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Low Back Pain

The 4 biggest questions answered on back pain

80% of adults experience low back pain at some point in their lifetime. It is also the biggest factor limiting activity in young adults under the age of 45. 

Those who seek medical care for their low back pain, up to one-third report pain of at least moderate intensity one year after an acute episode, and 20% report substantial limitations in activity. 

Are you a statistic? 

Here are the 4 key questions to consider on low back pain:

1. Is all low back pain the same?
2. Will it keep recurring or can I manage it to ensure it won’t come back?
3. Can I still do exercise if I have low back pain?
4. Do I need a scan?

1. Not all back pain is the same

The causes of back pain are varied. In young athletes, it is usually due to overload of lumbar joints from repetitive jumping or bending (i.e. gymnasts). Young adults often have a first episode of back pain after doing unaccustomed or heavy activities such as starting a new job that involves heavy lifting. These activities irritate their lumbar discs (cushion like structures that absorb impact between the vertebrae). Days before the onset of pain they feel some build-up of stiffness or “niggly”. 

It is common that individuals develop pain due to fatigue after repetitive movements in deconditioned core muscles, resulting in an overload of the lumbar joints.

Low back pain can be accompanied by other symptoms like numbness, tingling and weakness in the legs, this is commonly called sciatica.

2. Low back pain is often recurrent

If not well managed back pain can become recurrent.

Repetitive stress in the spinal structures as well as aging have a negative impact on the amount of water present in the lumbar disc, less water means less disc height and as a result their ability to absorb impact during daily activities or sports is compromised. This leads to disc tears and in worse cases rupture of the disc fibers (bulging disc). 

A flatter disc also causes a reduction in the space between the vertebrae, therefore, less space for the joint to move freely, which leads to low back wear and tear (osteophyte formation, facet joint arthropathy, and ultimately, spinal stenosis).

A weakness in the core muscles is a common feature in people that suffer from recurrent back pain.
A good analogy is thinking of the spine as a mast on a ship. The muscles that attach to the spine are the ropes that support the mast and prevent it from curving and becoming unstable. If the supporting muscles (core muscles) are weak or imbalanced, the spine experiences stress that can lead to pain, stiffness and ultimately degeneration.

There is good news, early management is key to recover from back pain and physiotherapists are the best to help with this. Getting better involves understanding your condition well, what to do and what to avoid will have a big impact on your symptoms. Hands-on physiotherapy will help loosen up stiff joints and tight muscles that may be contributing to the pain. Most importantly, a specific rehabilitation program focused on core strength and spinal mobility will restore and improve your back.

3. Being Active is encouraged

One of the most effective ways to relieve and prevent your back pain is to stay active! In the very acute stage some relative rest from aggravating activities will help but gone are the days of bed rest – this does more harm than good

4. It’s unlikely you’ll need a scan or Xray

The majority of back pain is not caused by a serious underlying condition, and imaging such as MRIs and X-rays are not usually necessary. However, they should be considered when patients present severe motor or sensory deficits (i.e. progressive or severe lower limb weakness, loss of sensation or reflexes) and to rule out other conditions.

In general, most adults over 60 years old will show degenerative changes in their spine when undertaking scans, however, not all of them will experience back pain. In addition, MRI findings of wear and tear in the lumbar spine are not predictive of low back pain in the future.


Blog written by Marisol Reyes Fuentes APA Musculoskeletal Physiotherapist 

If you want to know how Marisol can help you with these top tips, book an appointment with her now.

9968 3424 or book online.


Tonosu, J., Oka, H., Higashikawa, A., Okazaki, H., Tanaka, S., & Matsudaira, K. (2017). The associations between magnetic resonance imaging findings and low back pain: A 10-year longitudinal analysis. PloS one, 12(11), e0188057. doi:10.1371/journal.pone.0188057

William Rea, Sandeep Kapur, Hirachand Mutagi, Intervertebral disc as a source of pain, Continuing Education in Anaesthesia Critical Care & Pain, Volume 12, Issue 6, December 2012, Pages 279–282,

Zhang, Y.-g., Guo, T.-M., Xiong, G., & Wu, S.-X. (2009). Clinical diagnosis for discogenic low back pain (Vol. 5).

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