How to help lower back pain
What to do
- See a reputable professional for an assessment
- Keeping active and engaged with your daily life is important and can help reduce symptoms.
- You will probably benefit from strengthening and stretching exercises, as well as hands-on treatment.
Lower back pain is very common. It is the cause of more "years lost to disability" than any other condition [1]. So what can you do about it?
The first thing to do is book an appointment with a reputable professional. Osteopaths train for 4 years at Masters level. We can assess, advise, treat, and refer you to other healthcare professionals where appropriate. We can set your mind at rest if you are worried, and help you separate facts from fiction if you've been Googling your symptoms.
Spinal manipulation, join mobilisation, and massage-type techniques are advised for low back pain alongside exercises [2] and your osteopath will most likely use some combination of these during treatment. Your osteopath should always discuss every option with you,and you should always have the option to decline.
Exercises for low back pain
It is important that you see a reputable professional for a thorough assessment before embarking on an exercise programme. I will always discuss with you what exercises will help, and what will be achievable for you. For most people, simple strengthening exercises and stretches will be effective. Here are the simplest, most effective things you can do right now:
- If you spend most of the day sitting down, get up and move around as often as possible.
- If you spend most of the day on your feet, take some breaks sitting down.
Stretching is great for most people, and it's easy to do, even if you've never done any stretching before. Some people are hypermobile, meaning they are more flexible than most. In this case, I may advise some stabilising exercises.
General exercise that gets the heart pumping faster and the lungs working is good for nearly everyone. It releases endorphins, chemicals which help reduce pain. It's also great to take your mind off back pain. Exercise is good for just about everyone. If you've never done any exercie before, don't worry. We will find something that's enjoyable and works for you. Exercise might include activities such as t'ai chi, yoga, swimming, walking, and anything else that improves strength and coordination.
Your pain is real and not "just in your head"
For most people, low back pain is temporary and is very manageable. For some, though, it can last a long time and produce daily challenges. Psychological support can be useful in these circumstances to help work out ways to continue living the life you want [2]. When psychological help or counselling is suggested, it can seem that others doubt you are in pain, or that the "root cause" is not being addressed. Your clinician knows your pain is real, and it is important that you feel supported throughout your care.
To complicate things further, anti-depressants might be prescribed for long-term or severe back pain. Treatments like this are aimed at altering the brain's processing of pain. It might seem like an odd approach when the patient has pain in their back. But consider this: all experiences of everything happen in the brain, regardless of where the incoming messages originated.
Be assured, most osteopathic appointments involve hands-on treatment as well as support and advice.
"Do I need an MRI?"
It is tempting to think that looking inside you with technologies such as magnetic resonance imaging (MRI) can help. However, MRIs are only useful if surgery is likely to be an option. In most cases of low back pain, surgery will not be necessary. Therefore it is very unlikely that an MRI will provide any useful information.
Your osteopath will refer you for any imaging that is appropriate, such as MRI or ultrasound scans.
References
[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30488-4/fulltext
[2] https://www.nice.org.uk/guidance/NG59/chapter/Recommendations