PT Tip of the Month

Mechanical Low Back Pain

Mechanical Low back pain (LBP) or lumbago is pain that is localized to one side of the back which does not radiate below the knee. LBP remains the second most common reason patients see a physician in the United States. It is also the most common cause of disability for people younger than 45 years old and the third most common cause of disability in individuals older than 45 years. Approximately 60-80% of people in the United States will experience low back pain in their lifetime.

Causes

Mechanical low back pain is generally attributed to an acute traumatic event, but can also be result of a cumulative or overuse injury. Overuse injuries are most commonly seen with at the workplace. Mechanical Low back pain is a result of injury to muscles (strains) or ligaments (sprains), the facet joints, or the sacroiliac (tailbone) joints.

Of all cases of mechanical LBP, 70% are due to lumbar strain or sprain, 10% are due to age-related degenerative changes in disks and facets, 4% are due to osteoporotic compression fractures, and 3% are due to spinal stenosis. All other causes account for less than 5% of cases.

The position most at risk of causing acute low back pain includes forward flexion (bending forward), rotation and then attempting to lift a heavy object. The picture above shows a very common example of this motion. Please see our Ergonomics Tip of the month for tips on how to avoid injury through proper lifting.

Symptoms

    • Pain is often referred to the buttocks and thighs
    • Morning stiffness or pain is common
    • Pain when starting to move is common
    • Pain with forward bending and when return to an upright position
    • Pain is often produced or aggravated with: extension, side bending, rotation, standing, walking, sitting or with exercise.
    • Pain usually increases over the course of the day
    • Pain is relieved with position changes, especially lying down in the fetal position.

Treatment

Initial treatment for Lumbago, includes techniques designed to help with pain relief. These can include modalities such as cold compression, moist heat packs, soft tissue massage, gentle joint mobilizations, and if indicated lumbar traction. Another important aspect of the initial treatment includes improving passive range of motion and muscular length with passive stretching. As the pain subsides, treatment will focus on gaining active range of motion and building strength. An important aspect of building strength for low back injuries includes increasing core strength. Core strength involves building strength in muscles important for stabilizing the spine and pelvis. This type of strength if maintained can help to decrease the chance of re-injury. The most important part of the low back treatment plan includes education. The education with focuses on proper lifting mechanics, proper postures, ergonomics, injury prevention and self management of acute symptoms.

If you believe that you are suffering from mechanical low back pain, contact Beantown Physio - Brookline at (617) 232-PAIN or West Roxbury at (617) 325-PAIN to schedule a Physical Therapy evaluation.

References

  1. Orthopedic Physical Assessment. David J. Magee. 4th edition.

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33 Pond Avenue, Suite 107B Brookline, MA 02445 Tel: (617) 232-PAIN (7246) Fax: (617) 232-5196
1208B VFW Parkway, Suite 202 West Roxbury, MA 02132 Tel: (617) 325-PAIN (7246) Fax: (617) 325-7282