Although we treat more than just backs, we do see a lot of people with lower back pain. There are many potential causes for it, and often it’s impossible to be totally sure of the cause- even with X-rays or MRI. Instead, we want to determine if your back is safe to treat, and which structures are most likely to be involved.
Safe to Treat
Among the many causes of lower back pain are a handful of more serious problems. Our first step is working out whether your pain is within our remit, or if it needs further investigation from a doctor.
Red Flags for Lower Back Pain
We refer on cases where there are signs of:
fracture (including those related to osteoporosis)
infection
cancer
inflammatory disease
cauda equina syndrome
These conditions need medical intervention that osteopathy cannot provide. Some patients may benefit from symptomatic relief, but this is only ever appropriate in conjunction with medical management.
Causes of Lower Back Pain
In the absence of red flags, we start to look for indicators of more specific musculoskeletal conditions.
Muscle
Most lower back pain will come with some muscular involvement. Even if the original cause was not a pulled muscle, the brain often tightens up the surrounding musculature in response to pain.
Sometimes the muscle tightness is useful, so it may not be appropriate to relax off the muscles fully at the first appointment.
Joint
Two common examples of joint involvement are facet irritation and osteoarthritis. The facet joints are the two small joints at the back of the spine. These are the joints we “click” when we manipulate the spine. Facet joints can be irritated, or even locked. Sometimes this is the result of a vicious cycle, where a joint is sore, so the muscles tighten, so the joint becomes more sore. In cases like these, managing both aspects of the problem simultaneously can yield quick results.
Osteoarthritis is the “wear, tear, and repair” type of arthritis. It can occur in the spine, where it is technically called “spondylosis” or “spondyloarthritis”. Despite the common misconception that arthritis is just something you have to get on with, there may be something we can do to help. Movement is key for combatting arthritis, so if we can help restore lost movement in the back, you may find your symptoms diminish.
Disc
Intervertebral discs are found between each spinal bone, and are very firmly anchored to the bone above and below them. They are so secure that “a slipped disc” is a misnomer- discs do not slip. They can, however, bulge. If a bulging or herniated disc presses on a nerve, it can cause symptoms of conditions like sciatica. The location of these symptoms will vary depending on the affected nerve. Typical symptoms of an irritated nerve are shooting pain, numbness, and weakness. It is worth noting that not all nerve pain is caused by a disc, and not all disc problems cause nerve pain.
Discs can also be painful in isolation. Research shows that discs are more sensitive when they have been injured more, as new nerves grow into the disc. Despite this, studies show that most people over the age of 40 have at least one bulging disc. Less than half the population over 40 have back pain, which shows that disc bulges are not always painful. This also explains why routine imaging for simple back pain is no longer recommended.
Osteopathic Treatment for Low Back Pain at Eastbourne Osteopathy
Your low back pain treatment at Eastbourne Osteopathy will be tailored specifically for you, based on your osteopath’s findings at your first appointment. We want to get to the root cause of your pain, so it is often necessary to treat beyond the back. It may be the case that you have a foot problem that affects the way you walk, which has in turn overworked your back, for example. Similarly, it may transpire that your back is causing problems elsewhere. Our aim is to prevent recurrence after your symptoms improve, so come to your appointment prepared for this.
Depending on your case, treatment may involve massage or resisted exercises to relax muscles. Clicking a joint, or articulating it more gently may also feature. You may also be given exercises or lifestyle advice to continue your progress at home.
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