Living with Lower Back Pain

By: Chronic Therapy Team

Summary

In this easy-to-understand guide, we've taken a deep dive into the world of lower back pain, discussing its prevalence in Australia and the various factors that can cause it. We've highlighted the importance of getting a proper diagnosis and explored the connection between lower back pain, sciatica, and mental health. A variety of treatment options are covered, including medical cannabis, as well as handy tips to help manage lower back pain and support our loved ones who are dealing with it. By getting to know the ins and outs of lower back pain, we can empower ourselves to make informed decisions and find the best solutions for a happier, more comfortable life.


  1. What is Lower Back Pain?
  2. How Common is Lower Back Pain in Australia?
  3. Causes of Lower Back Pain
  4. Why is it Important to Properly Diagnose Lower Back Pain?
  5. Symptoms of Lower Back Pain
  6. Lower back pain and sciatica
  7. Back Pain and Mental Health
  8. Is lower back pain a type of Chronic Pain?
  9. Is lower back pain a disability in Australia?
  10. Treatments for lower back pain
  11. Medical Cannabis and Lower Back Pain
  12. Tips for Managing Lower Back Pain
  13. How to support someone with lower back pain
  14. Conclusion

1. What is Lower Back Pain?

Lower back pain refers to discomfort, aches, or stiffness in the lumbar region of the spine. This area consists of five lumbar vertebrae, supporting structures such as ligaments and muscles, and the spinal cord (1). Lower back pain is a common issue that affects individuals of various ages and can range from mild to severe, impacting daily activities and overall quality of life.


2. How Common is Lower Back Pain in Australia?

Lower back pain is a prevalent condition in Australia, affecting up to 80% of people at some point in their lives (2). It is the leading cause of disability in the country and accounts for a significant portion of healthcare expenses (3). According to the Australian Institute of Health and Welfare, approximately 4 million Australians (16% of the population) experienced back pain in 2017-2018 (4).


3. Causes of Lower Back Pain

There are numerous potential causes of lower back pain, which can be categorised as mechanical, non-mechanical, or referred pain (5). Some common causes include

Mechanical causes:

Muscle strains or sprains: Overstretching or tearing of muscles and ligaments due to heavy lifting, sudden movements, or poor posture (6).

Degenerative disc disease: Age-related wear and tear of the intervertebral discs, leading to reduced shock absorption and increased pressure on facet joints (7).

Herniated disc: Bulging or rupture of an intervertebral disc, which may put pressure on the spinal nerves, causing pain (8).

Spinal stenosis: Narrowing of the spinal canal, leading to compression of the spinal cord or nerve roots (9).

Facet joint dysfunction: Degeneration or inflammation of the facet joints, which connect the vertebrae and enable movement (10).

Non-mechanical causes:

Infections: Bacterial infections in the spine, such as discitis or vertebral osteomyelitis (11).

Tumours: Abnormal growths in the spine, which may be benign or malignant (12).

Fractures: Traumatic injuries or stress fractures due to osteoporosis or other underlying conditions (13).

Referred pain:

Kidney issues: Kidney stones or infections can cause pain in the lower back (14).

Gynaecological problems: Conditions such as endometriosis, ovarian cysts, or uterine fibroids can cause referred pain in the lower back (15).


4. Why is it Important to Properly Diagnose Lower Back Pain?

Proper diagnosis of lower back pain is crucial for several reasons:

Identifying the underlying cause:

A thorough evaluation, including a physical examination and medical history, can help determine the cause of the pain and guide treatment (16).

Ruling out serious conditions:

Some causes of lower back pain, such as tumours or infections, require urgent medical attention (17).

Developing an appropriate treatment plan:

A correct diagnosis allows healthcare providers to tailor treatment plans to the individual's specific needs and goals (18).

Preventing complications and recurrence:

Proper diagnosis and treatment can help prevent complications, such as chronic pain or disability, and reduce the likelihood of future episodes (19).


5. Symptoms of Lower Back Pain

Lower back pain symptoms can vary depending on the cause and severity of the condition. Common symptoms include (20):

  • A dull ache or sharp, stabbing pain in the lower back.
  • Stiffness and limited range of motion.
  • Muscle spasms or tightness.
  • Pain that worsens with movement or prolonged sitting.
  • Pain that radiates into the buttocks, thighs, or legs.
  • Numbness or tingling sensations in the lower extremities.
  • Weakness or difficulty moving the affected leg or foot.

In some cases, lower back pain may be accompanied by additional symptoms, such as fever, unexplained weight loss, or bladder problems, which may indicate a more serious underlying condition (21). If you experience these symptoms, consult a healthcare professional immediately.


6. Lower back pain and sciatica

Sciatica refers to pain that radiates along the path of the sciatic nerve, which starts in the lower back and extends through the hips, buttocks, and down each leg (22). It typically affects only one side of the body and is caused by compression or irritation of the nerve roots that form the sciatic nerve. This compression can result from a herniated disc, spinal stenosis, or other spinal abnormalities (23). Sciatica symptoms can include sharp, burning pain, numbness, tingling, or weakness in the affected leg (24). Treatment for sciatica typically involves addressing the underlying cause and may include physical therapy, medications, or, in severe cases, surgical intervention (25).


7. Back Pain and Mental Health

Chronic back pain, including lower back pain, can have a significant impact on mental health. Individuals with chronic pain are at an increased risk of developing mood disorders, such as depression and anxiety (26). This relationship is bidirectional, as individuals with pre-existing mental health conditions may also be more susceptible to experiencing chronic pain (27). Therefore, addressing mental health concerns is an essential component of comprehensive pain management. Treatment options may include psychological therapies, such as cognitive-behavioural therapy, relaxation techniques, or mindfulness-based interventions (28).


8. Is lower back pain a type of Chronic Pain?

Lower back pain can be classified as either acute or chronic. Acute low back pain typically lasts for a few days to a few weeks and is often related to a specific event, such as a muscle strain or injury (29). Chronic low back pain, on the other hand, persists for more than 12 weeks and may have a more complex etiology (30). In some cases, the cause of chronic low back pain may not be identifiable, making treatment more challenging (31). Chronic back pain may require a multifaceted approach to pain management, incorporating both pharmacological and non-pharmacological interventions (32).


9. Is lower back pain a disability in Australia?

In Australia, lower back pain is considered a disability if it significantly impacts an individual's ability to perform daily activities, engage in social interactions, or maintain employment (33). Chronic low back pain is a leading cause of disability in the country, contributing to substantial healthcare costs and lost productivity (34). Individuals with disabling lower back pain may be eligible for financial support or accommodations through programs such as the National Disability Insurance Scheme (NDIS) or Disability Support Pension (DSP) (35).


10. Treatments for lower back pain

Treatment for lower back pain is typically guided by the underlying cause, severity, and duration of the pain. Some common treatment options include:

Self-care:

Maintaining a healthy weight, practicing good posture, and engaging in regular physical activity can help prevent and alleviate lower back pain (36). Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, may also provide temporary relief (37).

Physical therapy:

A physical therapist can develop a tailored exercise program to strengthen muscles, improve flexibility, and restore function in individuals with lower back pain (38).

Medications:

Prescription medications, such as muscle relaxants, opioids, or antidepressants, may be used in some cases to manage more severe or persistent pain (39). However, these medications should be used judiciously due to potential side effects and the risk of dependence (40).

Spinal manipulative therapy:

Chiropractic care or osteopathic manipulation can help improve spinal alignment, reduce pain, and enhance function in some individuals with lower back pain (41).

Massage therapy:

Therapeutic massage can help alleviate muscle tension, promote relaxation, and provide short-term pain relief (42).

Acupuncture:

This traditional Chinese medicine technique involves inserting thin needles at specific points on the body to help alleviate pain and improve function (43).

Transcutaneous electrical nerve stimulation (TENS):

A TENS unit delivers mild electrical currents to the skin to help reduce pain signals and promote relaxation (44).

Cognitive-behavioural therapy (CBT):

CBT can help individuals with chronic back pain develop coping strategies, challenge negative thought patterns, and improve their overall quality of life (45).

Injections:

Epidural steroid injections, nerve blocks, or facet joint injections may provide temporary pain relief for some individuals with lower back pain (46).

Surgery:

Surgical intervention is rarely needed for lower back pain but may be considered for cases involving severe nerve compression, spinal instability, or unresponsive conservative treatments (47).


11. Medical Cannabis and Lower Back Pain

Medical cannabis has gained attention as a potential treatment option for chronic pain, including lower back pain. The active compounds in cannabis, such as cannabinoids (e.g., THC and CBD), may help modulate pain signals and reduce inflammation (48). Some studies have shown that medical cannabis may provide pain relief and improve function in individuals with chronic low back pain (49). However, more research is needed to fully understand the efficacy, safety, and optimal dosing of medical cannabis for lower back pain. In Australia, medical cannabis may be prescribed by a healthcare professional for patients with chronic pain that has not responded to conventional treatments (50).


12. Tips for Managing Lower Back Pain

Maintain a healthy lifestyle: Engage in regular physical activity, maintain a healthy weight, and practice good posture to reduce the risk of developing lower back pain (51).

Use proper lifting techniques: Bend at the knees and hips, keeping your back straight, and use your legs to lift heavy objects (52).

Modify your work environment: Ensure your workspace is ergonomically designed, with a supportive chair and proper desk height, to minimize strain on the lower back (53).

Apply heat or cold: Use a heating pad or cold pack to alleviate pain and reduce inflammation (54).

Stay active: Gentle exercises, such as walking or swimming, can help alleviate pain and maintain flexibility (55).

Stretch regularly: Incorporate daily stretching exercises to maintain flexibility and reduce muscle tension (56).

Seek professional help: Consult a healthcare professional for a proper diagnosis and individualised treatment plan (57).


13. How to support someone with lower back pain

Offer emotional support: Acknowledge their pain and listen empathetically to their concerns (58).

Encourage self-care: Help them maintain a healthy lifestyle, engage in gentle exercises, and practice relaxation techniques (59).

Assist with daily activities: assistance with household chores, grocery shopping, or other tasks that may be challenging due to pain (60).

Accompany them to appointments: Attend medical appointments to provide support and help them communicate with healthcare professionals (61).

Stay informed: Learn about lower back pain and its treatments to better understand and support their needs (62).


14. Conclusion

In conclusion, lower back pain is a prevalent and multifaceted condition affecting millions of people worldwide. The underlying causes can range from muscular strain and spinal stenosis to more severe conditions like serious spinal pathology. Accurate diagnosis is crucial to determine the appropriate treatment and management plan for each individual. Symptoms of lower back pain may present themselves differently and often coexist with other conditions such as sciatica and mental health issues. Treatments for lower back pain are diverse, including physical therapy, pain management, and alternative therapies like medical cannabis.

Living with lower back pain can be challenging, but understanding the condition, recognising the importance of a proper diagnosis, and exploring various treatments can significantly improve one's quality of life. Supporting someone with lower back pain requires empathy and understanding, as well as helping them adhere to their treatment plan and providing emotional support.

If you or someone you know is living with lower back pain and interested in exploring medical cannabis as a treatment option, don't hesitate to book a consultation with a Chronic Therapy doctor. They can provide the necessary guidance and support to determine if medical cannabis is appropriate for you, helping you navigate the path towards a more comfortable and pain-free life.


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