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Lower Back Pain

The lower back is the principal weight bearing region of the back, and as a result it is the most frequently injured.  Lower back issues are one of the most common musculoskeletal problems around the world. 90% of people experience back pain within their lifetime, with the majority of lower back pain problems resolving within six weeks.  


We have set out below 3 starter exercises for dealing with lower back pain. 

Lower back pain treated with physiotherapy at work by the Home Physios

Anatomy

The lower back area is known anatomically as the “lumbar spine” and it consists of five large vertebrae, connecting the spine with the pelvis. The vertebrae are separated by intervertebral discs, which are large in size, due to the weight bearing nature of the role played by the lumbar spine. Injury related to these discs is often referred to as a “slipped disc”, but the medical name for this is infact a “disc herniation” or “disc protrusion” and refers to the disc changing shape.  The discs themselves do not “slip” out of their natural position. 


The vertebrae are formed with a cavity through which the spinal cord runs.  The lumbar spine is supported by strong ligaments and powerful muscles which, as well as stabilising, are responsible for movement through the lower back. 

Symptoms of Lower Back Pain

The major symptom of a lumbar spine issue is lower back pain, often accompanied by restricted movement and stiffness.  Patients often report difficulties with carrying out activities of daily life, including  walking, standing, getting out of bed, and climbing the stairs.     


The pain is often felt as a sharp pain with movement, and an ache at rest.  It can be felt on a localised basis at a specific point of the back, or in some cases across the whole lower back.  In more severe cases, pain can radiate down the leg.  In situations where this is as a result of nerve entrapment, this is known as sciatica.

Common Causes and Conditions of Lower Back Pain

The causes of lower back pain are complex and varied.  Tissue injury can occur suddenly or with micro trauma that eventually results in pain. Patients can report injury with lifting or bending or with more innocuous movements such as sitting down awkwardly or overstretching in a yoga class.  To add to the complex nature of back pain, research has shown that the pain experienced does not always equate to the actual tissue damage, which can lead to difficulty making a diagnosis.


Back pain is classified by physiotherapists as either “acute” or “chronic” pain. The nature of your pain will have an impact upon the treatment which is recommended.   


Conditions which cause acute lumbar spine pain include:


  • Disc herniation and protrusion
  • Facet joint inflammation
  • Muscle strain
  • Nerve entrapment


Chronic lumbar spine pain is more typically related to an over sensitivity of the nervous system, rather than any structural abnormality, which is why it requires a different treatment approach.  


In rare cases, lower back pain can be related to more serious conditions such as cancer.  If you are suffering from any of these additional symptoms, it is important that you seek medical attention as soon as possible:


  • Night pain
  • Night sweats 
  • Weight loss
  • History of cancer
  • Worsening leg pain or weakness/numbness
  • Changes to bladder and bowel function or sensation     

Assessment of Lower Back Pain

Physiotherapy massage for lower back pain by the Home Physios in London

In order to draw up a tailored treatment plan for your lower back pain, your Home Physio will first need to undertake an assessment of your symptoms.  Your physio will consider your history, symptoms and the nature of your pain, including whether the pain is acute or chronic. 


Your assessment will include a physical examination, and consideration of your mobility and strength. Your physiotherapist will also palpate the spine, feeling for joint restriction and muscle tenderness.  If there is any reported leg pain, numbness or weakness, it will also be necessary to carry out a neurological assessment. 

Treatment and Management of Low Back Pain

Treatment of your lumbar spine issues will depend on the findings of the physiotherapy assessment. Treatment options include:

  • Joint mobilisation and manipulation
  • Joint or lower back back mobility exercises
  • Stretching and strengthening exercises 
  • Posture advice and education
  • Acupuncture


With back problems generally, there is an important balance to be struck between rest and activity in order to minimise the chance of acute issues developing into chronic issues, and to minimise impact on ability to return to normal activity and function.  It is important that you discuss this with your physiotherapist.   

Treatments for lower back pain: physiotherapy services offered by the Home Physios in London

Beginner exercises

  1. Lumbar rotations:  Lying on your back, with your feet on the floor and knees bent, rotate through the spine to slowly lower your knees to the floor either side of you and return to the middle.  Repeat the rotation on the other side.  
  2. Cat / Camel: On all fours, arch your back upwards towards the ceiling, tucking in your belly button and bringing your chin down to your chest (to create the “Camel” pose).  Then, reverse this position by looking up and bringing your belly button down towards the floor (the “Cat” pose).  Your hips should stay still throughout both movements.
  3. Knees to chest:  Lying on your back with your feet planted on the floor, slowly lift your legs and bring your knees to your chest.  Then, slowly return your feet to the floor and repeat.   


If you are looking for a local home physiotherapist to assist you with your lower back pain or lumbar spine problem, please don’t hesitate to get in contact with us for a consultation. Contact us on the form below, phone 020 8226 0187 or email - contactus@thehomephysios.com

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