Lower back pain

Lower back pain, or lower back problems, is a collective term for all issues in the lower back. These issues cause pain in the lower back and discomfort during daily activities. About 75% of adults experience back problems at some point. This can be for a short period, but the lower back can also cause long-lasting symptoms.

Types of lower back pain

Lower back pain is divided into specific lower back pain and non-specific lower back pain. With specific back pain, the cause of the symptoms is known. With non-specific lower back pain, there is no clear cause. About 90% of lower back problems consist of non-specific lower back pain.

Specific lower back pain
10% of back problems are specific back pain. Those back problems have a clear cause. There are two different types of specific lower back pain:

1. Back pain with nerve entrapment (lumbosacral radicular syndrome).
   In this case, back problems are present with radiating pain. This radiation is caused by a pinched nerve. The best-known example of this is a herniated disc.
2. Back pain caused by a disease or condition in the lower back.
   Examples include:
   - Bone fracture.
   - Osteoporosis.
   - Tumor.
   - Ankylosing spondylitis.
   - Infection.
   - Spinal canal stenosis.

Non-specific lower back pain
With non-specific lower back pain, there are back problems without a clear cause. The pain can radiate to the pelvis, buttocks, and thighs. The pain gets worse with certain movements, postures, or activities. The pain can be intermittent or continuous, and it may also get worse during the day.

Three phases of lower back pain

Lower back pain is divided into three phases. The division is based on how long the symptoms have been present.

• Acute lower back pain (up to six weeks).
• Subacute lower back pain (six to 12 weeks).
• Chronic lower back pain (longer than 12 weeks).

Lower back pain normally resolves on its own in the first six weeks. The body then heals the symptoms itself. It is important to keep moving. Treatment usually does not speed up recovery. Recovery can be hindered by fear or extreme pain. In that case, treatment in the first six weeks can be useful. This can be done with pain relievers and physical therapy.

Treatment of lower back pain

Treatment is often the same for both specific and non-specific lower back pain. The solution lies in moving properly (and continuing to move). A large part of the treatment will therefore consist of exercises.

To move well, massage, mobilizations, or manual therapy can be applied. These treatments aim to reduce pain and increase mobility. These forms of treatment provide relief, but often only temporarily if you do not subsequently move in the right way.

Specific lower back pain is also treated by moving correctly, even if there is, for example, a herniated disc or a fracture in the back. By keeping the back as strong as possible, the symptoms recover better. This does take longer than six weeks, and it is wise to seek advice from a physical therapist.

Surgery is performed when normal treatment does not work, or when symptoms arise due to nerve deficit or a fracture that can no longer recover. Fortunately, this is rare.

A physical therapist guides people with lower back pain. They also know when movement should be discouraged. Acute, subacute, and chronic back pain are treated in the same way. The big difference is that the longer the symptoms are present, the longer recovery will take.

Pain in the lower back

It has been scientifically proven that back pain itself does not say anything about the cause. Managing the symptoms properly and keeping the body as strong as possible reduce the pain, as long as you move in the right way. Avoiding pain by moving less is a normal reaction, but in many cases, it is counterproductive. In other words, by moving less, you often only get more lower back pain.

Take the self-check for lower back pain to assess your symptoms. Would you like help, advice, or do you have a question about lower back pain? Then make an appointment with a physical therapist near you.