Acute low back pain refers to pain in the lower back which has lasted for less than 12 weeks. The lower back is the region of the body where the lumbar spine is located. The lumbar spine is the bottom section of the spine and consists of five bones (vertebrae). Between these vertebrae are structures called discs which act as shock absorbers. There are countless muscles acting on the lumbar spine and a number of strong ligaments which provide the spine with stability. Many of these structures can be involved when you experience acute low back pain. Lower back pain can unfortunately happen to anyone at any time. Around 70% of Australian adults will experience lower back pain at some point during their life.
What causes back pain?
Acute low back pain can be caused by many factors such as:
- trauma (fall, car accident, lifting)
- muscle imbalances (postural issues)
- existing medical conditions
- rheumatological conditions.
Injuries can happen when you do something new, different or strenuous, such as lifting heavy items or playing a new sport. The pain may also occur because of a build-up of stress on the back that gradually turns into an injury. Although serious causes of back pain are rare, it is important that you have your condition assessed by a qualified health professional such as a physiotherapist. This is particularly important if your back pain is associated with other symptoms like fever, unexplained weight loss, pins and needles or numbness, or if your pain was caused by a high velocity trauma such as a car or sporting accident.
What should you do when Acute Low Back Pain occurs?
At the first sign of back pain, there are a few simple things you can do to provide short term relief and give your back the best chance of healing quickly.
Stay active: It may be tempting to stay in bed, it is important to keep moving as much as you comfortably can. By doing this, you can prevent stiffness and relieve muscle spasms. Your physiotherapist can prescribe a gentle exercise program tailored to suit your condition. They can also gradually progress your exercises to help you return to normal function as soon as possible.
Use heat: Heat has been shown to improve pain and function during the first 48 hours of back pain. A few easy options are heat wheat bags and hot water bottles. Make sure you test the heat before you apply it.
Find comfortable positions: Although you should remain as active as possible during the early stages of back pain, there are times when you need to be lying or sitting down. Find positions that allow you the most comfort, especially when sleeping. Using a pillow under the knees when lying on your back and between your knees when lying on your side can offer support and relief from pain. When sitting ensure your lower back is supported. You can use a rolled up towel placed in the small arch of your back. This will help provide support and may relieve the pain.
Stay positive: Back pain is a distressing and disabling condition, but it is important to remember that you will get better. With proper treatment you should regain normal, pain-free movement as well as improving the strength of the key supporting muscles that surround your spine.
How can your physio can help you?
Physiotherapists are experts in the assessment of musculoskeletal injuries, especially back pain. . They will provide a thorough examination to ascertain the structures responsible for your pain. The physiotherapist will also be able to give you a better understanding of the cause of pain and further self-management techniques. Your physiotherapist will also discuss the treatment options with you. Some options may include:
- joint mobilisation
- soft tissue mobilisation
- exercise (including stretches and core strengthening)
- acupuncture or dry needling
- electrical modalities (eg interferential or ultrasound)
- advice on recommended positions and postures at home and work during.
Physiotherapists are trained to provide exercise in a controlled, gradual and progressive manner catering for specificity. Exercise may be prescribed in a variety of ways including:
- home exercise program with individualised progression where appropriate
- individual or small group training.
Physiotherapists are able to assist in speedy recovery of the acute patient who is preferably referred earlier rather than later for treatment. There is indication that even a small number of physiotherapy sessions of education, management advice, exercise prescription and treatment are enough to show significant pain reduction for the acute patient.
Physiotherapists aim to treat the underlying cause of the back pain which will not only resolve your back pain, but prevent it from coming back again. It is important to consult a physiotherapist as soon as possible to assist with pain relief and improve movement. The earlier you get treatment and professional advice, the quicker they can help get your back pain under control and get you back to work, sport and life.