What it is Chronic back pain?
It can be defined as chronic pain localized on the back. Pain is considered chronic the duration is more than three months. Chronic pain in the low back can be secondary to a disc problem, a joint problem, and/or an irritated nerve root.
What are the causes of chronic back pain?
There are several causes of chronic back pain. Some of them are:
- Lumbar herniated disc. The center of a lumbar disc can break and as consequence can irritate a nearby nerve root.
- Degenerative disc disease. At birth, intervertebral discs are full of water. As people became older discs can lose normal hydration and wear down. As the disc loses water, it cannot resist forces as well and transfers force to the disc wall that may develop tears and cause pain or weakening that can produce herniation. The disc can also collapse and contribute to stenosis of the spinal canal.
- Facet joint dysfunction. There are two joints behind every spinal disc at each motion segment in the lumbar spine. These joints can be painful or can be painful in conjunction with a painful disk.
- Sacroiliac joint dysfunction. The sacroiliac joint is responsible to connect the sacrum at the bottom of the spine to every side of the pelvis. The sacroiliac joint can become painful secondary to any inflammatory process or if there is less or more motion of the joint
- Spinal stenosis. This condition usually produces severe pain. The reason for this pain is because the spinal canal became narrow and compress the nerve root.
- Spondylolisthesis. This condition occurs when one vertebra slips over the adjacent one. There are 5 types but the most common is secondary to a defect or fracture of the pars or secondary to a degenerative process. The pain can be caused by instability of the lumbar spine or the compression of the nerves with a consecutive radiation of the pain to the leg.
- Osteoarthritis. Spinal osteoarthritis is associated with age and is slowly progressive.
- Deformity. The spine has natural curves. If one of them change the other one is going to change in a pathological way. The deformity can produce lower back pain if it leads to the breakdown of the discs, facet joints, sacroiliac joints or stenosis.
- Trauma. Acute fractures or dislocations can produce back pain. In the case of trauma, the patient should be carefully evaluated by the medical doctor.
- Compression fracture. A fracture that occurs in the cylindrical vertebra can produce acute pain. This type of fracture is most common due to the weakness of the bones, such as from osteoporosis, and is very common in older people.
How can physiotherapy help with treating chronic back pain?
There are several physiotherapist interventions such as exercise, manual therapy, and acupuncture considered appropriate treatment techniques to use in the management of patients with back pain. The exercises applied to depend on the severity and the cause of the back pain
What Physiotherapy treatments assist (that Physiotherapy offers mostly and Cortisone/Corticosteroid injections otherwise if applicable)
The epidural corticosteroids injections are frequently used in situations of radicular pain. But the physiotherapy is very important as part of the management of a patient with back pain. Once the patient is classified according to age, type on injury or diagnosis, the Physiotherapy can lead the non-pharmacological treatment and management.
The best exercises for it if applicable
Exercises to try if back pain is eased by standing or lying down:
- Alternate arm and leg (bird dog)
- Backward Bend
- Hip flexor stretch
- Relax and rest
Exercises to try if back pain is eased by sitting down:
- Double knee-to-chest
- Piriformis stretch
- Single knee-to-chest
Exercises to try when no position eases your back pain:
- Front Plank
- Hamstring stretch
- Pelvic rock, sitting
- Pelvic rock, standing
- Pelvic tilt
- Side plank, beginner
- Side plank, intermediate
- Wall Sit