Back pain affects up to 85% of the population at some point during their lives. The good news is that 90% of people will improve within 3 months. Tom Hamilton, Physiotherapist at The Healthy Body Company has provided this great article that will assist us all in having a better understanding of the difference between acute and chronic back pain
So the goods news was that most people will have an improvement in their back pain within 3 months, however around 50% will have at least one recurrent episode. The lower back is often the culprit in back pain, so that is the focus of this article.
The treatment for back pain differs depending on not only the cause of back pain, but also how long the person has had their pain.
Acute lower back pain is classified as pain lasting for up to 2 weeks. Acute lower back pain often occurs suddenly and usually by trivial tasks, such as bending forwards to pick something up (we’ve all heard the saying “the straw that broke the camel’s back”, it’s apt here). Pain gradually increases over the next few hours and the person often finds themselves locked into a stiff position. It is not uncommon for pain to also radiate down into the buttocks or legs.
Management of acute low back pain is primarily focused on decreasing pain. It is important to note that everyone with lower back pain presents differently and there is no singular method to help manage the pain. Instead, there are a number of principles which are adapted specifically to each person. Therefore early assessment by your physiotherapist is vital so you can begin your recovery.
Management of acute lower back pain generally starts off by identifying positons of comfort. This will be different for everyone. Often side lying, lying on your stomach or back helps depending on the exact source of pain. Bed rest for the first 48 hours in a position of comfort also helps. However, bed rest for longer than 48 hours has been shown to be detrimental. After initial rest it is time to start moving, movement into directions which are ‘away’ from pain are encouraged. Any painful movements and prolonged postures (such as sitting, don’t forget sitting in the car) should be avoided. Your physiotherapist will help decide which movements and exercises are appropriate for you. Taping, pain medications, anti-inflammatories and electrotherapeutic modalities are other common treatment options which yourself and your physiotherapist may employ.
Once the pain is under control the physiotherapist will then identify and remove possible causes of the back pain e.g. activity modification , poor posture or poor biomechanics. The physiotherapist will then help restore optimal flexibility, strength and fitness.
Lower back pain, which has been present for longer than 3 months, is considered chronic back pain. Chronic lower back pain can be caused by a variety of things. In this time people may have acute exacerbations of their back pain (you know, when that back pain that niggles regularly is suddenly much worse), this is called acute on chronic low back pain and is initially managed the same way as acute low back pain.
Management of chronic lower back pain can be difficult as the cause of the pain is often irreversible and progressive in nature. This is where physiotherapy can help. The primary aim of physiotherapy is to slow down the progression of pain and to manage associated symptoms. Your physiotherapist will educate you on the expected course of your condition and the numerous rehabilitation and self-care options. It is important that you remain active and continue with normal activities for as long as possible.
Strong research evidence suggests physical activity and therapeutic exercise are effective for the management of chronic lower back pain.
There is some conjecture in the research as to the type and quantity of exercise, therefore your physiotherapist will help tailor a graded and active exercise program just for you. Taping, bracing, pain medications, anti-inflammatories, electrotherapeutic modalities and manual therapies (such as massage and manipulation) have also been shown to have some benefit in chronic low back pain reduction.
We know that lower back pain is a complex and common condition. Everyone presents differently and as there is no ‘gold standard’ exercise or treatment program. It is important to seek the help of highly trained health professionals, such as your physiotherapist. Physiotherapists will thoroughly assess the patient’s symptoms and work on an individualised management program best suited to the person and condition.
Tom Hamilton is a Physiotherapist and quite an excellent soccer player. You can see him in our Penrith practice.
