1 in 6 Australians are suffering from lower back pain at any one time. It is extremely common and can absolutely negatively impact your quality of life.

The anatomy

The lower back is also known as the lumbar spine. It consists of five vertebrae - L1 through L5. These vertebra connect to each other at facet joints either side. In between each vertebra is an intervertebral disc, which acts like a shock absorbing pad. Behind the disc is a column in which the spinal cord sits, which is made up of lots of nerves. These nerves will exit this column at different points along the spine to supply different things, such as your pelvis or your legs.

Symptoms of lower back pain

• Pain in the lumbar spine

• Can be a dull ache or a catching type pain

• Often aggerated by flexion (bending forwards), especially with rotation as in picking up a baby from a cot orsomething from the floor

• Sometimes aggravated by extension, such as bending backwards

• Can be across the whole lower back or more on one side or the other

• Sometimes referral into the buttocks or into the front of the hips or even down the leg

• Sometimes associated with pins and needles or numbness

Causes

• Disc bulge or herniation

• Facet joint

• Spodylolithesis

• Arthritis

• Sedentary lifestlyle

• Poor lifting technique

• Stress

• Overload

• Pregnancy

• Hypermobility

Asessment

• Subjective assessment: We will ask you lots of questions about the hip itself, about the rest of your body, any past injuries or surgeries, about what you do each day, your exercise routine and your health in general.

• Objective assessment of the lower back: We will assess how well you move and palpate the area.

• Full body assessment: We will always look at the rest of your body as well, to see if there are any areas that are contributing to your lower back pain. A common area that can contribute is the ribs.

• Internal examination: This is sometimes required in female patients to ascertain the location of all of the pelvic organs as well as the state of the pelvic floor.

Treatment may include

• Connect therapy approach

• Muscle releases and soft tissue massage to the lumbar spine

• Muscle releases internally to the pelvic floor if required

• Facet joint mobilisations

• Muscle releases and soft tissue massage to any other part of the body that is contributing to the problem

• Use of real time ultrasound for activation of deep abdominal wall (transversus abdominus) and pelvic floorpelvic floor muscles

• Individualised exercise program including stretching exercises and strength training

• Taping