Why does my back hurt and why isn’t it getting better?

By Bowskill Clinic on Saturday, May 12th, 2018

Low back pain is one of the biggest blights on our health and well-being and the evidence suggests that the burden on us as well as the economy is growing year on year.  So why is this the case and what do we need to know about low back pain to help how we heal recover and get back to a normal life?

Low back problems can be very painful but in many cases although the pain can make movement and everyday life difficult the causes are not so often serious. With any case of low back pain however it is important to exclude some of these more serious causes. The signs for these serious conditions are called red flags by doctors and these are ;

  • Rapid onset spinal pain with a high temperature
  • Numbness in the genitals or undercarriage
  • Problems with passing/ holding urine or faeces
  • Night pain especially in the thoracic or middle spine
  • A foot drop or sudden inability to use the muscles of the lower leg
  • Consistent extreme and continual pain not provoked by movement

These signs can mean that the cause of your symptoms are a full disc prolapse where the disc material is pressing on a nerve, an infection of the spine, the possibility of a tumour or space occupying lesion or more complex multi system illnesses.

If none of these are the case then there can be a variety of other things happening to provoke the symptoms. These may include mechanical problems with the muscles, joints and nerves. As we get older much as we get wrinkles on the outside our spines start to change and sometimes these changes make us a little more vulnerable to low back pain. When we have these kinds of problems for a while our brain which tells us how important the signals from these areas is can become sensitised. This means that it starts to be on the look out for pain signals and so increases the alarm signals it gets back which can mean more pain though at the same time no more damage is necessarily going on. In this environment  lots of things can influence how sensitive our central nervous system is. These can include high levels of stress, poor diet, poor movements which stress the particular mechanical issue with the spine, your level of threat from the pain (i.e. if the pain is stopping you from working, or threatens serious relationships then this creates a much bigger potential alarm signal), can all add to the problem.

For this reason it is often important to look at the pain from both ends of the spectrum. What part of the issue might be a mechanical problem that can be helped by manual therapy and exercise and what element might be that other factors have contributed to the bodies nervous system becoming inappropriately sensitive. By looking at the problem from all angles it is much easier to put together a strategy the looks at the whole and sum of all parts.

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