Lower Back Pain and Sciatica
Lower back pain is one of the leading causes of pain and disability around the world. Physiotherapy has been shown in multiple research papers to be very effective at managing the pain and dysfunction associated with problems in this area.
The Lumbar spine (lower back), is made up of 5 vertebrae (bones) in the lowest part of the spine. Lower back pain is a common condition that most of us will experience at some stage in our lives. There are several different causes of lower back pain, with the vast majority of cases being of musculoskeletal origin without any serious structural damage. These cases respond very well to physiotherapy and a structured rehabilitation program.
I also have pain in my buttock or running down my leg from my back. What does that mean?
Referred pain associated with lower back pain, often referred to as “sciatica”, can be due to either somatic referred pain or radicular referred pain, both of which are described below. Our physiotherapists are trained to use specific tests to determine the cause of leg symptoms and treat them appropriately.
Somatic referred pain is the most common cause of leg symptoms in patients with lower back pain and is often the cause of pain in the buttock or back of the hamstring. The symptoms are due to referred pain, where the pain sensations from the lower back are mixed with the sensations from the leg. Unlike radicular referred pain, there is no direct compression or irritation of the nerve roots that exit the spine, it is simply due to crossed signals between the sensory nerves coming from the muscles/joints of the back and those coming from the muscles/skin of the legs. This type of cross talk is similar to the cause of neck based headaches.
Radicular referred pain is the term used to describe symptoms in the leg that are due to compression or irritation of a nerve root in the lower back. The nerve root may be physically impinged by a disc or bone, or may be irritated by the inflammatory chemicals that are associated with an surrounding injury. Pain in the leg will often follow a dermatomal pattern, where the symptoms travel in a line from the lower back down to the foot. There may also be numbness/pin and needles/weakness in the leg . It is vital that radicular referral pain is assessed thoroughly by a physiotherapist or other professional therapist, as these nerve injuries can lead to weakness that can be longstanding.
How can physiotherapy help my lower back pain?
Physiotherapy is one of the most effective methods for the treatment of lower back pain. There is a large amount of research to support the techniques that we use. A majority of cases of lower back pain respond well to a program of manual therapy and graded exercises. Manual therapy can include massage, and joint mobilisations, dry needling and manipulations. These techniques reduce pain and help to restore movement. The exercise program typically includes a combination of range of motion and mobility exercises, trunk and leg strengthening exercises, and a gradual return to activities. Pilates has also shown to be a very effective tool in helping to prevent flareups.
