5 Tips to Manage Lower Back Pain

Back pain continues to be considerably difficult condition to prevent, treat and diagnose. According to the Australian Institute of Health and Welfare, 1 in 6 Australians reported back pain in 2017-2018, with 2 in 5 reporting that their the pain moderately affected their ability to perform activities of daily living (ADLs).

Particularly amongst adolescent rowers, back pain is common with 94% of Males and 78% of females reporting lower back pain at some stage - in varying degrees of pain and discomfort however.

What causes Lower Back Pain?

There can be many different causes of back pain and our ability to determine which structure is causing the pain is quite complex. Even with comprehensive imaging, we are often unable to say exactly what is causing lower back pain.

For some areas of the body, like an ankle, a specific diagnosis is important as this will guide treatment. It is generally a lot easier to make a diagnosis too.

What is most important when assessing lower back pain, is clearing specific or named pathology as being a cause which could be a radiculopathy (sometimes referred to as a pinched nerve that causes impairments to muscle strength and sensation), cauda equina syndrome (damage to the nerves at the very base of the spine) and other non-musculoskeletal causes. The majority of these conditions are rare, making up approximately 10-15% of all cases of back pain.

The 5 Tips:

1. Heat Packs or Ice? A lot of patients I talk to are confused about which one to use to the point they don't use either. You can generally use heat or ice for lower back pain. Sometimes in the acute stages, ice is nice to calm things down, particularly if there is burning or sharp pain (make sure ice is not directly on your skin). Heat can be better for improving mobility.

2. A small amount of bed rest is OK, but not for longer than a day. A lack of movement will cause rapid deconditioning of the muscles in and around your back

3. Focus on movements that are pain free - Quite often we are focused on avoiding painful movements so much that we avoid movement completely! Small amounts of walking (5-10 minutes) or cycling on a stationary bike are gentle ways to stay active. Depending on your level of mobility, swimming may be helpful too - walking in the pool or small amounts of swimming can allow your body to be comfortable with moving again.

4. Avoid sitting for longer than 30 minutes at a time. This is the amount of time it takes for postural fatigue to occur, it may happen sooner for some people. Even if you stand up every 30 minutes and sit back down, this will allow your body a little space to reset.

5. Be moderate and logical with your progression back into activities. If you are looking to return to sport, ensure that you have at least had a test out at training or trained at a lighter intensity. Occasionally your back will feel great at the time but feel very sore after activity - think of it as a shock to the system. 

What does a return to sport look like after a lower back injury?

A logical progression plan could look like: 

1. Walking at a Comfortable Pace

2. Walking Faster 

3. A Walk/Run Program

4. Continuous Running Program

5. Faster Running program

6. Sprinting

7. Sports Specific Activities

8. Modified Sports Training

9. Return to Play

Depending on the amount of time you have had away from training, this process may be accelerated (the shorter the pain has been limiting your ability to participate, the faster this process will generally be).  A small amount of pain may be acceptable - generally a 2-3/10 (0 being no pain and 10 being a very high level of pain) but should the pain get worse or your symptoms become concerning, it would be recommended to stop the activity. Some pain can be latent or delayed, hence a slow progression is recommended to help prevent big flare ups.

If you have back pain or are concerned about your progress, get in touch with The Rowing Physio on 04 2520 9020 or Book Online for an assessment and plan to treat your back pain.