LOW BACK PAIN Low back pain (LBP) is the UK’s most common cause of disability affecting about 70% of people at some point which leads to more than 2.5 million people in the UK suffering from LBP on a regular basis.
Very often simple cases of acute LBP settle themselves quickly without any intervention from a medical practitioner. Usually within a week significant improvement will be felt, but it may take 3 – 4 weeks before all symptoms have settled.
So who is affected by LBP?
Everybody can be affected by LBP but the most common age range is between 25-55. The cause may be a condition for which you have no control over such as degenerative disc disease or may be caused completely by yourself for example lifting poorly of sitting incorrectly. The good news is in either case with appropriate help and advice you should be able to either settle or significantly reduce acute LBP or sciatica.
Points to remember If the pain is very bad you may have to rest for a day or so but it is important to get active as soon as possible. Bed rest does not promote recovery but instead makes it more likely you will stiffen up and the muscles will become weaker.
Stay as active as possible and try to continue / return to normal activities as soon as possible. Even if you have to reduce your activity levels some is better than none and can prevent progression onto more chronic problems leading to longer term disablement.
Take pain killers regularly rather than just when you can no longer cope with the pain. People don’t like to take too many painkillers but it is important as to control the pain will allow you to be active and prevent more chronic LBP. A common fallacy is that this will mask the pain so leading to more damage but this is simply not the case.
It is normal to continue to get some pain at first when you return to normal activities. Pain does not equal further damage but instead use this as a guide to tell you how much and what you should be doing - pain at manageable level is ok, worsening pain suggest you are either overdoing things or performing the wrong type of activity.
PAIN CONTROL-MEDICATION There are a number of medications that can be purchased over the counter which would be suitable as the first line in controlling your LBP or Sciatica rather than contacting your G.P for either the same products or being prescribed stronger medication. Analgesics such as Paracetamol or Co-codamol can be purchased from your pharmacist while Ibuprofen and now Voltarol are two types of anti-inflammatory medication that can be obtained without prescription.
It is important to check with your pharmacist that the medication you purchase is suitable for you as an individual before taking them. You should not take anti-inflammatory medications for example with either of the following:
5)If you are on blood thinning agents such as Warfarin
It is important that you take your pain control at regular intervals not as and when you feel the need. The effect of anti-inflammatory medication for example may take several days to take effect so will not work efficiently if used as and when. Also by taking painkillers regularly and controlling the pain will enable you to get on with more normal daily activities and being more active is very important in dealing with LBP. There is a common misbelieve that by taking medication you are simply masking the pain and will cause further damage as this allows you to do too much. This simply isn’t true, in fact the reverse is true, the more active you can be the quicker you should recover and the less chance of secondary complications occurring such as stiffening and weakening of the lower back.
Better pain control usually will allow more effective treatment from your therapist. If you are in too much pain then it can make assessment and hands on treatment difficult thus reducing any benefit you may be able to gain from seeing the physiotherapist. Should these medications not provide sufficient pain relief to allow effective treatment then the therapist may speak to your G.P. on your behalf.
Exercises for acute LBP/sciatica There are many causes of acute LBP/sciatica and it is not possible from symptoms only to diagnose the specific pathology causing any one persons pain. This can’t be done over the phone either, instead a full and detailed assessment will need to be carried out by an experienced therapist.
This is important to remember when trying the following exercises. They are provided to allow you the patient to try and start some self treatment so as to speed up recovery and try to gain some relief from the pain. However it should be remembered that they have been given as a guide only before assessment and that at no time should they make your symptoms feel worse. The rule of thumb to remember for low back pain WITHOUT pain referred into the leg is - to feel pain in the back while doing the exercises is acceptable but worsening of the pain or pain spreading to the leg is not acceptable.
If you have acute low back pain and sciatica ‘pain referred into the leg’ before you start the exercises then remember - while doing exercises pain in the back or even an increase in back pain is acceptable, but the exercises must NOT aggravate the leg pain. If this occurs you must stop the exercises until you have seen a therapist and been fully assessed.
The most common cause of acute low back pain or sciatica is due to a disc prolapse or ‘slipped disc’ as it is commonly referred to. This is very treatable and will usually settle itself in time anyway. The extension exercises over the page would usually be the first to try in such a case so would be a good point to start from being the most likely cause. Remember they should never aggravate/produce any leg pain, if they do then stop and you may try the alternative set of flexion exercises.
The following exercises should help to reduce your low back pain or any pain referred to either leg from your back.
These exercises may increase your low back pain temporarily but should never produce or increase your leg pain. If an exercise does produce any leg pain then stop that exercise and regress to the previous one.
Once you can do an exercise without any aggravation then progress onto the next exercise, the next time you do your exercises. The exercise may be done as often as every hour.