Navigating Non-specific Lower Back Pain (LBP)
Up to 84% of the general population will experience an episode of LBP during their lifetime, and recurrence rates are high. In about 90% of cases LBP is non-specific which means there’s no structural damage or underlying condition causing the symptoms. Risk factors for non-specific LBP include low physical activity levels, smoking, obesity and high physical stress at work. To some people, not knowing the exact cause of the pain is unsettling. However, it can be reassuring to know that the diagnosis is nonspecific back pain which means there is no serious problem or disease of the back or spine. The pain can be acute (less than 2-4 weeks), sub-acute (from 4-12 weeks) or chronic (more than 12 weeks). At any stage of LBP, help is essential to reassure people and help them make sense of their pain, help them return to activities they enjoy and identify strategies to support recovery and improve function. In this article, we explore the importance of a holistic approach in managing symptoms including exercise and mindfulness
Understanding the lower back:
- The lower back is also called the lumbosacral area of the back. It is the part of the back between the bottom of the ribs and the top of the legs.
- Most of the lower back is made up from muscles that attach to, and surround, the spine. The spine is made up of many bones called vertebrae. The vertebrae are roughly cylindrical and between each vertebra is a disc. The discs between the vertebrae are a combination of a strong fibrous outer layer and a softer, gel-like centre. The discs act as shock absorbers and allow the spine to be flexible.
- Strong ligaments also attach to nearby (adjacent) vertebrae to give extra support and strength to the spine. The various muscles that are attached to the spine enable the spine to bend and move in various ways.
- The spinal cord, which contains the nerve pathways to and from the brain, is protected by the spine. Nerves from the spinal cord come out from between the vertebrae to take and receive messages to various parts of the body.
Understanding non-specific Lower Back Pain: It is more than just a physical ailment; it involves complex interactions between the body and the mind. When it comes to chronic pain conditions, central sensitisation, may be an underlying mechanism or cause. This is a phenomenon where the nervous system undergoes structural, functional, and chemical changes that make it more sensitive to pain.
What can you do to help manage symptoms?
- Stay as active as possible: This is true for both acute and chronic LBP. Exercise has been proven to increase pain tolerance in those with LBP. Often those who so have LBP are fearful to worsen their symptoms and avoid over strenuous/high impact activity. Classes like Pilates, Thai chi and yoga are low impact alternative working on elements like mobility, core strength and overall body control. This is not to say that there isn’t a place for weight and cardio training. Every individual is different and finding the best solution for yourself is important.
- Education on central sensitisation and acceptance that there is nothing sinister going but a hypersensitive nervous system. This can help reduce and anxiety and help to calm the nervous system!
- Cognitive Behavioural Therapy (CBT): Addressing the psychological aspects of chronic pain is integral to managing central sensitization. CBT, a therapeutic approach that explores the connection between thoughts, feelings, and behaviours, can be effective in changing patterns of thinking associated with pain.
- Mindfulness for Pain and Central Sensitization: Mindfulness techniques, such as deep and intentional breathing, can assist in calming the nervous system. Practice diaphragmatic breathing to promote relaxation and reduce stress, which may contribute to central sensitization. Mindfulness practice encourages the release of muscle tension and fosters a mind-body connection.
Take home message:
The most effective approach to non-specific lower back pain involves a much wider approach than just one specific element and looking at both physical and mental wellbeing is important. Encompassing strength, mobility, and mindfulness offers a path towards relief. By understanding the complexities of central sensitization and incorporating a well-rounded strategy, individuals can take significant steps towards managing their pain and achieving a better, more balanced life. Always consult with a Real Health Partner before beginning any new exercise or mindfulness routine, especially if dealing with LBP.
Image - www.freepik.com/free-photo/lumbar-pain_905654.
