Low-back pain (LBP) is common in athletes and non-athletes. The odds of getting LBP during your lifetime are 60% to 90%. For Athletes, the lower back is a frequent site of injury in a variety of sports, including gymnastics, football, weight lifting, rowing, golf, dance, tennis, baseball, basketball, and cycling.
The spinal column is made up of 24 bony vertebrae with alternating discs. The vertebrae are made up of the cervical spine (neck), thoracic spine (mid-lower back) and the lumbar spine (low back). Five additional bones are fused together to form the sacrum and three more comprise the coccyx or tailbone. Together, they allow for an upright posture and mobility in several directions and planes. The discs are actually a gelatinous form of cartilage contained within a dense fibrous mesh that lubricate the joints between the vertebrae and act as shock absorbers for the spine.
The lower back is a particularly vulnerable area for discomfort since it supports the entire weight of the upper body. LBP can be caused by a variety of factors including poor posture, weak core stabilizers, stress, pregnancy, compression of nerve roots, bone or joint disease and many others. This can lead to joint or nerve irritation, muscle spasm, disc bulges and spinal degeneration.
Although patients often attribute the onset of their back pain to a specific injury, more often the injury is quite trivial, like bending over, twisting, or sneezing. This is because much of the time onset of low-back pain represents the cumulative trauma over month or even many years. Using the circulatory system as an analogy – If the blood vessels in the body have suffered the chronic insult of atherosclerosis (plaque build-up) over the years, an acute event of shovelling snow may precipitate a heart attack; in the same way, a lifetime of poor posture and poor lifting and bending habits may stress the spinal muscles, joints and discs to the point that even a minor stress precipitates an acute episode of low back pain.
If low back pain is usually due to cumulative trauma, does that mean it’s most often mechanical? Ninety-seven percent of back pain in the population seen by primary care physicians is mechanical in origin – there’s something wrong with the muscles, ligaments, or connective tissue. Even a herniated disk is a mechanical cause. Individuals who are most aerobically fit have the least back pain.
Treatment for low back pain depends on the cause and may include any or all of the following: Chiropractic, Physiotherapy, Targeted Soft Tissue Therapy, Acupuncture, and Functional Rehabilitation. Treatment is initially aimed at decreasing pain, reducing inflammation and muscle spasm, and restoring normal motion to the joints of the spine and pelvis. Subsequently, the goals of treatment are to correct any muscular imbalances that may be contributing to the altered biomechanics, improve core stability, restore appropriate balance to the back, core and pelvic muscles and focus on lifting and sitting posture