Chronic low back pain is defined as low back pain persisting for at least 12 weeks, which is much different from an acute flare up.
For practical classification low back pain can be categorized into the three categories:
Specific spinal pathology
Nerve root pain
Nonspecific low back pain, where pain caused by a serious pathology or a nerve root has been ruled out
Who Develops Chronic Low Back Pain?
Chronic back pain was found more in women (70.3 per 1000 population) than men (57.4 per 1000 population) and the risk of chronic back pain increased with age. Factors like older age, previous incidences of back pain, and psychosocial disorders were factors that had a negative effect on recovery.
How Long Will It Take to Recover?
Most patients with back pain recover quickly. Overall, 60–70% recover by 6 weeks and 80–90% by 12 weeks. Recovery after 12 weeks is slow and uncertain. It is important for individuals to try and maintain a normal routine and continue modified work duties as less than half of people with lower back pain for more than 6 months decide to return to work.
What Are Some Symptoms Of Low Back Pain?
Pain and discomfort, localized in the lower back to the gluteal (buttock) region. Pain may be centrally, on one side or both sides of the lower back, with or without pain radiating to the buttocks, hamstrings, or lower leg.
Sharp pain travelling in a narrow band down the leg is known as radicular pain (possibly due to nerve root irritation).
Palpation of the lumbar spine may reveal tenderness with muscle spasms.
Pain may be aggravated by certain movements, such as bending, arching back, rotating or combined lower back movements.
What Can I Do to Fix The Problem?
A study by Hayden et al., (2005) sought to identify specific exercise intervention characteristics that decrease pain and improve function in adults with nonspecific chronic low back pain.
The study found that the most effective strategy seems to be:
Individually designed exercise programs, whereby the treating therapist completes a clinical history and physical examination and delivers an exercise program specifically designed for the individual participant.
The program is delivered in a supervised format (home exercises with regular therapist follow-up).
The patient is encouraged to achieve a high dosage of exercise. The National Guidelines for Physical Activity in Ireland recommend at least 30 minutes a day of moderate activity on 5 days a week (or 150 minutes a week).
Adding other conservative treatments, such as advice on staying active, medication or hands-on treatment, also resulted in improved pain and functional outcomes.
Stretching and muscle-strengthening exercises were the best types of exercises for improving pain and function. See some examples on another blog post here.
In conclusion, chronic low back pain is a slower recovery process than a normal bout of acute low back pain. However, with the proper exercise program for your individuals needs it is possible to stay active and manage your symptoms.
References
- Airaksinen, O., Brox, J., Cedraschi, C., Hildebrandt, J., Klaber-Moffett, J., Kovacs, F., Mannion, A., Reis, S., Staal, J., Ursin, H. and Zanoli, G. (2006). Chapter 4 European guidelines for the management of chronic nonspecific low back pain. European Spine Journal, 15(S2), pp.192-300.
- Andersson, G. (1999). Epidemiological features of chronic low-back pain. The Lancet, 354(9178), pp.581-585.
- BRUKNER, P., & KHAN, K. (2012). Brukner & Khan’s clinical sports medicine. Sydney, McGraw-Hill.
- Hayden, J., van Tulder, M. and Tomlinson, G. (2005). Systematic Review: Strategies for Using Exercise Therapy To Improve Outcomes in Chronic Low Back Pain. Annals of Internal Medicine, 142(9), p.776.
