The “lower back niggle” – an all too common complaint that usually presents as an on’-again, off-again pain that isn’t severe enough to warrant a trip to the physio but is annoying enough to take you out of action for a couple of weeks.
As a physio, I often find myself in a similar conversation with clients:
- Physio: Any other issues or injuries?
- Client: Oh, the occasional back stiffness but that’s pretty normal.
- Physio: Really? Tell me more about that.
- Client: Oh, it’s just a little stiff sometimes, it’s actually nothing really.
At this point, my job is to educate the client on why that lower back niggle is not “normal” and why it’s important to get it addressed. When asked why they haven’t addressed it earlier, it’s always one of a few different reasons:
“Normally it only lasts a couple of days – if I ignore it, it comes good”
Typically, someone with a lower back niggle will keep having episodes because the first time they had it, they ignored it and it went away. By that logic, doing the same thing should yield the same results, right? Well, that approach has two issues;
Firstly, recurring back pain is a sign that there are fundamental issues with the way that you move that are causing the problem in the first place. By ignoring these issues and waiting for the pain to subside, you haven’t addressed the root cause, and so another episode is inevitable.
Secondly, with each incidence of back pain, the structures that are responsible for the pain deteriorate and degenerate, making the problem worse. This is why over time, the lower back pain may take longer to resolve, or may be more severe with each episode.
“I’ll normally just get a massage and that solves it”
It seems to be the perfect solution – a deep tissue massage that really gets into the back; the pain goes away and the stiffness vanishes. The reason the massage feels great is because it is relieving the muscular spasm that is present with most back pain. This spasm is responsible for the feeling of tightness and restriction felt in the lower back, and by massaging the muscles they are lengthened and the spasm eases.
The issue here is that this again doesn’t actually solve the problem. The muscular spasm is a symptom, not a cause. It would be the equivalent of re-filling a punctured fuel tank and thinking that the problem is solved. Muscular spasm may be the result of:
- Back muscles carrying too much load
- A sign of poor mobility
- An ineffective core
- Stuck joint, irritated disc or inflamed nerve
Without intervention, the massages will slowly begin to lose their effectiveness and the feeling of release won’t last as long.
“It’s not actually anything serious”
The mindset that pain or stiffness of any kind is ‘normal’ is a dangerous one. By allowing the body to just ‘deal’ with pain, we encourage several changes in the body that – long term – can have serious consequences.
I’ve already discussed how, with each episode of stiffness or pain, structures in the body deteriorate and worsen, making complete resolution harder over time. In addition to this, the body only deals with these issues by compensating and shifting the issue elsewhere. That means that the longer the lower back is ignored, the more likely it is that another issue will arise that will be too big to ignore – hip, upper back, even neck and shoulder issues can be traced to a lower back niggle that wasn’t sorted earlier.
Further to this is that as the brain gets used to sending pain signals to the lower back, it starts to make this process easier and more efficient, meaning that the body is more susceptible to feeling pain. Left unchecked, this can be severely debilitating and have an enormous impact on a person’s ability to function.
“It’s only when I do _______, but I just avoid that now”
For me, this is devastating to hear, as “_________” is usually a physical activity or hobby that the client just gives up on. In some cases, parents stop chasing their kids around or joining in during play time because of an issue that can be corrected! Most of the time, we don’t even realise we’ve put aside these movements, it’s just a natural solution to the problem.
Pulling back on exercise, a sport or a hobby is absolutely not the answer to the ‘lower back niggle.’ It’s not a sign of getting older, it’s not the body telling you to stop – it’s your body telling you to do it right. By fixing the issues causing the back pain, people can continuing living a healthy, active lifestyle, which has immeasurable benefits for their long term health.
I hope that if you’re one of the many people “dealing” with a lower back niggle – particularly if you’ve given up something you used to do because of it – you seek out the help required to get it sorted and get back to doing the things you want to do.
Or, this particular blog was written by Sam Crossland – Physiotherapist at Precision Physio Concord. If you would like to work specifically with Sam, you can contact him through the Precision Physio Concord clinic: 02 9736 3950 or book in online.