Low back pain (LBP) can affect approximately 50-80% of adults at some point in their life. LBP can impact an individual’s physical and mental health, making it difficult to complete everyday tasks. LBP can cause discomfort with everyday activities such as sitting, standing, walking, and sleeping. As physiotherapists, we understand this challenge and want to work with you to re-gain mobility and strength so that you can return to the activities you enjoy with reduced pain and greater function.

Common causes of LBP

LBP can be caused by a variety of factors, some of which include:

  • Aging: Wear and tear on the spine as we age can cause weaker vertebrae and cartilage.
  • Traumatic injury: A traumatic incident such as a fall, hit, or motor vehicle accident.
  • Physically demanding professions: Physical demands from a job that produce a high spinal load and impact on the spine. This can include jobs that require repetitive or prolonged heavy lifting, twisting, bending, or carrying, including athletes who engage in high intensity physical activities.
  • Prolonged sitting: More sedentary jobs that do not promote good posture, such as sitting at a desk for extended periods of time.

Here are some common types of LBP that we often treat in a clinical setting:

Common types of LBP

  • Strain/sprain: When muscle fibers are overly stretched or torn, a lumbar strain can occur. Conversely, when ligaments are torn from their attachment site, a lumbar sprain can occur. A lumbar strain or sprain can arise from gradual overuse or sudden injury.
  • Disk herniation: A herniated spinal disk occurs when the center of one of the disks, which live between the vertebra of the spine, protrudes through a tear in the annulus, which is the tough rubbery exterior that houses the nucleus. A herniated disk can irritate nearby nerves causing pain, numbness, or weakness in an arm or leg. Our disks become less flexible as we age causing them to be more susceptible to changes in our spine.
  • Spinal stenosis: Spinal stenosis refers to the narrowing of the spinal canal, putting pressure on the spinal cord and the surrounding nerves. This can cause leg pain or cramping, depending on what level of the spine is affected.
  • Spondylosis/spondylolisthesis: Spondylosis refers to the degeneration of lumbar vertebrae, whereas spondylolisthesis is a condition involving spinal instability in which one vertebra slips out of place onto the vertebra below it. Both spondylolysis and spondylolisthesis can cause LBP.
  • Piriformis/glute syndrome: Piriformis syndrome can occur when the piriformis muscle compresses the sciatic nerve, causing inflammation, pain or numbness in the buttock or hip. Symptoms may increase with prolonged sitting or impactful activities such as running or climbing stairs.

Although there are more types of LBP, these are common types that we see clinically.

Physiotherapy treatment options

Here are some ways that physiotherapy can help with various types of LBP:

  • Education: Your physiotherapist can provide you with education on appropriate ergonomics to control LBP, methods of pain control, exercises to increase lumbar mobility and strength, or put you in contact with other health professionals who can help.
  • Stretching exercises: Physiotherapists can show you exercises that can stretch your spinal cord or specific vertebrae that may be affecting your pain. Stretching muscles such as your hip flexors can also help relieve LBP.
  • Strengthening exercises: Strengthening exercises can include strengthening the muscles that support our back such as the transverse abdominus, trapezius, latissimus dorsi, rhomboid major, and more!
  • Manual therapy: Mobilizations of the lumbar spine can provide pain relief, decrease stiffness, and improve range of motion in the joint by stretching fibrous tissue.
  • Referrals: Physiotherapists can make appropriate referrals to physicians if obtaining imagery for your back is required to support our treatment plan such as x-rays, ultrasound, or MRI.

Our physiotherapists will collaborate with you one-on-one to develop a treatment plan that is right for you and your goals. An initial assessment will include gathering information on your history with LBP, observing how your back moves in different directions, assessing the strength of various muscle groups that support the back, and performing specific tests which assess the muscles, nerves and bones that commonly affect back pain. From there, we will decide the best course of action depending on our findings. We aim to educate you on our findings, reduce pain, improve mobility and strength, and provide you with the best treatment plan that aligns with your needs and goals in order to help you return to the activities you love most.

By: Madison Ruffo, Queen’s University Student PT