Lower Back

Acute Low Back Pain

Acute low back pain is back pain which presents suddenly, usually in the lower lumbar area which may sometimes radiate to the buttocks, hamstrings or lower leg. Acute low back pain may be due to a sudden or repeated biomechanical loading event or there may be an insidious onset of pain (eg. no obvious cause of pain). Acute low back pain often has no specific source of pain (eg. there is no specific structure in the back which is damaged or injured) and usually people recover quickly. 
  • Sudden onset of low back pain 
  • May have pain in the buttocks, hamstrings or lower leg
  • Feeling of stiffness or tightness in the lower back 
  • May have some restriction of normal movement 
  • May have muscle spasms

It is important to know that acute low back pain has an excellent natural history and most people will experience significant improvement within 2-3 weeks. Your treatment plan will depend on the severity of pain and your clinical findings. A treatment plan may look like:

  • 2-3 sessions of physiotherapy in the first week 
  • Progressing to weekly or fortnightly sessions of physiotherapy for the next 2-3 sessions
  • Further physiotherapy every 2-3 weeks as required
  • Exercise physiology for strengthening if there is an identifiable structural cause of your pain to prevent more frequent episodic back pain.
  • Hydrotherapy is valuable in the acute phase when gentle movement is required if land-based activity is not tolerated.

 

  • All of our physiotherapists 
  • All of our exercise physiologists 

Spondylolisthesis Sprain

Spondylolisthesis is the forward movement of one vertebra on another. In most cases it is the L5 vertebrae (bottom of the lumbar spine) which slips forward on the S1 vertebrae (top of the sacral spine). Spondylolisthesis can often be asymptomatic and patients may not even be aware of the defect. Around 50% of adults over 80 have an asymptomatic spondylolisthesis. 

  • Gradual onset of low back pain 
  • May have pain which radiates to the buttocks, hamstrings or lower legs
  • Usually associated with pain when extending the back 
  • 1-2 physiotherapy appointments per week for 2-4 weeks 
  • Progressing to fortnightly reviews for a further 4-8 weeks
  • Progressing to appointments every 3-4 weeks for 1-2 further visits. These may include appointments with an exercise physiologist for further strengthening and sport specific rehabilitation 
  • Hydrotherapy under the supervision of a physiotherapist or exercise physiologist is very helpful in managing Spondylolisthesis.
  • All of our physiotherapists
  • All of our exercise physiologists

Radicular Pain And Radiculopathy

Radicular pain refers to pain which occurs in the buttock or leg from an irritated or compressed nerve root. Radiculopathy occurs when an irritated or compressed nerve root causes neurological symptoms such as weakness or sensation changes which occur in one or both legs. Radicular pain and radiculopathy can occur separately or together and the terms are often used interchangeably. This usually occurs in people between the ages of 20-50 and is more common in males than females. 

  • Sudden or gradual onset of low back pain 
  • Sharp or burning pain in the buttock, hamstrings or lower limbs, usually associated with a movement such as forward bending
  • May have pins and needles or numbness in the leg 
  • Pain is often aggravated by sitting, bending, lifting, coughing or sneezing 

If you have any changes in bladder or bowel function or deteriorating neurological symptoms (eg. progressing lower limb weakness or numbness) it is important for you to see your GP ASAP. 

This will depend on the severity of your condition, your clinical findings and your individual goals. An example of a treatment plan for radiculopathy is: 

  • Physiotherapy twice a week for 1-2 weeks 
  • Progressing to weekly or fortnightly sessions for a further 4-8 weeks. These may include some exercise physiology sessions for further strengthening and activity specific drills. 
  • All of our physiotherapists
  • All of our exercise physiologists

Lumbar Osteoarthritis

Osteoarthritis is the most common form of arthritis to affect the lower back. It usually occurs in the elderly and is an imbalance between cartilage breakdown and formation. This can cause thinning of the cartilage, and loss of joint space. There is not one single cause of lumbar osteoarthritis but factors such as age, and high BMI can increase your risk. 

  • Non-specific low back pain 
  • Morning stiffness which lasts <30 minutes 
  • May cause numbness or pins and needles in the lower limbs 
  • Some people may not have many symptoms at all 

  • Physiotherapy once or twice weekly for 2-3 weeks
  • Progressing to fortnightly visits for a further 3-4 sessions. 
  • Progressing to exercise physiology to maintain strength, function and formulate a long-term management plan 
  • All of our physiotherapists 
  • All of our exercise physiologists