Medical A-Z – Lower back pain

LOW BACK PAIN

Non-specific low back pain (NSLBP) is tension, soreness and/or stiffness in the lower back region for which it isn’t possible to identify a specific cause. Several structures in the back, including joints, discs and connective tissues, may contribute to symptoms (Royal College of General Practitioners, 2009).

CAUSES

Most back pain is what's known as 'non-specific' (there's no obvious cause) or 'mechanical' (the pain originates from the joints, bones or soft tissues in and around the spine) (NHS, 2020).

The people most likely to suffer from NSLBP are those whose jobs involve a lot of heavy lifting and carrying, or those who spend long periods sitting in one position or bending awkwardly. Overweight people are also more prone to back pain – their backs carry a heavier load and they tend to have weaker abdominal muscles, which usually help to provide support to the back (Peters, 2008).

ORTHODOX TREATMENT

Treatment for NSLBP usually involves medication to relieve the pain and inflammation, such as aspirin and ibuprofen. The application of heat and/or ice is also recommended for pain relief and to increase mobility (NINDS, 2020).

Gentle stretching and regular movement are also advised. General practitioners can provide information on appropriate back stretches and often suggest regular, low intensity exercise alongside this, such as swimming, walking and yoga (NHS, 2020).

COMPLEMENTARY THERAPY

The National Institute for Health and Clinical Excellence (NICE) guidelines recommend manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) for managing low back pain with or without sciatica, but only as part of a treatment package including exercise, with or without psychological therapy (NICE, 2020).

In a recent study on the effects of acupressure on NSLBP, researchers randomly assigned 67 participants into three groups: relaxing acupressure, stimulating acupressure or usual care. Participants in the acupressure groups were trained to administer acupressure on themselves, and spent between 27 and 30 minutes daily, over the course of six weeks, performing the technique. Researchers said, "Compared to the usual care group, we found that people who performed stimulating acupressure experienced pain and fatigue improvement and those that performed relaxing acupressure felt their pain had improved after six weeks." (Murphy et al, 2019).

A randomized controlled trial that evaluated the effects of foot reflexology on back pain following coronary angiography was recently published in Complementary Therapies in Clinical Practice. Conducted in 2018-2019, 120 patients were recruited to the study and randomly allocated to either a control group, receiving routine postangiography care, or a reflexology group. Those in the reflexology group reported significantly less pain intensity than those in the control group. (Kardan et al, 2020). In 2008, a study published in the British Medical Journal (BMJ) followed 579 participants over the course of a year as part of a randomised control trial on the impact of the Alexander Technique on NSLBP. The study found that Alexander Technique lessons provided benefit to patients in terms of back pain relief and reducing recurrent back pain (Little et al, 2008).

NB: The information provided in this article is not all encompassing and intended as an overview only. It should not be used for the purposes of ‘diagnosis’. Members or clients presenting with any symptoms should always consult a GP or other relevant health practitioner. The advice of a doctor, pharmacist or other suitably qualified person should be sought before taking any form of medication or treatment.

References

For full references, go to fht.org.uk/IT-references