonspecific LBP. 

Radicular Lower Back Pain
The next category is radicular LBP, and this refers to nerve pain. Which can be categorized as any sort of shooting or sharp pain that you might experience within the lower limbs. So, whether you have got pain radiating through your glutes, hamstrings or all the way down to your toes this can be radicular LBP. Probably the more common one that you may have heard of is sciatica.   


Management of Lower Back Pain 

90% of people that experience chronic LBP have reported that they have zero symptoms of pain after three to four months with no type of intervention, whatsoever. So that is including not having surgery, pharmacological intervention or any type of exercise program.

So basically after three to four months of having that LBP, with nothing done at all, they have now got total relief of their symptoms. Now you might be thinking how this occurs, basically what these individuals are doing is becoming completely sedentary. So they are doing nothing at all activity wise, in hope that it is going to relieve their LBP. They are not getting any incidental exercise and no structured exercise either. So the reason why this is a little bit of an issue is because LBP has one of the highest reoccurrence rates of any form of pain at all. So, if we just cease all movement every time we have a flare-up of our LBP, which we know might be quite common because it has a really high reoccurrence rate, that is where we are going to see some really negative physiological outcomes in terms of our health. 

So we might see reductions in cardiorespiratory fitness, reductions in muscular strength, we might see some negative implications in our metabolic health. Also for the older population this is where it becomes really important because we might see things such as sarcopenia, muscle atrophy, and then a really decreased overall function in their capacity just to live their daily lives.

Chronic Pain Cycle

The chronic pain cycle is an instrument that is used to sort of determine and analyze the psychosomatic and physiological aspects that contribute towards chronic pain. For example if someone is experiencing chronic LBP and they start to avoid any form of activity in hopes that that will sort of reduce their LBP over time, that sort of magnifies or catastrophizes their LBP. Then we see reductions in both one's physical and mental health over time. 

How to Break the Chronic Pain Cycle

The number one thing on how to break this pain cycle is actually just knowing about it. So hopefully you are already one leg up from watching this video and now having an understanding of how chronic pain works, from sort of a psychosomatic and physiological perspective and then relating that back to you.

The first thing to do is to try to consciously remove any aggravating sort of positions or movements that you generally do throughout the day that tend to aggravate your LBP. So if it is sitting down for too long, make sure you get up and change your posture. If it is bending over too much, finding another way to complete those movements.  So, just try to consciously remove as many aggravating movements as we can. 

Step two is to establish a positive connotation around exercise. How to do this with your LBP is to write down three to four exercises or stretches that you know you can complete pain-free that don't aggravate your lower back. Try to do these three or four times per session. 

Another important step is to take time to do some things that you enjoy as well. So if you have got hobbies, whether that is reading or gardening, or whatever it may be, take some time to do some things that you enjoy as long as they do not aggravate your LBP. 

Then the last one is that chronic pain is often so closely related to chronic stress. So it is important to think about some ways that we can sort of deregulate your nervous system as well. If you need a bit more advice on how to de-stress, have a watch of some of our other videos on stress. 

If you are needing help to manage your LBP, contact us at our Caulfield South Clinic today!


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