Chronic low back pain

What is it?

Chronic low back pain is pain felt in the lower back region, which can spread into the buttocks and legs. It can be very disabling and severe for some people, or it can be a background niggle for others. The word chronic means someone has had it for a long time, usually longer than several months.

What causes it?

90% of chronic low back pain is described as non-specific chronic low back pain. That means that there is no one specific cause for it. For years chronic low back pain has been thought of as a disorder of the spine caused by damage to certain structures in the back. Research has shown however that the ‘damage’ that is shown up on scans is actually commonly found on scans of people who don't have any back pain. ‘Wear and tear’ findings are completely normal, a bit like having grey hair.

It has been increasingly recognised that cognitive and behavioural factors have an influence on whether someone’s back pain can become chronic and persistent. Being overly anxious or fearful, or having lots of stress, a history of depression or social isolation are factors that are linked to a greater risk of the pain becoming persistent. Also changes in the way we move, alongside high levels of muscle tension around the spine can cause low back pain to persist. Often we change the way we move in an attempt to avoid the pain, and protect the back, but there is some evidence that these protective movement strategies can actually abnormally stress the back more, causing more pain.

What can we do for it?

At Physio Art our physios believe in taking a very thorough assessment, and we will consider all the factors that we know can be linked to chronic low back pain. We want to get to know you, we’ll ask you about your history, and how your back pain behaves, but we’re also interested in your life as a whole - your work, family, your life’s passions, how you sleep, what makes you tick, what makes you sick, and most importantly what you desire. 

We’ll design a management programme that will address all the factors that we think are contributing your back pain. This may involve addressing some unhelpful beliefs that you have about your back with up to date understanding of pain science, we may address some unhelpful behaviours such as avoidance of activities or the opposite - inappropriate pacing of activities. We’ll work with you to improve the way you move, this may involve some specific postural or strength and conditioning exercises, or some training in muscle relaxation or top tips such as ‘relax the belly’ or ‘lift the chest bone’. 

We may recommend you do Pilates, or have some acupuncture or some hands-on treatment, or do some Mindfulness, or encourage you to do something you’ve been wanting to do, such as book that 10k race, or Zumba class.

We aim to empower you to take control, make goals and reach them. It’s not an easy journey to make on your own, but with our support it’s possible. We’ve treated hundreds of people whose quality of life has improved dramatically with our input.

Our physios are trained in Cognitive Functional Therapy which is a technique pioneered by Professor Pete O’Sullivan. For more information on CFT please visit:

http://www.pain-ed.com/blog/2013/04/12/cognitive-functional-therapy-as-an-intervention-for-chronic-low-back-pain/

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