Have you ever had a bout of low back pain?
Chances are that for up to 80% of you reading this, the answer is yes.
The duration of which your low back pain may last is dependent on its cause - for which we categorise as either mechanical, or, inflammatory.
Typically if your back pain has been classified as mechanical in nature, we would expect it should settle down within 4-6 weeks. Mechanical pain, relates to muscular and soft tissue issues such as strength imbalances and straining. They tend to be caused by activities and accidents.
There are seven factors affecting a patient's recovery duration from mechanical causes:
1. Severity: On average, mechanical pain would last for 4-6 weeks in most cases. However, if it has been caused by an accident where substantial injuries were sustained, the pain may become chronic, lasting for more than 3 months.
2. Treatment: How soon an individidual seeks treatment after experiencing symptoms - and the quality of the advice for which they received affects their recovery rate.
3. Posture: The individual's ability to have a flexible arrangement to blend sitting with standing at work and home is an important factor in recovery.
4. Sleep: Most of our muscular recovery is done during sleep. The quality and quantity of a patient's sleep is a crucial component for them to promote recovery.
5. Stress: A high level of stress actually causes muscles to tense up unnaturally - potentially aggravating any strains. Stress also negatively affect the quality of a patient's sleep, meaning slower recovery.
6. Medication: Appropriately prescribed medication can help the patient manage their pain. Please note this does not mean supplements which aren't well studied.
7. Personal beliefs about pain, injury and recovery: The placebo effect is a widely known phenomenon. Your perceptions about the treatment and pain you are experiencing can actually affect bodily processes such as immune system responses and hormonal releases. These in turn can affect your recovery!
Unfortunately, a high proportion of individuals go on to have repeated episodes of low back pain or suffer after 3 months. If this is the case, we say the pain is chronic.
If you have chronic back pain, chances are it might be inflammatory back pain. Low back pain can come in many forms and have very different repurcisions as well as treatment.
Inflammatory back pain is caused when the vertebrae your spine - particularly in the lower regions - become inflammed. A possible cause for the inflammation may be an immune response whereby the joints are seen as foreign objects by the body and consequently attacked.
Unfortunately, inflammatory pain cannot be cured, but with the right treatment, that pain could be effectively managed. Medication for inflammatory conditions such as ankylosing spondylitis tend to be fast acting - patients may have a marked improvement in their pain within a week!
If unmanaged however, inflammatory pain could lead to severe issues such as a fusion of the spine, leading to a hunched posture and potentially, organ problems.
So whilst inflammatory conditions cannot be cured, treating the pain and managing their progression can be relatively quick. The reason why a lot of patients coming to us have experienced years of back pain without resolution is because their inflammatory conditions were treated as mechanical issues.
If your back pain has been lasting for more than 3 months, and you have went to multiple health practitioners without result, you should be looking for someone with expertise in inflammatory conditions, because back pain comes in many forms.
Here at BJC Health, us Physio’s and EP’s are lucky to work with a great team of rheumatologists. Over time, they have helped us all develop the knowledge and skills to better identify the different
types of low back pain that may walk into our clinic. Identifying the type of back pain is an essential step in establishing a suitable management plan for our clients.
We believe inflammatory back pain is present in up to 5% of all people with low back pain.
What does this mean?
If you are diagnosed with inflammatory back pain, the treatment and management is quite different to those with what is commonly referred to as mechanical back pain. Unfortunately, inflammatory
back pain can often get mistaken for mechanical low back pain, meaning that traditional treatments may not offer such great improvements. This can result in an individual with inflammatory low back pain experiencing symptoms for longer than 3 months.
We know how frustrating it can be to feel like your symptoms are sticking around and you aren’t progressing. Pain can act as a strong de-motivator, and hold you back from confidently moving and doing the things you want to do.
Our physiotherapy team is currently offering a free back check for anyone who would like to speak to one of the team to see if your low back pain is inflammatory or mechanical. We are keen to help
ensure you are on the right track with your treatment, and if not, we are hopeful we can offer a solution to help you move forward.
