From a small niggle to complete debilitation, lower back pain is a very common problem that affects literally millions of people worldwide.
Unfortunately, we are all likely to suffer at some stage in our lives and the usual solution is to reach for the painkillers.
However, a recent clinical review published in the British Medical Journal reports that paracetamol, a very common pain relieving medication, is actually ineffective for the treatment of lower back pain. What’s more, the subjects in the studies who took paracetamol were shown to be four times more likely to have abnormal results on a liver function test. Not good news.
So what are the alternatives?
Well, the most important question to consider first is what’s actually causing your lower back pain.
By asking this question and discovering the correct diagnosis you’ll be able to choose the right techniques or treatments to get to the root cause and head you towards a much speedier recovery.
For the most part lower back pain is caused by strains to the soft tissues, the muscles, tendons or ligaments, and or the joints underlying them.
Back issues tend to be lumped together because quite often they have similar symptoms, but the underlying causes can be very different and therefore the most effective treatment will vary.
Here I have compiled 6 of the most common lower back problems I see in my clinic to help guide you towards the best form of treatment for your problem.
1. Acute Muscle or Joint Strain
This is probably the most common injury to happen to the lower back and quite often occurs when lifting, over reaching or from a sporting injury. Symptoms can include muscle spasm, pain (which can be severe) and restricted movement
Overreaching, twisting or stretching causes the muscles, tendons and ligaments in the area to tighten to prevent further damage and inflammation will build up as part of the natural healing process. Fast treatment is the most effective for this:
• Immediately put an ice pack on the area for ten minutes at least. Repeat this several times until the inflammation begins to subside.
• If the muscles have tightened up you could also alternate with a hot pack to help them relax, but start and finish with the cold pack to ease the inflammation and reduce the pain.
• As with any injury rest is important to allow the body time to heal, but don’t spend hours sitting or lying down as this could make it worse. Find a good balance and when it has calmed down a little, stretch the area out.
• You may find massaging arnica cream into the strained area beneficial.
2. Disc Prolapse
This is a more serious condition that requires medical attention. A prolapse means that the disc, the fluid filled sac that sits between the vertebrae like a cushion, bulges out of place. It can press on a nerve causing pain or pins and needles down the leg. Usually it is worse in the morning because the disc absorbs more fluid overnight, therefore making the bulge bigger. It mostly occurs when lifting awkwardly or in a sporting injury. You should consult your GP or health practitioner first for a correct diagnosis. Initially rest is important, but once it has settled and on the advice of your medical practitioner, it is a really good idea to strengthen the area. I recommend Pilates because this targets the core muscles of the abdomen. Strengthening the core muscles will support the lower back and reduce the risk of any further prolapse. Try to find an experienced teacher and one who understands your problem.
3. Degenerative Joint Disease
As we grow older the discs that sit between the vertebrae in our back become thinner and the joints become more compressed. Wearing of the cartilage in between can occur, known as degenerative joint disease or osteoarthritis (OA). An injury can also contribute towards this, as can being overweight.
Contrary to popular belief there are plenty of ways to combat OA:
• Keep moving is the best advice, as inactivity leads to stiffer joints and sitting for long periods compresses them further, potentially causing further damage. Even going for a gentle walk for five minutes can do wonders. Low impact regular exercise is best such as yoga, swimming, qi gong.
• A heat pack placed over your lower back can bring some pain relief and increase flexibility to the joints, allowing the muscles and ligaments to relax.
• Eat foods that are natural anti-inflammatories. Foods high in omega 3 fatty acids, such as oily fish are especially recommended. Other hugely beneficial foods are leafy green vegetables, red/blue berries, nuts and seeds, turmeric, ginger and garlic.
• Doing some stretching exercises everyday to decompress your lower back will open out the joints, keep them moving and elongate muscles. Try this simple exercise:
➢ lie on the floor, putting a pillow behind your head for support.
➢ Bring your knees up towards you
➢ Place your hands on your knees and gently pull them in towards you. You should feel your lower back opening out a little. (You may find it easier to do this one leg at a time.)
➢ Repeat this several times at least twice a day.
• Some supplements may be helpful in the treatment of OA, such as glucosamine and chondroitin and more recent studies have suggested that Vitamin D could be beneficial. The effectiveness and safety of taking supplements is very much down to the individual, so I would recommend speaking with a qualified health practioner in this area to determine whether this could be a good option for you.
4. Repetitive Strain Injury (RSI)
More commonly seen in the upper body, this type of injury can occur in the lower back when an action is continually repeated over a long period of time causing stress to the joints or soft tissues. It happens due to a repetitive pattern in movement usually caused by work or sport. For example, if at work you constantly have to turn to your right, the right side of your lower back could become compressed, irritated and inflamed. It is important to address this issue quickly as it can fast become a debilitating injury:
• Try to adapt and balance the movement of your body throughout the day.
• If a pattern of movement is unavoidable then stretching in the counter direction would be beneficial. Your aim is to balance out your body preventing one side taking all the strain.
• A regular massage with an experienced therapist may be helpful too.
5. Work Posture
Many of us tend to spend our days sitting huddled over a computer, at work, home, or both.
This lack of movement coupled with poor posture at our desks can lead to stiffness and compression in the lower back causing aching. The obvious answer is to get up and move around, but as this is not always possible, setting up your workstation well is really important. Here are some tips:
• Sit right back in your chair so that your back is supported by the chair back.
• In order to do this you will then have to pull your chair right in to your desk in order to reach your keyboard easily. (You may find you have to remove the chair arms.)
• Ideally your feet should be flat on the floor so it is really worth taking the time to adjust your chair height accordingly. Use a foot rest if necessary.
The aim is to feel relaxed and well supported when sitting. Stretching regularly and even taking a walk at lunchtime will be hugely beneficial too.
6. Period Pain
For some women lower back pain can occur during the monthly cycle due to the uterus contracting and the network of nerves that run through the pelvis. Here are a few ideas to find relief:
• Using a heat pack, hot water bottle or soaking in a hot bath can help relax the tension in the muscles.
• You might not feel like doing much exercise if you are aching, but some gentle movement has been shown to help relieve the symptoms. Try gentle walking, swimming, cycling, yoga or tai chi and avoid higher impact activities such as running, which can cause jarring.
• Stretch out your lower back gently. Some yoga stretches have proved very good for this, for example, downward facing dog or child’s pose.
• A recent study has suggested that acupuncture may be beneficial for some women with painful periods, including reducing back pain. Always find a practitioner that is fully qualified and registered.
• Diet can also have an effect on your cycle. A well balanced diet with plenty of green veggies is best and try to avoid alcohol, caffeine and salt which can heighten symptoms for some.
• On the preventative side, studies have shown that women who exercise regularly tend to have less painful periods, so this may be something to consider and put in place if you do tend to suffer on a monthly basis.
It is important to note that if you develop back pain suddenly with your period and it is not the norm for you or you have any other unusual changes it is essential to consult with your GP as it could be a sign of a more serious problem.