Lower back pain is one of the most common musculoskeletal problems we see at The Bath Practice. It can appear suddenly after lifting, exercise, or an awkward movement, or it can develop gradually without an obvious cause.
For some people, back pain is a temporary problem. For others, it can become persistent or keep returning, affecting work, exercise, sleep and everyday life.
If you are experiencing lower back pain, Rosie can assess your symptoms, help identify factors that may be contributing to the problem and discuss an appropriate treatment and management plan.
What is lower back pain?
Lower back pain refers to pain or discomfort in the lumbar region – the area between the bottom of the ribs and the pelvis. The lower back is made up of vertebrae, discs, muscles, ligaments and nerves. These structures work together to provide both movement and stability while dealing with the demands of everyday activities.
Back pain can therefore present in many different ways. You may experience:
- A dull or persistent ache across the lower back
- Sharp pain with certain movements
- Pain predominantly on one side
- Stiffness after sitting or when getting up in the morning
- Muscle tightness or spasm
- Pain extending into the buttock, hip or thigh
- Difficulty bending, twisting or getting out of a chair
- Pain after prolonged sitting, standing or walking
- Repeated episodes that improve and then return
Sometimes pain can travel from the lower back into the leg and may be accompanied by pins and needles, numbness or weakness. This can indicate irritation of a nerve and may be associated with sciatica.
Most episodes of lower back pain are not caused by anything serious. However, a thorough assessment is important, particularly when symptoms are severe, persistent or unusual.
What causes lower back pain?
There isn’t always one identifiable cause of lower back pain. Sometimes symptoms follow an obvious event such as lifting something heavy, starting a new activity, exercising or spending several hours gardening. In other cases, pain develops gradually.
Common factors associated with lower back pain can include:
Changes in activity
A sudden change in what you ask your body to do can sometimes trigger symptoms. This might be an unusually physical weekend, moving house, returning to the gym, increasing your running distance or simply doing an activity that your body isn’t currently accustomed to. Equally, periods of reduced activity can sometimes contribute to stiffness and discomfort.
Prolonged or repetitive positions
Back pain is often blamed on “bad posture”, but there is no single perfect posture that everyone should maintain. However, spending long periods in the same position can become uncomfortable. Regularly changing position and moving throughout the day is often more practical than attempting to maintain one supposedly perfect posture.
Muscles and joints
The muscles and joints of the lower back and pelvis can become painful or sensitive following injury, unfamiliar activity or changes in loading. This can sometimes be accompanied by significant muscle guarding or spasm, giving the sensation that the back has suddenly “locked”.
Age-related changes
Changes to the discs and joints of the spine become increasingly common as we get older. Terms such as “degeneration”, “disc changes” or “wear and tear” can understandably sound concerning. However, these findings are also frequently seen on scans of people who have no back pain at all. A scan therefore needs to be interpreted alongside your symptoms and physical examination rather than viewed in isolation.
Previous episodes of back pain
People who have previously experienced lower back pain are more likely to experience another episode. For recurrent problems, management may therefore involve more than simply trying to settle the current symptoms – improving strength, activity levels and confidence in movement may also form part of a longer-term approach.
Stress, sleep and general health
Pain is influenced by more than muscles and joints alone. Poor sleep, stress, illness, reduced activity and general health can all affect how we experience pain and how quickly we recover. This doesn’t mean that back pain is imaginary – rather, it reflects the fact that pain is a complex experience influenced by many different factors.
How can osteopathy help with lower back pain?
People commonly visit an osteopath for assessment and treatment of musculoskeletal lower back pain. At The Bath Practice, the first step is understanding your particular presentation rather than assuming that everyone with back pain has the same problem.
We consider your lower back alongside the surrounding areas, including the pelvis and hips, and take into account your work, exercise, previous injuries and general activity levels. Depending on what we find, osteopathic treatment may include:
- Joint mobilisation
- Soft tissue techniques
- Stretching
- Manipulation where clinically appropriate
- Advice about movement and activity
- Exercises to improve mobility or strength
Treatment is tailored to the individual and will always be discussed with you first.
For somebody experiencing a recent episode of lower back pain, the initial aim will usually be to improve comfort and help them return gradually to normal movement. For recurrent or longstanding back pain, treatment may place greater emphasis on understanding contributing factors, gradually increasing activity and developing strategies that help you manage your back more independently.
Osteopathy isn’t appropriate for every cause of back pain. If your symptoms suggest that investigation or assessment by another healthcare professional is required, we will explain this and advise you on the appropriate next step.
What should I expect at an osteopathy appointment?
If you visit The Bath Practice for lower back pain, your first appointment will begin with a detailed consultation. Your osteopath will ask about your current symptoms, including when they began, where you experience the pain and which movements or activities make things better or worse.
We will also ask about relevant aspects of your medical history, previous episodes of back pain, injuries, work, exercise and medication. Some questions may initially seem unrelated to your back — these form an important part of the assessment and help us identify symptoms that may require further medical investigation.
Examination
With your consent, your osteopath will then perform a physical examination. This may include assessing movement through your lower back, pelvis and hips and carrying out any relevant orthopaedic tests. If your symptoms suggest that a nerve may be involved, we may also perform a neurological examination, which can include testing muscle strength, sensation and reflexes.
We will explain what we have found and discuss our impression of the problem with you. If osteopathic treatment is appropriate, treatment can usually begin at your first appointment.
Do I need an MRI or X-ray for lower back pain?
Most people with straightforward lower back pain do not require a scan. Your symptoms and physical examination can often provide enough information to begin an appropriate management plan.
MRI scans and X-rays can be valuable when there is a clinical reason for performing them, but they also commonly identify changes that may not be responsible for somebody’s symptoms. If we believe further investigation is appropriate, we will explain why and recommend that you speak to your GP or another suitable healthcare professional.
Should I rest with lower back pain?
When your back is particularly painful, temporarily modifying certain activities can be sensible. However, prolonged bed rest is generally not recommended for uncomplicated lower back pain.
For many people, continuing with manageable everyday movement and gradually returning to normal activities is preferable. Initially this might simply involve taking short walks, regularly changing position or temporarily reducing activities that significantly aggravate your symptoms. As things improve, activity can usually be increased gradually.
What about longstanding or recurring lower back pain?
Longstanding back pain can be particularly frustrating. Some people who visit our osteopathy clinic in Bath have experienced symptoms for months or years and may already have tried several different treatments or exercise programmes.
Persistent back pain is often more complex than a recent injury, and it would be unrealistic to suggest that one treatment will resolve every longstanding problem. However, a thorough assessment can still be useful. We can review your history, consider what has already been investigated or attempted, assess how you currently move and function, and identify factors that may be possible to change.
For most people, this may include manual treatment alongside a gradual return to activity or specific exercises. For others, the most useful outcome may be gaining a clearer understanding of their symptoms and developing a realistic plan for managing them.
When should I seek urgent medical advice for lower back pain?
Seek urgent medical advice if you develop:
- New difficulty controlling your bladder or bowel
- Numbness around your genitals, buttocks or inner thighs
- Significant or rapidly worsening weakness in one or both legs
- Severe back pain following significant trauma
- Back pain accompanied by fever or feeling significantly unwell
You should also speak to an appropriate healthcare professional about persistent or unexplained back pain if you have unexplained weight loss, a history of cancer, a weakened immune system or other significant medical concerns.
Frequently Asked Questions
Osteopaths commonly assess and treat people experiencing musculoskeletal lower back pain.
Treatment will depend on your individual presentation, but typically will include manual therapy, movement advice and exercise prescription.
The first step is establishing whether your symptoms are appropriate for osteopathic treatment and whether further investigation is required.
There is no set number.
A recent episode of uncomplicated back pain may require a different approach from symptoms that have been present for several years.
Your osteopath will discuss this with you based on your examination, response to treatment and progress. We don’t recommend an arbitrary course of treatment simply because somebody has back pain.
Walking can be a useful way of remaining active during many episodes of lower back pain.
The appropriate amount will vary from person to person. Starting with a manageable distance and gradually increasing it is often preferable to either complete rest or pushing through significantly worsening symptoms.
In many cases, yes.
Exercise and physical activity can form an important part of recovering from and managing lower back pain.
The type and intensity will depend on your symptoms. Your osteopath can help you decide what activities you can continue, what may temporarily need modifying and how to gradually return to your normal exercise.
Book a lower back pain assessment in Bath
If you’re experiencing lower back pain and would like to know whether osteopathy may be appropriate, you can book an initial consultation with Rosie at The Bath Practice for a full assessment.
Book online or call us on 01225 427835.
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Email at: info@thebathpractice.co.uk
or call: 01225 427835
The Bath Practice is located at: 26 Monmouth St, Bath BA1 2AP