Chronic low back pain is low back pain that is present for greater than 3 months, affecting 84% of the population at least once in their lifetime. Chronic low back pain episodes account for 30% of sick leave longer than 6 months, and 20% of workplace incidents.
Non-specific low back pain is non-radiating pain with no signs of serious underlying conditions, spinal stenosis, or radiculopathy. ‘Non-specific’ refers to no known pathoanatomical cause leading to difficulties managing low back pain and the persistent burden of chronic low back pain.
Specific low back pain is caused by a definitive disease or structural problem of the spine, causing pain to radiate to other parts of the body. Nerve irritation, often described as sciatica, can also present down one leg below the knee. The causes of chronic low back pain are similar to acute low back pain and can result from irritation to the joints, intervertebral discs, muscles, ligaments and nerves.
Frequently Asked Questions
What causes chronic low back pain
Chronic low back pain can be caused by poor posture and body mechanics, poor core strength, psychological factors and stress and lifestyle factors including sedentary lifestyle, obesity, and smoking. In addition, more serious diagnoses leading to chronic low back pain include muscle or ligament strain, degenerative disc disease, herniated or bulging discs, spinal stenosis, osteoarthritis, and spondylolisthesis. Imaging can be used to make a diagnosis and assist in developing a treatment plan.
How do you diagnose chronic low back pain?
A physiotherapist will take a comprehensive patient history and conduct a physical examination to determine your impairments. Diagnostic imaging may be required to rule out any serious pathology, although it may not be deemed necessary. A treatment plan will be developed to manage the impairments identified.
What are the evidence based treatment of chronic low back pain?
The best evidence-based treatment for chronic low back pain is physical therapy. A physiotherapist can prescribe exercise and provide you with a strengthening program. Functional strength, coordination and biopsychosocial approaches including the McKenzie method can be applied to maximise lumbar spine function. In addition, manual therapy including spinal manipulation and mobilisation can be used in conjunction with exercise to alleviate pain and improve mobility of the lumbar spine. Education on pain management and posture can be provided to promote improved lifestyle behaviours.