Low Back Pain
Low back pain, Lower back pain, lumbago
We treat using a combination of techniques including soft tissue Active Release Techniques, Trigger point therapy which can include dry needling, spinal and pelvic manipulation, Microcurrent and particularly important rehabilitation of the spinal stabilising system where required.
What is it?
Low back pain refers to pain arising from one or of structures in the lower back..
How does it happen?
Low back pain results from damage to structures in the back (i.e. muscle, ligament, disc, nerve and bone). It
commonly occurs following a relatively simple movement such as bending forward or twisting through the
spine. However, lower back pain can also occur through more complex and forceful movements of the lower
spine.
How does it feel?
Low back pain is experienced as pain from the lower back. This is often a dull or strong ache, which is made
worse by movement. In some situations, it may prevent you from ‘straightening up’ to a normal standing
posture. The pain may be central in the back, to one side or on both sides of the spine. It may also radiate
down into the buttocks, back of the thigh or lower leg.
What should you do?
If you have low back pain, you should consult your nearest sports medicine professional for an appropriate
assessment, diagnosis and treatment.
What shouldn’t you do?
If you have low back pain, you shouldn’t ignore the problem and continue to participate in sport. This may
lead to the problem increasing and result in a prolonged recovery. In addition, you should avoid other
activities which aggravate your pain.
Could there be any long-term effects?
Low back pain usually does not produce any long-term effects, as long it is properly diagnosed and
appropriately treated. Recovery usually takes place in a number of days to weeks. The main ongoing
problem associated with low back pain is its tendency to re-occur if poorly managed.
Management
The assistance of a sports medicine professional is important in the treatment of low back pain. Initially, they
can assist in diagnosing the problem and determining its severity. From this information, the we should be
be able to determine an appropriate treatment plan. This may initially involve techniques to reduce your
pain. These may the modalities mentioned above. When your pain has settled sufficiently, we will be able to
provide you with a series of stretching and strengthening exercises designed to return you to your normal activities,
while reducing the chances of your back pain re-occurring.
Acute nerve root compression
What is it?
Acute nerve root compression refers to when a nerve leaving from the spinal cord is compressed by a
structure within the back.
How does it happen?
Acute nerve root compression most commonly occurs when an intervertebral disc prolapses. An
intervertebral disc refers to the disc between two vertebrae in the lower back. When this disc is injured, its
contents may prolapse or bulge outwards into the spinal canal that contains the spinal cord and the nerves
that lead on towards the legs. This bulge, therefore, can compress these structures. The mechanism of
injury can occur following a relatively simple movement such as bending forward or twisting the spine, as
well as through a more complex and forceful movement of the spine.
How does it feel?
Acute nerve root compression produces a sudden onset of pain felt in the lower back. This may be
associated with the inability to stand up straight and made worse by sitting, bending, lifting, coughing or
sneezing. In addition, this nerve compression may produce pain within the legs. This results from
compression of the nerves to the legs. This source of leg pain may be sharp, shooting, and accompanied
with pins and needles, numbness or weakness in the legs.
What should you do?
If you have or suspect you have an acute nerve root compression, you should consult your nearest sports
medicine professional. If, in addition to back and leg pain, you have numbness in the saddle region and are
having difficulty passing water (urination) you should go to your nearest emergency department.
What shouldn’t you do?
If you have or suspect you have an acute nerve root compression, you shouldn’t ignore the problem and
continue to participate in sport. This may lead to your problem increasing which may prolong your recovery.
In addition, you should not perform any activities that aggravate your pain.
Could there be any long-term effects?
Acute nerve root compression does not usually produce any long-term effects, as long as it is appropriately
diagnosed and treated. Recovery usually takes place in a number of weeks. However, in some cases, this
period may be prolonged. This will largely depends on the size of the disc bulge and the extent of nerve
compression. If the disc bulge is extremely large and causing severe nerve compression, it may be
necessary to undergo surgical procedure to release the pressure on the nerve. This will prolong your
recovery time.
Management
The assistance of a sports medicine professional is important in the treatment of acute nerve root
compression. Initially, they can assist in diagnosing the problem and determining its severity. This may
require the use of imaging techniques such as an X-ray, CT scan or MRI. From this information, the sports
medicine professional will be able to determine an appropriate treatment plan. This may initially involve
techniques to reduce your pain. These may include activity modification, anti-inflammatory medications,
spinal traction, electrotherapy treatment, or taping of the back. When your pain has settled sufficiently, the
sports medicine professional will be able to provide you with a series of stretching and strengthening
exercises. These will be designed to return you back into sports participation, while reducing the chances of
the injury re-occurring.
Stress fracture of the pars interarticularis (pars defect)
What is it?
Often referred to as a ‘pars defect’, a stress fracture of the pars interarticularis refers to an incomplete
fracture or crack within the rear portion of a vertebra.
How does it happen?
A stress fracture of the pars interarticularis is usually a result from an overuse injury. In activities that require
excessive arching or rotation of the lower back, the rear portion of the vertebral bones are overstressed. In
response to this increased stress, the bone increases its bone turnover. Bone turnover involves the removal
of weakened, damaged areas of bone and the laying down of new bone at the same location. To do this, old
bone is resorbed (removed) before it is replaced with new bone. If bone formation cannot keep up with bone
resorption, areas of weakness can develop within the bone. These can develop into a stress fracture if the
bone is continually loaded. This is commonly seen in activities such as gymnastics, fast bowling in cricket,
tennis, rowing, dance, weightlifting, pole vaulting and any throwing activities such as baseball pitching,
javelin, discus and hammer throw.
How does it feel?
A stress fracture of the pars interarticularis results in pain that is felt in the lower back. This pain is usually
on one side of the spine and is made worse through activity, particularly those involving arching of the back.
Occasionally the pain may extend into the buttocks. In some situations, the stress fracture of the pars
interarticularis may be asymptomatic and it may have been discovered incidentally following an X-ray of the
lower back.
What should you do?
If you have or suspect you have a stress fracture of the pars interarticularis, it is advised you avoid activities
which aggravate your pain and seek the assistance of a sports medicine professional.
What shouldn’t you do?
If you have or suspect you have a stress fracture of the pars interarticularis, you shouldn’t continue with
activities which aggravate your pain by making it worse. These will lead to further pain and deterioration of
your condition.
Could there be any long-term effects?
A stress fracture of the pars interarticularis is a serious structural problem within the back. Despite this,
appropriate management can usually return you to your desired activities without ongoing problems.
Management
The assistance of a sports medicine professional is important in the treatment of a stress fracture of the pars
interarticularis. Initially, they can assist in diagnosing the problem and determining its severity. This may
require the use of imaging techniques such as an X-ray, CT scan or MRI. From this information, the sports
medicine professional will be able to determine an appropriate treatment plan. This may include activity
modification, electrotherapy treatment, taping of the back, and the progression through a series of stretching
and strengthening exercises relevant for injury recovery.
Spondylolisthesis
What is it?
A spondylolisthesis refers to the slipping of one vertebra (spinal bone) forward on another. The term is
derived from the Greek language spondylos, meaning vertebra, and olisthanein, meaning to slip or slide.
How does it happen?
A spondylolisthesis results from damage to the rear portion of a vertebra. This portion of the vertebral bone
acts as an anchor to stop the main body of the vertebra from slipping forwards. When the back portion of the
vertebra is damaged, it enables the main portion of the vertebra to slip forwards resulting in a
spondylolisthesis.
How does it feel?
A spondylolisthesis results in pain felt in the lower back. This pain is usually aggravated by activity,
particularly activities that involve extension or arching of the back. Occasionally the pain may extend into the
buttocks, back of the thighs and the lower legs. In some situations, the spondylolisthesis may be
asymptomatic and it may have been discovered incidentally following an X-ray of the lower back.
What should you do?
If you have or suspect you have a spondylolisthesis, it is advised you avoid activities that aggravate your
pain and seek the assistance of a sports medicine professional.
What shouldn’t you do?
If you have or suspect you have a spondylolisthesis, you shouldn’t continue with activities that aggravate
your back or make the pain worse. These may lead to further vertebral slipping and deterioration of your
condition.
Could there be any long-term effects?
A spondylolisthesis is a serious structural problem. It is a condition that does not repair itself and a condition
with which people have to live with for the rest of their lives. Despite this, appropriate management can
usually help you continue with your desired activities, without ongoing problems.
Management
The assistance of a sports medicine professional is important in the treatment of a spondylolisthesis.
Initially, they can assist in diagnosing the problem and determining its severity. This may require the use of
imaging techniques such as an X-ray, CT scan or MRI. From this information, the sports medicine
professional will be able to determine an appropriate treatment plan. This may include activity modification,
anti-inflammatory medications, electrotherapy treatment, taping of the back, and progression through a
series of stretching and strengthening exercises to assist in stabilisation of the lower back.
Sacroiliac joint disorders
What is it?
The sacroiliac joint is the joint that is found between the two pelvic bones (sacrum and ilium) at the back of
the pelvis. The sacrum is a continuation of the vertebral column. Disorders of this joint refer to any condition
affecting the function of the joint.
How does it happen?
The exact cause of a sacroiliac joint disorder is not clear. However, it may result from excessive movement
in the joint. This excessive movement stresses the ligaments and soft tissue structures that support the joint.
If the ligaments and supporting structures are continually stressed and overstretched, pain and inflammation
of the sacroiliac joint can result.
How does it feel?
Sacroiliac joint disorders generally cause pain. This is frequently experienced very low in the back, around
the top of the buttocks. It is often only felt in one buttock; however, in some instances it may be felt in both.
The pain may also be referred to the groin or the front and outside of the thigh.
What should you do?
If you have or suspect you may have a sacroiliac joint disorder, you should consult your nearest sports
medicine professional.
What shouldn’t you do?
If you have or suspect you have a sacroiliac joint disorder, you shouldn’t ignore the problem and continue to
participate in sport. This may lead to your problem deteriorating, resulting in a prolonged recovery. In
addition, you should avoid activities that aggravate your pain.
Could there be any long-term effects?
Sacroiliac joint disorders usually do not produce any long-term effects, as long as they are properly
diagnosed and appropriately treated. Recovery usually takes place in a number of weeks. Occasionally this
recovery may be prolonged if the injury is severe.
Management
The assistance of a sports medicine professional is important in the treatment of a sacroiliac joint disorder.
Initially, they can assist in diagnosing the problem and determining its severity. From this information, the
sports medicine professional will be able to determine an appropriate treatment plan. This may involve
activity modification, the use of anti-inflammatory medications, soft tissue treatment such as massage and
stretching, and the progression through a series of specific strengthening exercises. Occasionally an
injection of an anti-inflammatory may be injected into the sacroiliac joint to stimulate healing.
Iliolumbar ligament sprain
What is it?
The iliolumbar ligament is a ligament that runs from the pelvis bone (ilium) to the lowest lumbar vertebra in
the back. A ligament sprain refers to a ligament that is overstretched and injured.
How does it happen?
An iliolumbar ligament sprain occurs when the ligament is overstretched. This usually occurs when the lower
back is forcefully bent, arched or twisted.
How does it feel?
An iliolumbar ligament sprain results in lower back and upper buttock pain. This is usually felt deep in the
back and to one side of the spine. It may be made worse through activities such as bending, arching or
twisting the back.
What should you do?
If you have or suspect you have sprained your iliolumbar ligament, you should consult your nearest sports
medicine professional.
What shouldn’t you do?
If you have or suspect you have sprained your iliolumbar ligament, you shouldn’t ignore the problem and
continue to participate in sport. This may lead to your injury deteriorating which may prolong your recovery.
In addition, you should not perform any activities that aggravate your pain.
Could there be any long-term effects?
An iliolumbar ligament sprain does not produce any long-term effects, as long as it properly diagnosed and
appropriately treated. Recovery usually takes place in a number of days to weeks.
Management
The assistance of a sports medicine professional is important in the treatment of an iliolumbar ligament
sprain. Initially, they can assist in diagnosing the problem and determining its severity. From this
information, the sports medicine professional will be able to determine an appropriate treatment plan. This
may involve activity modification, the use of anti-inflammatory medications, and soft tissue treatment such as
massage and joint mobilisation. If recovery is prolonged, an injection of an anti-inflammatory directly into the
iliolumbar ligament may be used to stimulate healing.