A Guide to Better Understanding Lower Back Pain Mangement

Unfortunately, whether you like it or not, it is likely that at some point in your life you have experienced lower back pain. Whether it was after a long day out in the garden, doing something as simple as picking up a bag of groceries or if it occured completely “out of the blue”, the onset of back pain can be gradual or sudden and can often take hold of your life.

There are multiple causes of lower back pain including joints, discs, and muscles to name a few. The question however is often not “what one structure is causing the pain, but how many?” Due to the huge role that the lower back plays in bearing load, it is no surprise that multiple structures can be involved at any one time. For this reason, you will often receive a diagnosis of “non-specific lower back pain” as it cannot be pinpointed to any one structure. The treatment for lower back pain, regardless of the structures involved, can often follow a very similar course.

 


The foundation of the management of lower back pain remains the same in most cases. This key treatment aim is increasing your core and pelvic stability, as inhibition of your stability muscles occurs in response to inflammation and pain. A common misconception is that “core” stability means having a six-pack but believe it or not, you can have a six-pack, and still have a weak core. The core muscles that your physiotherapist teaches you to retrain are your Transversus Abdominus (TA), the multifidus and your pelvic floor. These muscles support your spine and help you regain pelvic stability. The TA muscle is the deepest abdominal muscle and attaches to the bones of the back as well as the lower six ribs and runs around the trunk to the front of your abdomen where it meets and joins through connective tissue. Below, it attaches to the top of your pelvis. (Picture a can; the TA forms the sides of the can, your pelvic floor the base and your diaphragm the lid). When you contract your TA, it pulls all the bones of the pelvis together and stabilises them, providing a solid unit for your limbs to move from. This muscle acts somewhat like a corset, helping to support your back as well as the bonus of defining your waist!
There are many exercises that specifically target our TA, but first it is important to train the activation of this muscle. If your mind doesn’t know how to activate the TA muscle before performing these exercises, then all you will be doing is training the wrong muscles. TA will remain inactive and lower back pain will persist.
Pilates is a great way to increase your core and pelvic stability as well as tone up. Pilates focuses on six principles, which are; centering, concentration, control, precision, breathing and flow. These principals are what sets Pilates apart from the rest of the fitness world and are what help you achieve that strong core and pelvis for your body to move upon.


The physiotherapists at Physionorth aim to not only provide you with relief of pain in the short term, but also strive to provide you with a plan to help prevent reoccurrences and help aid in self-management of their lower back pain into the future. If you have lower back pain or are just looking to tone up and increase your core and pelvic stability, come in and visit us at Physionorth. You can see one of our friendly physiotherapists for treatment, or enquire about joining one of our intimate Pilates classes that are run here in the clinic.
Don’t let pain take hold of your life! Seek help today!
Liana Chapman Physiotherapist