Understanding Back Pain

What is Back Pain?

Back pain refers to discomfort, stiffness, or pain located in the upper, mid, or lower back. It can range from mild and intermittent to severe and constant, significantly impacting daily activities.

Common Presentations

  • Dull, aching pain

  • Sharp, localised pain

  • Muscle stiffness of spasms

  • Limited mobility and difficulty moving

Manage Low Back Pain
Causes of back pain

Common Causes

  • Muscular sprain or ligament strain from excessive or sudden loads and forces

  • Sustained postures and unaccustomed ergonomics

  • Previous disc injuries or recurrent history of back pain

  • Inflammatory conditions (e.g., Ankylosing Spondylitis, Sacroiliitis)

  • Trauma

  • Stress and lifestyle factors

Prognosis

Most episodes of acute back pain improve significantly within 2-6 weeks, though recurrence is common. Persistent (chronic) back pain, lasting beyond 3 months, may require comprehensive management strategies

Low Back Pain of Acute Duration

Acute Back Pain

Acute back pain lasts less than 6 weeks, often linked to specific incidents like lifting, bending, or injury

Types of Back Pain

Chronic Back Pain

Persistent Back Pain

Persistent back pain continues for 12 weeks or more. It may result from complex interactions of biological, psychological, and social factors.

Back Pain with Radiculopathy

Referred Back Pain

Refers to back pain accompanied by pain, tingling, or numbness radiating into the legs due to nerve involvement, commonly from disc herniation or spinal stenosis.

Osteopathic back assessment

Assessing Back Pain

Assessment typically involves:

  • Comprehensive clinical history

  • Physical examination (mobility, strength, neurological assessment)

  • Imaging (when indicated)

  • Identification of biopsychosocial factors

Evidence-Based Management

Management strategies supported by current clinical evidence include:

  • Exercise and physical therapy: Tailored exercise programs and manual therapy

  • Education: Information on self-management strategies, activity modification, and reassurance about the generally benign nature of back pain

  • Cognitive Behavioural Approaches: Psychological interventions for persistent back pain.

  • Medication: Short-term analgesics may be indicated but used cautiously and in accordance with clinical guidelines.

  • Referral: To specialists or interdisciplinary teams when necessary.

Management of back pain