Lower back pain is only slightly less escapable than death and taxes: it affects about 80% of people throughout their lifetime.
As debilitating as it is, it does usually resolve itself. It is uncommon for this pain to persist longer than a couple of months after an acute injury.
Of the cases that do persist the majority of these (around 85%) are what is termed non-specific lower back pain.
One of the main reasons for pain persisting is the development of faulty movement patterns and postures which create repetitive stress on the back. This repetitive strain is what leads to the vicious cycle of pain.
Examples of factors which might influence lower back pain include:
– Use of repetitive postures or movements such as sitting for people with a desk-based job or lifting for nurses/health care assistants
– Muscle strains or sprains
– Lack of exercise resulting in a stiffening of the spine
– Lack of exercise resulting in deconditioning which means you are more likely to strain the back during the performance of everyday activities such as lifting and bending
– Correcting faulty movements and postures will improve the way you load and use your back. However, this alone may not resolve your pain: there are other factors that influence pain and need to be considered and addressed.
Other examples of why back pain may persist are listed below.
– Physical factors (such as altered postural and movement patterns)
– Lifestyle factors (such as chronic stress, activity levels, conditioning and sleep disturbance)
– Cognitive factors (such as beliefs, fear, negative emotions, anxiety and low mood)
– Nervous system factors (such as sensitised structures, reduced pain thresholds, altered pain processing and stress response)
– Structural pathology (which is significant for a small group of people)
Different combinations of the above examples are present for each person with back pain and combine together to cause a vicious cycle of pain.
Research shows that focusing on one aspect of pain alone such as physical influences (posture and movement) is ineffective, especially when pain is long lasting.
An approach to address all of the things which contribute to pain will give the best results.
By Lindsay Wheeler and Faye Billingham