Sooner or later, most people will experience some type of back injury during their lifetime. In many cases, it is a simple sprain or strain from overuse or from employing an improper lifting technique. In others, the injury may be more serious as in the cases of a bulging or herniated disc, or spinal stenosis. Regardless of the type of injury, it’s important for patients not to ignore lower back pain. The sooner a patient receives a proper diagnosis, the sooner they can start treatment in order to get back to their daily activities.

Anatomy of the Lower Spine

The lower back is commonly referred to as the lumbar region of the spine. It consists of 5 bone vertebrae (L1-L5). Each encompassing a spongy spinal disc on either side. At the base of the lumbar region is a large, triangular bone called the sacrum. This triangular bone resides between the two major hip bones, both referred to as the ilium.

The sacroiliac joints are on both sides of the sacrum where it meets with the left and right hip (ilium) bones. The sciatic nerves are major nerves on either side of the lumbar region. They travel through each ilium bone and innervate both legs. When an individual experiences lower back pain, it’s important to determine whether the pain is coming from the lumbar region or perhaps further down in the area of the sacrum or the sacroiliac joints.

Common Back Injuries

Sprain/Strain

Sometimes an individual will experience an acute jury to their lower back that manifests in the form of back spasms and/or local lower back pain. Too much lifting, bending, or twisting movements from activities such as shoveling snow, lifting heavy boxes, or yard work can aggravate weak lower back muscles, especially if an individual isn’t accustomed to such activity. Typically an individual experiencing this type of back injury notices pain upon movement, but will not have pain that radiates down either leg.

Bulging/Herniated Disc

With this type of injury, one or more of the spongy discs located between the spinal vertebrae becomes compressed and forms a bulge, or tears (herniates) with some of the disc material spilling out and pressing against adjacent tissues and nerve roots. This type of injury can occur gradually or through some type of traumatic injury. Individuals with this type of injury often experience more pain while sitting and they may have (sciatic) pain radiating down one or both legs.

Spinal Stenosis/Arthritis/Degenerative Disc Disease

As a person ages, it’s not uncommon for them to experience degenerative and arthritic changes throughout their spine. The spongy discs between the spinal bones begin to flatten, causing the disc contents to pinch adjacent nerves. In the case of spinal stenosis, the disc contents begin to compress the area where the spinal cord normally resides. With these types of conditions, the patient may feel pain going down one or both legs as well as chronic lower back pain. Without treatment they may also experience more advanced symptoms such as weakness upon standing, thus making it very difficult to walk and conduct daily activities.

Healing From Injury

When an individual experiences a soft tissue injury, there is typically a common pathway to healing. After an injury, inflammation will occur in and around the injured tissues in an attempt to mobilize the area. This is followed by tissue regeneration to replace the damaged tissues. It’s also crucial to strengthen and stabilize key muscles in and around the area of injury in order to allow injured tissues to fully recover as well as to prevent injury from reoccurring.

In order to facilitate this healing process, it’s important to receive a diagnosis to determine the exact nature of the injury. In many cases, the patient may have a simple sprain or strain whereas, in other instances, it could be more serious as in the case of spinal stenosis. For those patients referred to a physical therapist, the therapist will likely begin the process of reducing inflammation through the use of techniques such as cryotherapy, ultrasound, and laser treatments. Next, a PT will introduce stretching exercises designed to lengthen and re-align key muscles. A physical therapist will also have their patients perform strengthening exercises perhaps by way of aquatic therapy, in order to strengthen surrounding supportive muscles such as the transverse abdominis (abdominal) muscles, which are key to a strong lower back. Lastly, a physical therapist will design an at-home exercise program so patients can maintain the strength and stability they worked so hard for while in physical therapy.

Summary

If you are experiencing lower back pain, we can help! Please contact Cawley Physical Therapy and Rehab at 570-208-2787 or contact us at cawleyptfrank@gmail.com for more information.