Lower back pain is the leading cause of sick days, and affects most adults at some point. The BMJ suggests that almost a third of adults suffer from some degree of back pain every year. Your osteopath is equipped to help you manage these episodes, and try to reduce their incidence in the first place.
Lower back pain can have a number of structural causes, such as arthritis or a pulled muscle. We have tests and patterns to look for to pin down the likely structures involved. But pain does not exist in a vacuum, and other factors like stress, pain beliefs, and personal history will influence pain too. We look at a person as a whole, so diagnosing any physical factors is as important as identifying the psychological and social factors. For patients with chronic lower back pain, this is absolutely key.
Understanding that your back is strong and stable is a good place to start- beliefs like this are associated with lower pain scores. Your osteopath can help you to see this, and provide you with the exercises and comfort to strengthen it further.
At your first appointment, we will take a case history to understand your symptoms in context. This includes some questions about general health that may seem unrelated, but are important to rule some conditions in or out. Then we move onto a physical examination, for which you may have to remove some clothing, so wear underwear that you are comfortable to be examined in. Shorts and a sports bra are fine if you prefer. With all of this information gathered, we can give you a diagnosis, prognosis, and treatment plan.
Except in very unusual circumstances, we will provide treatment in the first appointment. This is hands on, and may involve stretching or massaging muscles, and gently moving joints. Sometimes clicking joints can be helpful too, but nothing will be done without your full consent. Most patients are also provided with advice or exercises to continue their progress between appointments. These will be tailored specifically to you to make them as effective as possible.
Unfortunately, it's not an easy question to answer! Some mild muscle strains may only take a few days to fully resolve, whereas more complicated cases can take months. There is similar variability for associated sciatica. For more simple cases, the earlier treatment is sought, the quicker things resolve. This is partly because the sooner a problem is addressed, the less opportunity there is for the body to adapt to the dysfunction. Like holding a phone in the crook of your neck will eventually cause tension in the neck and shoulder on that side, the same is true for adapting to pain. The body is very good at protecting areas it perceives to be at risk, but this action tends to have an equal and opposite reaction elsewhere.
As a general rule, movement is good for lower back pain. The days of prescribing "bed rest" for simple back pain are long gone. Movement helps the brain to realise that the area is safe, and allows a quicker return to full function. It also helps to encourage blood flow to the area, which can help to heal any injuries, as nutrients are brought in and waste is removed.
Your osteopath will be able to give you a rough idea of how long your back pain might last at your appointment.