Back pain
In this blog we’re going to share exactly what you should do if you're struggling with Lower Back Pain (LBP). This article is fully referenced for all the science geeks like us out there, but before we get into solutions, we're going to start off by answering an age-old question... 

What Is Causing My Lower Back Pain? 

It’s, without doubt, the most common reason our clients visit us! 
We typically see the most common causes and contributors towards Lower Back Pain include: 
Disc herniation 
Facet joint locking 
Nerve root irritation 
Leg length discrepancy 
Sacroiliac joint dysfunction 
Posterior/Anterior pelvic tilt, to name a few (Borenstein and Calin, 2012). 
Did you know that LBP affects 10-30% of the world’s population, with 80% of people stating that they have been affected by LBP at some point in their life. This makes LBP the most debilitating injury globally! (Ardakani et al). 
The impact of LBP can be compared to conditions like Heart Disease and Diabetes when you consider the financial impact it has on our Health Care System (Ardakani et al. 2020). However, even though it's occurrence is common, the cause isn't as simple to diagnose as you may think. The reason being that the lower or ‘lumbar’ spine is made up of: 
5 Vertebrae 
6 Bones 
7 Ligaments 
10 Sets of Nerves 
10's of Muscles ranging from very large to very small 
As you’ve probably figured out, this means it is a very complex structure! Regardless of the complexity, there are still an array of simple things you can do to help alleviate your pain (Gleinert-Rożeket et al. 2020). 

The Uncomfortable Truth 

Most people try to resolve LBP by treating the symptoms which can reduce discomfort for a period, however this can lead to cyclic back pain which reoccurs every few months or years. Sound familiar? 
What we really need to do is determine the cause of your pain. This is also known as the Pain Generator. As catchy as this phrase may be, the uncomfortable truth is that many practitioners fail to identify 'the pain generator' during a consultation which again can lead to treating the symptoms of pain, rather than what's causing pain in the first place. 

I can’t find the cause! Is my Lower Back Pain in all my head? 

Symptoms of your pain are created through a variety of different pathways, whether it be physical in nature such as a mechanical dysfunction or chemical which is caused by inflammation. 
This can all be aggravated through an additional mentally driven fear avoidance behaviour. This means that you may inadvertently avoid certain situations or positions that you believe could cause further injury to your back out of the fear of a flare up. A good example of this is those of you that may have been told that “your spine is unstable so you shouldn’t bend forward”. Help! 
If you’ve struggled in the past to identify the cause of your pain, it may be because your practitioner is not looking at the bigger picture. When you think of your lower back, it has an upper body and lower body attached at either end. If either end is not pulling its weight or moving as it should (known as a dysfunction) then the lower back may have to work harder than usual to compensate for this. Due to the large prevalence of Lower Back Pain amongst the working population, we need to find a way to help to fix the problem, especially when you consider the effect its having on our health care system. So, what's the best solution? 

Are you ready for the juicy facts? 

We have already identified that discovering the cause of your symptoms is the most vital aspect to a long-term recovery. But what’s next? How do I break the cycle of my back pain returning? Well, Goldman and Jones (2011) state that: 
“Manual Therapies such as; soft tissue therapy and manipulation reduce muscular strains from reoccurring in the future’. 
This is supported by Hidalgo et al. (2013) who also found that: 
“Soft tissue techniques, spinal manipulations and mobilisations help to significantly reduce short- and long-term back pain”. 
However, these successful results only occurred when they were twinned with a personalised exercise programme. 
According to Smith and Grimmer-Sommers (2012), one of the most effective ways of reducing lower back pain for the long term is by adhering to your personalised rehabilitation routine. The reason being, partaking in an exercise regime designed around your diagnosis or dysfunctions not only reduces pain scores but significantly reduced injury recurrence in the future too (Grimmer-Sommers 2012) (Brummit et al. 2013). 
Paley and Johnson (2016) also investigated how exercise reduces our perception of pain. They found an improvement of people’s reports of pain once exercise regimes were followed and also saw a significant improvement to mental health. What more could you ask for?! 
To summarise: 
Exercise regimes that are specific to your pain generator can help to alleviate your symptoms/pain, improve your mental health and reduce the cause from re-occurring! This is all accelerated when combined alongside soft tissue treatments and manipulations. 

So Here It Is! A 4 Step Plan To Fix Your Back Pain 

Identify triggers and get informed - Before you seek out help try to identify the circumstances that caused your problems initially. 
Find the best practitioner for you - Once you know what aggravates and alleviates your symptoms, find your nearest practitioner at Fire & Earth to help find the solution. 
Establish the plan - The right practitioner will determine a prevention and/or maintenance plan to help you to fix the dysfunctions and driving causes behind your pain generator. 
Stick with it! - Once you have a solution, don't forget to do your homework to stay pain free...or you'll end up back square one. 
So, there you have it, a quick 4 step roadmap on how to fix your back pain. 
If you would like help to break the cycle of your lower back discomfort, then book an appointment HERE with one of our skilled practitioners today. We’re here to help, and we have a great deal of experience in the written theoretical and practical treatment approaches to lower back pain. 
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