Low back pain is a common condition worldwide and has fast become one of the leading causes of disability internationally. Acute low back pain is any bout of low back pain that has been present for less than 3 months. Symptoms of acute low back pain can include localised pain on one side or pain that radiates out to the flanks and into the buttock areas, there will also be restriction of movement, usually due to pain. Often if the nerve is irritated you can get pain and altered sensation down the leg beyond the knee. Acute back pain can be the result of irritation of the joints, intervertebral discs, ligaments or nerves, with some associated muscular tension.
Medical imaging is not required and non-pharmacological treatments include encouraging self management and support, encouraging movement and beginning physiotherapy. Red flags for acute low back pain may include severe pain when supine and/or at night, aged <16 or >50 years, signs and symptoms of infection, and persistent symptoms >4 weeks. Yellow flags may include the belief that pain and activity are harmful, sickness behaviours, low or negative moods, previous history of back pain with time off work, and a lack of social support.
Frequently Asked Questions
What causes acute low back pain?
Causes of acute low back pain may are generally musculoskeletal in nature including lumbar muscular sprain/strain, herniated intervertebral disc, spinal stenosis, osteoarthritis, degenerative disc disease, facet joint arthropathy or spondylosis/spondylolisthesis. Other causes can be more serious and present as red flags including infection, malignancy, pancreatitis and other diseases.
What treatments are used to manage acute low back pain?
Non-pharmacological treatments including physiotherapy will be used to manage the impairments of acute low back pain. It is important that you remain mobile and as physically active as possible. Physiotherapy treatment will involve aerobic activity, muscle strengthening, postural control as well as some passive interventions such as spinal manipulation, massage and spinal mobilisation.
In addition to this, your doctor may prescribe you some pain relief medication to be used in conjunction with physical therapy.
What will happen in my first physiotherapy appointment?
The practitioner will conduct a thorough assessment, gathering a medical history and examining your impairments. Risk stratification tools including the Keele STarT Back screening tool may be used to identify whether you are low, medium or high risk, determining the appropriate treatment. Patient education and active therapy encouragement will be provided in addition to passive and active interventions to manage impairments. A treatment plan will be developed to monitor progress and enhance consistency.