The top 5 most common types of low back pain and what to do about them
Written by Osteopath Sophia Barlow, Sophia is a Registered Osteopath and a graduate from The British School of Osteopathy. She was a prize-winner at The Annual Chiropractic, Osteopathy and Physiotherapy Conference 2008 where she presented her undergraduate paper on Low Back Pain and the NHS.
Apart from muscles spasm the 5 most common types of low back pain are often cited as being the following:
- Radicular pain – where a nerve coming out of the spinal cord is irritated, possibly compressed for example by a vertebral disc.
- Facet joint pain – where one of the small joints which interconnect the spine has become painful.
- Sacro-iliac pain – which affects one of the (two) joints at the very base of the back where it connects to the pelvis.
- Discogenic pain – where an intervertebral disc between the spinal levels becomes painful.
- Spinal stenosis – where the spinal canal and areas just next to it become narrower due to bony changes associated with ageing such that nerves and small blood vessels can become affected.
Each one of these needs careful diagnosis of the presenting individual in order to attain the safest and most effective advice and treatment. These presentations often have symptoms in common, and they all need an expert eye. In addition sometimes some of these and other causes of low back pain will need urgent attention.
So people, in the first instance if you have low back pain, speak to an expert, and by that I mean a qualified health professional, not Google…
That said, as an osteopath I am often asked what are the main things that one can do to keep a healthy and so more likely pain free back. And for that we need to dive into your actual real body…
It does sometimes surprise me that people are loathe to think about the insides of their bodies, when you consider that these are the vehicles within which, and via we live our lives. And of course the amount we get out of life is directly related to how well these bodies are functioning.
So when it comes to your low back we do need to consider this whole picture, from the intrinsic health of the tissues to the way the back has evolved over time, all the way through to naughty habits that you may have picked up along the way. We call these things predisposing and maintaining factors. And this is some of the advice that I give to patients who leave my clinic in order for them to give themselves the absolute best chance of not getting their back pain again. Because they are in charge of the vast amount of their ‘maintaining factors’ and so are you.
First of all let’s talk about the health of the tissues themselves.
Vertebral discs are nearly 80% water, so guess what, they love you being well hydrated. But not only that, ALL your soft tissues will not only get less damage if you are well hydrated, but they will also heal faster. Life is much easier for a well hydrated body. So yes, do try to drink your 7-8 glasses of water per day, or around 1.5 litres.
All that nagging about hydration is spot one, and not just to look 10 years younger.
Talking about the health of your tissues, your body needs to be fed properly if it is to function properly. We have often heard the phrase you are what you eat, and although I do not advise specifically on diet, I do like to remind my patients that their bodies need to have sufficient nutrients and vitamins in order to be in the very best shape they can be. By this I mean less prone to injury as well as quicker healing, certainly not being a particular shape or size. I am often irritated by the ridiculous coverage that the media gives to particular body shapes or sizes. They are many many more healthy shapes than you might imagine.
So yes, nutrition is super important and not just for your back health but for your overall health.
And I don’t mean just eating fruit and veg, have a little dive into the physiology of your body, what does it really need? For example, did you know that vitamin D is actually a steroid hormone, a group of hormones including female reproductive hormones whose outer layer is made of lipid. We all need enough cholesterol in our diets to make certain types of hormones.
Yoga is often the way forward. I often find myself advising patients, once they have recovered from a back injury, to consider looking at yoga. And I have given this advice to patients from the ages of 18-80 yrs. Sometimes I have to slightly brace myself for some eye rolling as yoga does sometimes come with a particular image. But I have seen some amazing results for my patients who have popped yoga into their health toolkits. First of all, I do think that when something has been around for hundreds if not thousands of years then it might be worth a look to see what can be learnt.
But specifically the way the practice of yoga is undertaken it ticks so so many boxes for many of my patients. It addresses relaxation and stretching of tight glutes and external hip rotators (specifically the piriformis muscle, which is often involved in sciatic pain). It helps with diaphragmatic breathing which helps with the movement of the entire spinal column. It helps build back and abdominal musculature support.
There is quite simply hardly a musculoskeletal stone unturned when it comes to yoga. But for this reason it is very important to have my next piece of advice front of mind when stepping into a class…Listen to your body. The fact is that you and you alone have the most information about your body. You are literally living in it. But people do not always listen to their bodies, sometimes their bodies can be literally screaming at them and it will go unnoticed, or certainly unacknowledged.
You alone know if that hamstring is feeling a bit tight when you are in a class or a match. You alone know if you haven’t had enough sleep and are feeling aching from that gardening, not giving yourself enough time to recover. Your know if your mouth is dry from thirst, or if your shoulder has been nagging for months now not weeks. You are as in charge of your health as any of us can be, you have resources and health professionals around you to access if you need them. You know when you need to take a break and if you listen hard you’ll also get to know when you can push things a little bit further… Listen to your body, (not for example your PT), and act on that information.
So finally, and just as importantly comes exercise. Grimace or cheer, whichever it is we do all need to exercise. I am often asked by patients what is the best exercise? And you may be relieved to hear that I always answer; whatever exercise you enjoy the most. Research says that compliance is directly linked to enjoyment when it comes to exercise. So simply put if you don’t enjoy it you’re probably not going to do it for that long, so choose something that you like. That is not defeatist, it is the winning approach.
Now of course, some people just hate exercise so for them I say try to think how you could make it enjoyable, the place, the people, the clothing or equipment – whatever it is even if it costs a little bit more, you may as well spend your money on something you are actually going to do. It will be well worth it, for your back and general health into the future.
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