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General keys as to when to refer to a doctor are:

If the pain is severe

If there is swelling

If you hear a cracking or snapping at the time of the injury

If you cannot perform your normal day to day duties

If there is disturbed function following an accident or injury such as nausea, dizziness, blurred vision, paralysis or weakness.

If the pain continues beyond 7-10 days.1

WHAT IS LOWER BACK PAIN?

Lower back painaffects the muscles in the lower part of the back. It can be described as:

· Acute if it is less than 6 weeks

· Sub-acute if it 6-12 weeks

· Chronic if it is more than 12 weeks

Many people have suffered from low back pain, costing millions in lost work as well as medical and insurance resources. Lower back muscle pain is one of the most common back complaints, affecting four out of five people at some point in their lives. Although most lower back muscle pain will fix itself out within a few days to a few weeks.

LOWER BACK MUSCLE PAIN – AMERICAN STATISTICS

·      80% of society will suffer back pain of some type

Low back pain

·      88% will be asymptomatic in 6 weeks

·      98% in 24 weeks

·      99% in 52 weeks

·      97% of causes are unknown

·      2% attributed to disc problems

·      29% will require conservative treatment only

·      1% will require surgery

·      The rest will recover spontaneously2

RISK FACTORS – LOWER BACK PAIN

Postural deformities and leg length, in general, don’t seem to predispose to lower back pain. Studies of static work postures indicate an increased risk of lower back muscle pain sitting with a bent over working posture seems to carry significant risk, for example sitting in a car for more than half a work day can lead to three times the risk of disc herniation.3

·      Physically heavy, static work postures

·      Frequent bending and twisting, lifting and forceful movements

·      Repetitive work and vibrations

·      Tallness leads to increased risk

·      Sciatica is more frequent in obese people

·      Weak trunk muscles and decreased endurance

·      Coughing – leading to decreased blood supply to essential areas

·      Social factors i.e alcoholism, history of divorce, level of education, history of depression.4

SYMPTOMS OF LOWER BACK MUSCLE PAIN

Lower back muscle pain means a pain or ache somewhere between the bottom of the ribs at the back and the top of the legs. That may begin suddenly or follow obvious strain or injury or it can come ‘out of the blue’.

Pain may also travel for example down the buttocks even to the foot. It can be worse bending and is often much worse when sitting. Pain that is agonizing can be experienced when rolling over in bed or possibly sitting up. Coughing or sneezing can aggravate the pain. Back muscles may also go into painful spasms.

Lower back muscle pain may be combined with pain in the leg traveling down the knee. This is otherwise known as sciatica, because the main nerve in the leg (the sciatica nerve) is being irritated by pressure on it..

If in doubt consult a health care practitioner such as a doctor, chiropractor, physiotherapist an osteopath or myotherapist.

GUIDELINES

The first thing to rule out is other obvious conditions which may cause back pain. You really need to be on the watch out for ‘red flags’ or warning signs, which are factors that may need more rapid treatment. They may point to something more serious than a mechanical problem. If any number of these apply to you it is recommended please make sure that you see your doctor.

·      You are younger than 2o when you first get back pain

·      You are older than 55 when you first get back pain

·      The pain follows a violent injury

·      The pain is constant and getting worse

·      You have had or have cancer

·      You are on steroids

·      You are drug abuser

·      You have HIV

·      You are generally unwell

·      You have significant and unexplained weight loss

·      You have significant trouble bending forward over a period of time

·      You have developed nervous system problems – numbness, loss of power etc

·      You have developed an obvious structural deformities

·      If the pain continues over 4 weeks

CONCLUSION