What is Lower Back Pain?

Lower back pain describes discomfort around the lumbar region (located between the top pelvis and below the rib cage). This is a general term used to describe conditions such as muscle spasms, back sprains and spinal conditions. According to the Australian Institute of Health and Welfare, about 4 million Australians report experiencing back problems [1]. Approximately 1 out of 7 people experience persistent or long-term pain. Back pain becomes increasingly more common in those over the age of 25. Due to the general nature of lower back pain, there can be many different types of conditions and causes related to it. As a result, it’s essential to consult a GP about why you may be experiencing lower back pain and what type of treatment options may be suitable for you.

Lower Back Pain Symptoms

The main symptom of lower back pain is pain and discomfort around the lower part of the spine. However, many conditions can cause lower back pain which has various accompanying symptoms, including:

Stiffness
Muscle tightness
Tingling, burning and numb sensations that travel from the back to the leg (see: piriformis syndrome and sciatica)
Difficulty with specific movements (e.g. bending over, sitting to standing, walking, lifting, etc.)
Weakness
Pain that varies from dull to sharp

Lower Back Pain Causes

As lower back pain is a broad term, there are many causes of back pain. Acute lower back pain (persisting for less than three weeks) is usually caused by specific changes, inflammation and injury to the surrounding area. On the other hand, chronic back pain (which has lasted for more than three months) can have various other contributing factors [2] (e.g. stress, depression, anxiety, etc.). Examples of causes of back pain include:

Muscle spasm or injury
Back sprain (or damage to the ligament(s) along the spine)
Disc condition (e.g. bulge, herniation, etc.)
Vertebrae conditions (e.g. spinal stenosis, spondylolisthesis, etc.)
Arthritis
Osteoporosis
Organ problems (e.g. kidney stones, urinary tract infection, etc.)
Fractures
Tumours
Physical injuries (e.g. contusions, muscle tightness, etc.)
Infections
Nerve problems

Tests and Diagnosis

Given the large variety of causes for lower back pain, it’s important to see your GP for a diagnosis. Under most circumstances, symptoms will resolve over several weeks. However, long-term and persistent back pain may require further testing and assessments. Examples of tests that your GPs may refer, includes:

Physical Examination

Your GP may first perform a physical examination. Depending on your symptoms, they may require you to expose the area for observation and perform specific movements from your lower back (e.g. bending forwards, squatting, etc.). If this is not enough information for your GP, further investigations may be warranted.

Imaging

Imaging techniques, such as X-rays, CT scans and MRIs (read here for more info), may be referred by your GP to identify injuries to the lower back. You may be required to travel to a medical and/or radiography centre where detailed images of the structures in your lower back region will be taken. Additionally, any abnormalities, such as injuries or specific conditions, may also be shown on these images.

Blood Tests

If your GP suspects certain conditions, they may request blood tests. These tests will look for specific indicators which may help determine a diagnosis for your lower back pain (e.g. infection, inflammation, etc.).

Lower Back Pain Treatments

Under most circumstances, most episodes of lower back pain are temporary and will resolve over time. However, treatment may be offered to fast-track recovery. Those with chronic back pain (symptoms lasting longer than three months) should require treatment to prevent symptoms from persistent and worsening.

Medication

Your GP may advise over-the-counter or prescribe medications for back pain relief. Medications, such as anti-inflammatories and paracetamol, may be recommended depending on your symptoms, medical history and any other drugs you may be taking.

Physiotherapy

Referrals to a physiotherapist may be made to assist with the short-term and long-term management of your lower back pain. Physiotherapists are qualified health professionals who specifically treat musculoskeletal and physical conditions. They assist with the self-management of your back pain to help ease your symptoms and keep you moving. Depending on your presentation and symptoms, your physiotherapist may utilise a range of treatments, including:

Lifestyle strategies and recommendations
Prescribing corrective stretches and exercises for lower back pain
Hands-on techniques for short to mid-term pain relief (e.g. massage, mobilisations, manipulations, dry needling, etc.)
Electrotherapy
Taping

Injections

Injections around the lower spinal region can help with persistent symptoms of lower back pain and nerve-related conditions (i.e. sciatica). These injections aim to target the affected site of your pain with medications, such as epidural steroids and/or corticosteroids. It may help relieve pain and inflammation around your spine to help restore movement. Additionally, an injection may allow you to participate in your physiotherapy more freely.

Medical Specialist

A referral to a medical specialist (e.g. neurologist, orthopaedic specialist, etc.) could be made if symptoms persist or worsen. Additional testing, guidance and advanced treatment options may be available.

Recovery

Most cases of low back pain will resolve over time. Conditions such as muscle spasms and strains are common reasons some people experience lower back pain. With the proper self-management and treatment, these injuries will be healthy. However, more long-term conditions, such as osteoarthritis and scoliosis, may require maintenance, such as being mindful of posture, exercise and keeping active. Symptoms from these conditions come and go but can be controlled with specific strategies.

Complications

Although most conditions will heal and improve, some people may experience chronic back pain. This refers to situations where back pain persists for more than three months. Physical limitations from chronic back pain can impact work, relationships and exercise. Chronic back pain can be caused by various causes, including spinal conditions, stress and other medical problems (e.g. kidney stones, tumours, etc.). It’s essential to see your GP as soon as possible to receive the necessary testing and treatment to help prevent developing chronic issues.

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