Low back pain is the leading cause of disability in the United States and one of the most common conditions seen by physical therapists.

The Effects of Low Back Pain

Low back pain can limit or prevent one’s ability to sleep, move, work, or engage in social activities. And it can lead to physical and emotional fatigue and exhaustion.

Causes of Low Back Pain

Low back pain may be an acute condition, which means it has been experienced for a short amount of time. Or it may be chronic, which means it has lasted months to years. In either case, it can involve one or several of the structures related to the spine and pelvis. These structures include joints, ligaments, intervertebral discs, nerves, and muscle. Pain and symptoms may be present in the midline of the spine as well as in regions of the low back, hips, legs and feet.

Causes include trauma, accidents, underlying disease conditions, sports related injury, arthritis and osteoporosis, and pregnancy. It also can be the result of increased stress on the body caused by prolonged sitting, standing, or other sustained positions.

Dysfunction from key muscles in the spine and pelvis can be significant contributors to low back pain. For example, trigger points in the psoas muscle – a hip flexor that runs from the lumbar vertebrae to the thigh bone – frequently lead to low back pain.

Treatment

Treatment for low back pain should begin with a thorough evaluation by a physician or physical therapist.

Upon completion of the physical therapy evaluation, the physical therapist will establish a plan of care and this will be shared with the coordinating physician.

In most cases of nontraumatic low back pain, the prescription is not bedrest. Patients are encouraged to continue with daily activities as possible. The physical therapist will have a dialogue with the patient about prior level of activity and how to go about daily activities – with modifications as needed – while in physical therapy care.  

Some Preventive Measures

It is important to understand that low back pain is common. Once an individual has experienced an episode of low back pain, the chance of recurrence at some point in the future also is common. This should not necessarily be cause for alarm. The best way to manage back pain is to recognize it when it occurs, to know when to contact a medical professional, and to have a few strategies to reduce the chance of recurrence.

Some general preventative measures include:

  • Maintaining good general mobility and strength. A physical therapist can assist with how to obtain this.
  • Maintaining ergonomic positioning for sitting and work activities.
  • Regular exercise.
  • Pursuing early intervention in event of acute episode of low back pain.

While proper rest is important, the prescription for low back pain rarely is to lie down in complete immobilization and wait for the pain to resolve spontaneously. Consulting a medical provider, such a physician or physical therapist, early in the pain episode can be helpful to determine the best treatment. The medical provider will discuss daily activities and how to continue with life with or without appropriate modifications.