NSLBP stands for Non-Specific Low Back Pain and is defined as pain or discomfort localised to the lumbo-sacral region, which is the area below the ribs and above the gluteal crease (where the upper leg meets the buttock), with or without referred leg pain.
The symptoms of low back pain include:
- Pain across the lower back that may radiate into the buttocks, thighs or groin
- Stiffness and limitation in movement of the spine – especially bending forward or leaning back
- Spasm of the muscles surrounding the spine
- With severe pain and spasm, the back may tilt to one side causing a change in posture or a list
Low back pain affects nearly 60-80% of people throughout their lifetime, and it can affect any age group. Within that 60-80% of people who will suffer from NSLBP 10% will have a significant disability from it, which results in loss of productivity at work and decreased the quality of life.
NSLBP is the most common condition treated by physiotherapists in Australia and is the second most common reason that people attend a General Practitioner (GP) after seeking treatment for colds and flu. NSLBP can be defined as Low Back Pain (LBP) without a known specific cause or pathology of the spine (i.e. tumour, fracture, spinal canal stenosis, osteoporosis or inflammatory disorder). Any innervated structure in the lumbar spine can be a possible source of pain. This includes the muscles, fascia, ligaments, nerve roots, facet-joints, discs and vertebrae.
NSLBP is often classified into three stages (acute, subacute and chronic) according to its duration of time that the person has suffered from pain.
- Acute lower back pain is usually defined as an episode persisting for less than 6 weeks.
- Subacute lower back pain between 6 and 12 weeks, and
- Chronic lower back pain for 12 weeks or longer.
Those that have chronic lower back pain can get an acute flare up and this is known as acute on chronic.
The recurrence rate of NSLBP is approximately 60%, and most individuals are likely to experience another episode of LBP within 3-6 months. Therefore, proper treatment and rehabilitation with a long-term management plan are extremely important.
It is not uncommon for people to not really know why their back pain started. Often people will say “It just went” or “I woke up with this pain”. However, most likely the cause has been there a lot longer. There are all sorts of reasons people get back pain but the most common reasons are
- New use – When you start a new activity or do something you haven’t done for a while you may not feel it at the time but over the coming days you become acutely aware
- Misuse – Constantly loading the body in an unbalanced way like poor posture
- Overuse – Repeated use of a muscle group resulting in muscle imbalance
- Abuse – Loading the spine too much ie carrying heavy loads
- Disuse -Lack of movement
Anatomically and through research, we now understand that after an initial onset of low back pain whatever the cause there is a dramatic weakness & incorrect firing pattern in the key spinal stabiliser muscles. Importantly, without specific retraining, these muscles do not spontaneously recover. Despite the lack of pain, this ongoing weakness means the spine is not receiving the support required to prevent ongoing shearing forces across the disc & joints to prevent chronic or recurrent NSLBP.
Pilates can be a highly effective therapy to use in the recovery of back pain. Pilates trains the body to create balance in the muscles and focuses on the smaller stabilizing muscles around the joints in the body. Having trained the small stabilisers in the body, you will be less likely to develop back pain again.