Lower back pain is currently one of the most common health problems affecting people in the industrialised world. In spite of advances in medicine, the incidence of both acute and chronic back pain has not decreased. In contrast, doctors caring for patients in mission hospitals and other third world facilities see few back problems. People in poorer companies tend to be active and they don’t spend much time in bed. Everyone is active unless they are extremely ill.
A 1997 study concluded that between 50-80% of the population of developed countries suffer from back pain at some time during their lives. A total of 40% of people have even suffered from back pain at some time this year. That is why back pain is considered normal and only between 25 – 40% of people with backache seek medical attention.
That’s why back pain is one of the most common causes of sick leave. Backache costs the health system an enormous amount of money. In the United States it is the most expensive condition for the health service, costing even more than other diseases like cancer.
There are many types of backache. It can start suddenly or progressively and can be due to known causes: exertion, trauma, etc… or unknown causes.
The causes of back pain can be classified into three groups:
- Serious spinal conditions: fractures, infections, cancer, spinal cord problems, which are generally responsible for fewer than 2% of all back problems.
- Nerve root conditions, which account: for fewer than 10% of all patients.
- Simple, non-specific or mechanical back pain: This group is made up of around 90% of all patients.
The first group requires specialised medical attention and the other two groups benefit from active physiotherapy. These two groups account for 98% of patients with back pain and the majority are caused by mechanical problems with the spine, including problems with the discs (protrusions, hernias, extrusions).
Mechanical pain in the lumbar spine appears when a joint between two vertebrae is in a position of excessive tension from the surrounding soft tissues, for prolonged periods or with repetitive movements. To get an idea of how easy it is to trigger certain mechanical pains, try this simple exercise.
Bend back a finger on one hand back with the other hand, until you feel a pull. When you hold your finger in this position you will initially feel some slight discomfort, but little by little this discomfort will turn into pain. Sometimes it can take up to an hour for pain caused by stress to appear.
Stress on the tissues is usually caused by postures or movements with the lumbar spine in a bent position, with the back curved or relaxed:
- Sitting on the sofa, in a work chair or in the car.
- Standing with your back bent forward doing any activity with your knees straight.
- Bending forward repeatedly while standing, with or without weight.
Over time, people doing these movements or adopting these postures become unable to straighten up. The back can even get locked in a bent position. Everyone knows someone who has a postural problem of this type.
There are different types of mechanical lumbalgia:
At our physiotherapy practices, to treat this type of condition, after obtaining a medical diagnosis we analyse the individual case, taking into consideration the patient’s symptoms and the results of any medical tests he or she may bring along. We do a thorough physical examination to confirm that the pain is definitely of mechanical origin before deciding on a therapeutic approach.
Mechanical treatment is as follows:
- Patients are told what the problem is so that they understand what is happening.
- Patients have an important, active role in the process because they must correct their posture and do progressive, individualised exercises regularly throughout the day to correct the mechanical problem.
- Lastly, patients are given a maintenance plan to prevent relapses.
D. Macià Lledó Ronda Fisioterapeuta – Ctro. Fisioterapia especializada Fco. Lledó Clínica LLedó Fisioterapia.
The information published in this media neither substitutes nor complements in any way the direct supervision of a doctor, his diagnosis or the treatment that he may prescribe. It should also not be used for self-diagnosis.
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ASSSA advises you to always consult your doctor about any issue concerning your health.
