PHYSIO OPINION: What commonly causes low back pain?

Low back pain (LBP) and associated sciatica (leg symptoms originating from the lower back) is the leading reason why the local residents of St Kilda visit Acland Street Physiotherapy.

Low back pain affects 60-80% of the population  (see reference) throughout their lifetime. According to multiple recent studies, about 10% of the population are physically disabled by low back pain.

Low back pain is usually characterised into 3 types:
1. Acute - Symptoms experienced for less than 6 weeks.
2. Sub-acute - Symptoms experienced between 6-12 weeks.
3. Chronic - Symptoms experienced for greater than 6 weeks.

At Acland Street Physiotherapy, we commonly see patients in all 3 categories with both the acute and chronic categories being the most functionally debilitating for our patients.

Non-specific or mechanical lower back pain accounts for approximately 90% of the cases of low back pain presentations in primary care, that is seen by physiotherapists. 10% are generally more serious medical conditions that need urgent medical intervention.

​Very occasionally at Acland Street Physiotherapy are we presented with more serious medical conditions associated with low back pain symptoms. In such cases, we generally refer these patients directly for further diagnostic imaging or back to their primary GP for further investigations. 

Through taking the patients history and physical testing, physiotherapy assessments aim to rule out the unlikely chances of a more serious medical condition or emergency. In addition, it aims to identify the impairments and likely causes that may have contributed to the pain and the likelihood of the lower back condition becoming persistent. 

From our many years of experience, non specific low back pain is commonly caused by disorders of the neural or musculoskeletal structures of the lumbar spine, which often responds well to physiotherapy treatment and advice.

Diagnostic imaging (ie. x-ray, CT scan or MRI of the lumbar spine) are generally not recommended in the first month of lower back pain and only when more serious medical conditions are suspected. 

Sciatic or leg pain originating from the lower back condition is a common presentation. Like low back pain, it is often due to disorders of neural or musculoskeletal structures of the lumbar spine assessed by a physiotherapist. In addition, low back pain is generally caused by the result of such structures. 

International clinical guidelines recommend non-pharmacological management of non-specific low back pain which is commonly physiotherapy treatment. Physiotherapy treatment often involves manual therapy to alleviate the symptoms and encourage movement, therapeutic exercises, personalised education and supportive taping. Prevention of lower back pain recurrence involves the physiotherapist to devising an individualised exercise program for you to target the specific issues assessed, as well as to improve general health and wellbeing. This could involve a home exercise program, supervised gym program, recommending pilates or yoga classes, or a gym and swimming program. 

Learn about some self help exercises for your low back here.