11 Things to Help You Understand Your Back Pain

Written by: Physiotherapist Loulou Negoescu.

Your back is a strong structure that provides support for your pelvis, legs, ribcage, arms and skull. The spine is made up of bones called vertebrae that are stacked together to form a S shaped column. 

Each vertebra (bony part) is cushioned by spongy tissue called intervertebral discs. These discs act as shock absorbers and give your spine its flexibility. A mesh like tissue called ligaments helps to hold the spine together as well as the muscles of the back and spine! The spine carries the nerves that make up part of your spinal cord which is responsible for the movement and sensation in your legs and arms! This is why sometimes you might experience referred back to other places beyond your back.

If you have back pain, you’re not alone. It’s a common problem experienced by many Australians. In fact 1 in 6 Australians reported back problems in 2014–15. That’s 3.7 million people.

Top 11 things I would like you to know about recovering from Lower Back Pain.

1. Lots of things can drive up your sensitivity to pain.
   These include lack of sleep, emotional and physical stress.

2. Stay active
   Aim for a small amount of walking, bike riding, gentle stretches, water walking, any low impact activity you previously enjoyed. Pay attention to the things that make you feel better – you might find that small amounts of light activity actually helps to reduce your pain.

3. Try to pace yourself
   Rather than returning to exactly what you were doing before your back was sore – build up your tolerance to exercise slowly this will help to reduce flair ups.

4. Aim to stay at work
   Possibly on restricted duties if required, and developing a plan with your employer to return to your full work. Your doctor, physiotherapist and occupational therapist can help you with information about how to stay at work.

5. Change your position often
   If you have been sitting or standing in one position for a period of time (for example when at work, or while travelling).

6. Relaxation techniques
   Learn some relaxation techniques to reduce stress levels and related muscle tension. Try massage, heat or cold packs and gentle exercise. Seek advice from a physiotherapist.

7. Pain doesn’t equal harm.
   Each time you move and feel pain it doesn’t mean that you are making it worse, it just means that the muscles and tissues in your back are sensitive.

8. An MRI scan of your back is not a great indicator of how well you can recover
   The natural ageing process causes changes of EVERY structure of the human body. Just like wrinkles are normal of ageing skin, changes to the intervertebral discs, facet joints and vertebral bodies are normal of an ageing spine. The important thing to remember is, do the MRI findings specifically relate to your pain. Don’t let your scan results influence your beliefs and how you behave. Come in and chat to one of our experienced physiotherapists and let us reassure you, and assess you and NOT your image findings.

   A recent study on the prevalence of age related changes on spinal imaging showed a staggering 80% of 50 year olds with NO back pain had findings of disc degeneration and 60% had disc bulges.

9. Try to improve your overall health
   – Such as losing weight if you are overweight
   – Quitting smoking might also help to reduce your pain as there is a high association with cigarette smoking and back pain.

10. See a healthcare professional
    And expect to play an active role in your recovery! The evidence suggests that the best outcomes include:
    – Education – pain is very complex and sometimes it can help to understand how it works!
    – Pacing strategies
    – Graduated movement and exercise program
    – A multidisciplinary team including cognitive behavioural therapy.
    – Occasionally pharmaceutical treatments such as medication.
    – Referral for a scan (MRI) if necessary. 

11. Try to be patient.
    If you have had this pain for a long time, it can be very frustrating and affect all areas of your life. However, be patient as your pain can improve.

There are also a number of things that can make it more likely that the back pain will become persistent, such as:

• already living with, or developing, negative beliefs about your chances of recovery
• already living with, or developing, depression or anxiety
• work-related issues.

In a very small number of people, back problems are caused by a serious condition such as cancer, inflammatory problems, infection, fracture or compression of the nerves in the spine. However this is rare, and your doctor/physiotherapist/medical team will check for these causes.

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