Learn about safe, effective options for managing back pain
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Understanding Low Back Pain
Low back pain is a symptom rather than a disease itself. It can result from several general conditions or unknown ones. The exact etiology of back pain may be challenging to diagnose though the lumbar discs, facets, and sacroiliac joints make up a large portion of mechanical low back pain. [1] Low back pain may be due to underlying medical conditions in rare circumstances. A global burden of disease study in 2012 found that 80% of people will experience low back pain at some point in their life, while 20% of people suffer from low back pain at any one time. [2,3]
Back pain may start with an initial injury or insult to and of these structures leading to some level of discomfort. The duration of affliction a person experiences varies from one person to the next. Some may last days, while others experience an ache that can persist for weeks. Treatment goals can include pain management strategies and return to activities you enjoy. [4]
Many factors contribute to low back discomfort. Some are modifiable or can be changed, resulting in improvements in pain, while others are not. Modifiable factors include physical activity, overall health, and smoking status. Non-modifiable elements can consist of age and prior history of low back discomfort, to name a few. This list is by no means exhaustive but provides a few starting points to consider. [5] Posture is not part of this list though prolonged periods of sitting do directly influence your overall physical activity.
Pain management strategies
Treatment strategies include continuing daily activities even if you experience some mild discomfort. It is essential to recognize that pain management strategies are meant to assist you with maintaining daily activities without additional discomfort. Participation in your care with a healthcare provider is always a good option, especially if you have concerns, discomfort endures or progresses.
When should I get evaluated? [4]
Treatment can help manage your discomfort and return to activities that you enjoy. Symptoms that you should consult your healthcare provider include:
Unexplained swelling, redness, or deformity to the area of skin
Weakness not due to pain
Fever/chills/feeling ill
Troubles breathing or shortness of breath
Inability to perform movements or activities
Pain at rest
Sudden weight loss or loss of appetite
Pain down one or both of your legs
Previous therapies or treatments are not as effective in managing your discomfort
Other symptoms of concern include:
Loss of sensation through the legs, groin &/or the anal region
Loss of control of bowel movements or difficulties passing urine
Pain as a result of trauma
Pain associated with a loss of consciousness
I have back pain. What should I do?
Continue with daily activities that you are comfortable performing and consult your health care provider should you have specific questions about management strategies. Put simply – motion is lotion for your joints.
Treatment options include: [4]
Manipulation or mobilizations
Strengthening or stretching exercises
Massage
Acupuncture
Talk therapies
Medications
Concluding remarks
Low back pain is widespread, with most people experiencing at least one episode in their lifetime. People with similar injuries have varying pain levels, meaning that higher levels of pain do not indicate higher levels of damage. In the absence of a traumatic event, medical imaging is commonly not required before starting care. For many, low back pain can be recurrent with various levels of intensity. If you are uncertain of ways to best manage your discomfort it is a good time to consult with a member of your healthcare team.
Resources [4,6,7,8]
Telephone Resources
BC Pain Support Line: 1-844-880-7246
BC Mental Health Support Line (Available 24/7 for BC residents) - 310-6789 (no area code)
BC Crisis Line (Available 24/7 to everyone) - 1-800-784-2433
Canada Crisis line (Available 24/7 to everyone) - 1-833-456-4566
Paramedics: Contact the Critical Incident Stress Team through the Ambulance Paramedics of BC
References
[1] DePalma, M. J., Ketchum, J. M., & Saullo, T. (2011). What is the source of chronic low back pain and does age play a role? Pain medicine, 12(2), 224-233.
[2] Hurwitz, E. L., Randhawa, K., Yu, H., Côté, P., & Haldeman, S. (2018). The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. European Spine Journal, 6.
[3] Hoy, D., Bain, C., Williams, G., March, L., Brooks, P., Blyth, F., ... & Buchbinder, R. (2012). A systematic review of the global prevalence of low back pain. Arthritis & Rheumatism, 64(6), 2028-2037
[4] Low back pain. Canadian Chiropractic Guideline Initiative. 2021 [cited 8 December 2021]. Available from: https://www.ccgi-research.com/lowbackpain
[5] Wong A, Karppinen J, Samartzis D. Low back pain in older adults: risk factors, management options and future directions. Scoliosis and Spinal Disorders. 2017;12(1).
[6] Proper Lifting. BC Chiropractic Association; 2021 [cited 8 December 2021]. Available from: https://www.bcchiro.com///wp-content/uploads/2019/06/proper-lifting-web-final.pdf
[7] Chiropractic Care and Back pain. Canadian Chiropractic Association; 2021 [cited 8 December 2021]. Available from: https://www.chiropractic.ca/wp-content/uploads/2013/12/Chiro-and-Back-Pain.pdf
[8] Sit less, Move more. American College of Sports Medicine; 2021 [cited 8 December 2021]. Available from: https://www.exerciseismedicine.org/wp-content/uploads/2021/04/EIM_Rx-for-Health_Sit-Less-Move-More.pdf