There are multiple structures within the lower back that can be a source of back pain and these include, intervertebral discs, facet joints, sacroiliac joint or referring pain from surrounding structures in the hip and glutes. You may have heard of a bulging disc or a disc herniation and this is where the contents of the shock absorbing fluid sacks between vertebra protrudes most commonly posteriorly into the spinal canal. This can cause acute localised pain in the lower back and can also compress the nerves and give neural pain and symptoms into the buttock and potentially down the leg. There are facet joints within the vertebra which can become overloaded and inflamed and cause localised pain. The focus for this particular blog is non-specific lower back pain where there is no particular structural cause of their pain. It is important to have input from your healthcare practitioner however you may find that the self treatment and management techniques in this blog can be beneficial for those with almost any of these lower back conditions.
What is non-specific lower back pain:
Non-specific lower back pain is a broad term used to describe lower back pain that has no specific structural cause of the pain but instead may be a result of a combination of inflammation, muscle imbalance, weakness or tightness and tension. The muscles of our core, glutes, lower back and surrounding the pelvis are all designed to work together to stabilise and support our body throughout many single leg and high intensity movements.
If some of these muscles are not strong enough or able to activate and work as they should then it results in an imbalance and lack of stability and can cause muscle imbalance and overload in other areas that then leads to pain. We will break this down a bit more specifically to help you reduce your trouble with non-specific lower back pain.
What are the symptoms of non-specific lower back pain:
The most common symptoms with lower back pain is progressively worsening pain generally in the lower back and morning stiffness. You can have pain that is more prominent on one side over the other if the overload and imbalance or tightness is affecting one side more, but often people report that their pain changes and what is sore one day on the left has flipped to the right the next day etc.
You may experience some referring pain into the buttock or down into the back of the leg and this may be a result of tight muscles triggering the sciatic nerve as it passed below the glute muscles. Occasionally you may experience some sharp shooting pain and this can be a result of tight muscles causing pain and irritation in particular movements.
What are the causes of non-specific lower back pain:
Prolonged positions that cause gradual overload and progressive tightness including sitting, standing, rotation etc as you may experience with repetivie tasks at work.
o Desk and seated jobs can cause poor posture which results in a combination of weak and poor activation of the abdominals, shortening and tightness through the hip flexors which both contribute to forward rotation of the hips. This causes excessive load and pressure on the lower back and over time impacts the way the lower back accepts loads and lead to pain that is not due to a structural injury but an overload of poor mechanics and muscle weakness/imbalance.
o Similar occurrences can happen when in prolonged standing jobs if our core muscles do not activate well and help to counteract the anterior pull on the pelvis.
Acute rotation or picking up an object that has caused a muscular protective spasm. Can feel a bit like a strained muscle however in this case the body has rapidly tightened and grabbed the muscle to protect it and leaves you feeling tight, sore and imbalanced.
An increase in exercise or activity that causes excessive tightness of the glutes, lower back muscles or the quads that can all pull on the lower back can be a cause of non-specific lower back pain.
Management of non-specific lower back pain:
Reducing any excessive loads on the lower back that may be causing increased tightness and stress. You do not need to stop doing everything but it may be really beneficial to be mindful of the activities you are doing that may be causing you additional load through the back while you do a structured core and glute strengthening program to help you manage loads in the future.
Implementing a core strengthening program to help ensure they are active and preventing excessive pelvic tilt throughout their activities. When your core is strong and able to activate quickly, it acts as a stabiliser and protector of the back. Loads that should go through the spine in a mechanically optimal way are able to do so if the core is supporting us. However if we are weak in the core, and our abdominal muscles are unable to support us there will be excessive load going through the back which can cause muscle overload, tightness, stiffness and pain.
Utilising some self-massage and manual therapy techniques to physical help reduce the tension and stiffness in the muscles surrounding the lower back. Trigger point through the glute muscles and along the ITB band. Foam rolling through the quadriceps and ham strings and also static stretching through the hip flexors and glutes to ensure that as best you can you are reducing tightness and excessive pulling from surrounding muscles.
Lastly, seeing a physiotherapist or remedial massage therapist to help with some manual therapy to more specifically release the fascia and muscles around the back and help to mobilise the joints that may be stiff and locked up from the excessive use and tightness.
Services at RIGS that can help with you non-specific lower back pain:
Hot pool
o The heat and magnesium in the CWT hot pool will provide a great muscle release technique and allow the fascia and muscles to relax and reduce their pulling on the back. Additionally the magnesium in the pool helps the body to reduce the sensitivity of our pain receptors so you will naturally reduce the pain you feel by submerging in the hot pool and allowing for magnesium absorption.
IR Sauna
o The IR sauna has a benefit at the deepest level of tissue and muscle to stimulate muscle relaxation and recovery and increased cell activity. This allows for muscle relaxation, improved tissue healing and recovery and overall reduced inflammation in areas that may be inflamed.
Compression boots and hips
o The compressions can allow for increased muscle relaxation and reduced muscle tightness/tension and reduce the pull these muscles may have on surrounding lower back.
As mentioned earlier, these are recommendations that are generalised for those that have non specific lower back pain and may be slightly different for different people. Additionally, even if you have bulging discs, facet joint inflammation or SIJ instability and these are the structural causes of your pain of imbalance you can greatly benefit from self release techniques and from a strength and stability program. Follow up with your healthcare professional for more individualised advice on how to best manage and recover from your lower back pain.
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