The purpose of this blog is to educate and inform you on all things low back.

Feel free to try our advice, ensuring any activities and exercises you try are pain free and always comfortable to do.

If you need extra help, we are here for you.

Low Back Pain Facts

If you have back pain, you are in good company, in fact according to The Australian Institute of Health and Welfare (1), about 4 million Australians have it every year!

But don’t worry, most low back pain is acute, or short term, and lasts a few days to a few weeks.

Here are some key back pain facts for you:

  • Men and women are equally affected by low back pain.
  • Exercise and physical activity are very important for the prevention and management of back problems.
  • Finding a balance of exercises for back pain is important. Both too little and too much activity increases the risk of ongoing low back pain.
  • Risk factors for lower back pain include:
    • – Heavy manual workload
    • – Repetitive lifting
  • Your body weight can increase your risk of having back problems.
  • Persistent back pain is defined as pain that persists for 12 weeks or longer.

If you have experienced pain for a long time, latest research suggests that exercise is more effective at reducing pain than taking medication.

Speaking to a Physiotherapist about performing some gentle exercises or stretches each day can also help ease a lot of common back pain symptoms.

Read all the facts here in our Low back pain facts blog

Learn About Your Spine

Your spine is built to move, bend, lift, carry, run and have fun with!

Listen to Josh, one of our Mount Barker Physiotherapist team, explain all things spine:

What structures make up the back?

The lower back where most back pain occurs includes:

  • Five bones (vertebrae) (referred to as L1-L5)
    • – They support much of the weight of the upper body.
  • Rubbery pads called discs
    • – They act like shock absorbers throughout the spinal column to cushion the body’s movements.
  • Bands of tissue known as ligaments
    • – They hold the vertebrae in place.
  • Tendons
    • – They attach the muscles to the spinal column.

Read all the facts and advice here in our Learn about your spine blog

Acute Low Back Pain

What is acute Lower back pain?

Most people will have at least one episode of acute low back pain in their lifetime.

Sometimes acute episodes start for no reason. You can even just wake one morning with back pain!

But don’t worry, acute back pain will usually settle quickly. For the vast majority of people, it will only last for 2-6 weeks.

The first few days can be painful and you will feel like limiting your activities and avoiding the painful movements. This is totally normal, as your brain is trying to protect you from causing any further pain and discomfort.

Often there is no one low back structure that can be blamed for your pain, which means there can be a couple of components that need attention.

How to get your back moving again with acute low back pain

1. Josh explains in simple terms about why it’s important to get moving again to help your low back pain:

Persistent Lower Back Pain

Persistent low back pain is defined as pain that continues for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. Even if pain persists, it does not always mean there is a medically serious underlying cause or one that can be easily identified and treated. In some cases, treatment successfully relieves chronic low back pain, but in other cases pain continues despite medical and surgical treatment.

What can cause lower back pain?

Most acute low back pain is mechanical in nature, meaning that there is a change in the way the components of the back (the spine, muscle, intervertebral discs, and nerves) work together and move.

Most commonly, what I see in day to day practice is someone who has done too much too soon or has done an activity that is not common to their routine. We are used to a certain level of physical activity and the body can cope with it fine. It is when we try to do more than our base capacity is when we can hurt our back. For e.g. lifting or moving furniture to help someone move house or driving really long distances for a holiday and then lifting heavy bags or camping gear out of the car.

De-conditioning is also responsible for low back pain. If you have not been looking after your physical health and not exercising you can lose muscle bulk from your lumbar spine and core area. That reduces your baseline capacity to do physical activity. Reduced muscle strength and endurance can lead to you having pain in that region.

Read all the advice here in our Persistent low back pain blog

Why do we get leg pain coming from our back?

This post will explain why and how we can get leg pain from our lower back with some informative videos that help us understand.

To start with lets quickly cover the different types of pain;

  1. Nociceptive -> pain provoked by noxious stimuli e.g. touching a hot plate, being pinched or exposure to a chemical.
  2. Neuropathic -> damage or irritation to our nerves or nervous system
  3. Nociplastic -> pain arising from the altered function of our nervous system
    (Jones and Rivett 2018)

Now that we have covered the main types of pain, let’s explore how and why we get referred pain.

Referred pain can be a result of neuropathic and nociceptive pain.

1. Somatic referred leg pain

  • Somatic referred pain is pain that is being referred into your leg from a structure in your back.
  • Somatic structures include: muscles, discs, ligaments, bones etc. Anything musculoskeletal tissue that has a nerve supply is classed as a somatic structure.
  • Referred pain is pain perceived at a location other than the site of the painful stimulus/ origin.
    • It is the result of a network of interconnecting sensory nerves that supplies many different tissues.
    • When there is an injury at one site in the network it is possible that when the signal is interpreted in the brain signals are experienced in the surrounding nervous tissue.
    • Source: https://www.physio-pedia.com/Referred_Pain

A common low back example is an inflamed lumbar facet joint referring to pain into your buttock and back of thigh area.

2. Radicular referred leg pain

  • Although commonly referred to as ‘sciatica’, the term lumbar radicular pain (LRP) is anatomically more correct. This is because it can affect other nerves, not just the sciatic nerve.
  • The pain may track down into different areas of your thigh, lower leg and foot, either the front, back or side.
  • This is when a nerve is irritated or compressed as it’s coming out of your spinal cord and passing through the radicular canal between your vertebrae. The radicular canal is pictured below.

Radicular pain will be felt where that spinal nerve travels to and the area it supplies. Each lumbar spinal nerve supplies a different area of your leg, in what we call a dermatome distribution.

Read all the advice here in our Why do we get leg pain coming from our back blog

Do you need a scan or investigations for your lower back pain?

Low back pain is one of the most common reasons why people visit their doctor or emergency care.

Severe low back pain may be daunting and may lead you to think something is seriously wrong, But, as hard as it may be to understand, the majority of cases of low back pain are not serious and spinal imaging is not necessary.

When you visit your physiotherapist they will conduct a thorough examination in order to determine the presence of clinical red flags. “Red flags” alert your health care provider to potential sinister pathologies where imaging may be appropriate.

Read all the advice regarding scans here

What treatment options are there for lower back pain?

For treatment of patients with chronic low back pain, the guidelines recommend the use of:

1. NSAIDs and antidepressants

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In my opinion, clinically, Acute low back pain does respond well to NSAIDs when combined with a good explanation of the presenting injury and some strapping of the lumbar area with sports tape. Persistent low back pain on the other hand can respond well to medications/ antidepressants as prescribed by your GP in combination with pain education and guided exercises by your Physiotherapist or Exercise Physiologist.

2. Exercise Therapy

The best exercise for managing your back pain is the one you would like to do. Activities like going for a walk or riding your bike or going for a swim may help your back pain. Once you have the correct diagnosis given by your Physiotherapist, you can discuss what is the best exercise for you to manage your back pain. Physiotherapist’s also work with Exercise Physiologists to design the best possible program customised for your needs.

Read all the advice here in our treatment options for lower back pain blog

Treatment options for leg pain

Leg pain coming from the back is very common and quite frustrating. In order to understand how to treat leg pain it is important to establish what the type of leg pain is and what is causing it.

Medical management

There are many different types of pain relief which may help your leg pain. Some of the most common types include non-steroidal anti-inflammatories (NSAIDs), analgesics and nerve pain medication.

NSAIDs

Common NSAIDs include aspirin, voltaren, nurofen and ibuprofen, which are available over the counter at Pharmacies. Your GP can also supply prescription anti-inflammatories such as Mobic, celebrex, naproxen or stronger voltaren or brufen tablets. NSAIDs should always be taken under the direction of a pharmacist or your GP.

Analgesics

The most common analgesic used to treat more mild pain is Panadol/paracetamol, however your GP may be able to prescribe stronger medication such as opioids (eg. Tramadol or codeine)

Nerve medication

Medications used to treat nerve pain act differently to other pain medications as they act more on issues with the nervous systems. Low doses of antidepressants or epileptic medication are commonly seen prescribed for nerve pain (eg. Endep or lyrica).

Read all the advice here in our Treatment options for leg pain and symptoms from the lower back blog

What Medicines Help With Low Back Pain

What are the best pain tablets for back pain?

Matthew Ash, a Spinal Physiotherapist at myPhysioSA in Adelaide explains there is enough evidence to confirm that using anti-inflammatories (non-steroidal anti-inflammatories or NSAID’s) is the most effective medication to use for easing acute low back pain.

You will need to consult your doctor or pharmacist to get further advice about the best pain tablets for back pain to see if they are appropriate for you.

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Should I just take some painkillers and push through my back pain? Or is it causing damage?

Pain is NORMAL! It is a vital protective response within our nervous system, designed to tell us if there is danger.

In some cases, pain may in fact indicate danger or damage to the body. The human body is a fantastic healer, however in this case, taking medication to push through pain could cause further tissue damage, and therefore would not be the right choice.

However, sometimes a pain response is merely protecting us against potential danger, without actual damage being present.

Read all the advice here in our Low back pain medications blog

Exercises for low back pain

At myPhysioSA we love helping people.

Below is some of our best educational advice just for you.

Our clinical staff have put together blogs and videos that will run you through some education, tips and great exercises to get you feeling and moving better.

How to get your back moving again

Get professional back pain advice from our Partner Physiotherapist Josh Stewart from myPhysioSA, Adelaide, Australia.

Josh explains in simple terms about why it’s important to get moving again to help your low back pain.

Other key learning points in this video include:

  • The latest research tells us that it is important to get moving early and keep moving if you have low back pain
  • Start with safe gentle movements “non-sweaty movement”
  • How to start pacing activities
  • The truth about posture and back pain

Lower back stretches to reduce pain

If you have a tight back, try these safe and effective stretches to help loosen your back and improve your mobility.

Ellen demonstrates 5 of the best back stretches you can do. Ellen talks you through each stretch and explains what and where you should feel each stretch, and how long to hold your stretches.

Lower back strengthening exercises

Functional Strengthening

Josh gives the best starter exercise to activate your back, hip and core muscles that you can start doing right away to help low back pain.

Learn about the latest Physiotherapy advice for how to better manage your low back pain. Use these tips starting from today and get on top of your pain.

Best core strength exercises

At myPhysioSA we love setting our clients up with customised targeted strength and conditioning programs, either in our Fitness Studios or as home programs.

Bow and arrow

Stand up with the extremities of a band in your hands. Your body should be turned sideways facing the band anchor point, with one foot and the same-side hand forward.

Pull the band with your back hand and push/reach forward with your front hand in a reciprocal movement.

Repeat up to 20 times each side.

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What is Pilates?

Pilates is a whole body, low impact style of exercise that can be done at home or in a class. It aims to build strength and control, while improving postural alignment and flexibility. It can be done with or without equipment.

Below are some examples of introductory Pilates exercises

Pelvic Tilting + Glute Bridge

Lie on your back with your knees bent and your feet flat on the floor. Activate your core stability muscles, tilting your pelvis towards you so that your lower back flattens and your tailbone rolls off the floor. Now tighten your buttock muscles and continue to peel the rest of your spine off the floor until you are in a bridge position. Hold in the bridge position before you then lower, keeping your navel drawn in and slowly lowering your spine back down onto the floor one vertebrae at a time. Keep your buttocks tight until your pelvis rests on the floor.

Progression: in the bride position, slowly drop one knee out to the side while maintaining pelvis and spine position.

Regression: begin with pelvic tilt and squeeze your glute muscles together, slowly raise just your hips off the ground and slowly back down. Keeping lower back and ribs on the ground

Click here for all our starter Pilates exercises blog

Physio exercises for leg pain coming from your back

Here’s some of our best advice and tips that you can try that may be useful to help your leg pain that is coming from your back.

Stretching

Stretching can be a great adjunct treatment for your leg pain whilst also increasing your mobility. Typically when you hear the word stretch we automatically think of muscles and tendons, what is often forgotten is you can also mobilise your joints – focusing on range of motion, and interestingly your neural structures (e.g nerves) as well!

How to stretch your back muscles

Below are some targeted stretches for some of the main common contributors when it comes to tight muscles in the back.

Quadratus Lumborum back (QL) stretches

In the below video David, an experienced Physiotherapist, teaches three simple stretches that can ease your low back pain.

Lower back pain prevention

There are many different factors that can contribute to why we develop low back pain – type of work (eg. Sedentary desk work, heavy manual labour or anything in between) , sport, activity levels, age.

Life can also be very busy and it can be hard to think about our bodies and do what is best for them every day. It can be as simple as taking 5 minutes every morning to move your body.

David Wilson takes us through the best low back stretches to do each morning.

Low back pain summarised

Sprains and strains of the muscles and tissues around the spine are the most common cause of low back pain. However, the truth is that we usually cannot pinpoint the exact structure or cause for low back pain.

We are all designed with protective mechanisms to look after our body when there is danger to the tissues. If you hurt your back, it is normal to experience some pain and protective muscle guarding, which often changes our postures and how we move.

Everyone is different, so recovery times are going to vary from person to person. A lot of minor low back sprains & strains will settle down over a few weeks; however, they can take up to 12 weeks to settle in some cases.

We know in most cases of back pain the spine itself is strong & sound, and does not need to be ‘protected’ further by avoiding movement and activity.

It is widely accepted that complete rest is unhelpful when managing low back pain, whether that’s following an acute injury or with more persistent pain.

In the first few days after an injury, it is better to reduce and modify your level of activity, however keep moving and stay as active as you feel comfortable.

The purpose of this blog is to educate and inform you on all things low back.

Feel free to try our advice, ensuring any activities and exercises you try are pain free and always comfortable to do.

If you need extra help, we are here for you.

At myPhysioSA it’s all about you. Your problem, your pain, your customised solution.

We think the best Physio is one who actually listens to you and finds out what a good result would be for you. A result that gets rid of your pain and gets you back into what you need to be doing again faster. We think that our Physio’s at myPhysioSA do this the best!

Our key goal in Physiotherapy is to find out what is causing your problem. This is the tricky bit; it’s the bit we love. And then we will teach you how to keep the problem from returning.