Lower back pain is the leading cause of disability worldwide (Hartvigsen, Lancet 2018). Most people will have it at some point. The good news is that most episodes settle, and there is a lot you can do while they do.
Common causes
- Muscle and ligament strain, often after lifting, twisting or a sudden movement
- Irritated facet joints, the small joints at the back of the spine
- A slipped or bulging disc, sometimes with pain down the leg (sciatica)
- The sacroiliac joint, where the spine meets the pelvis
- Pregnancy and the months after birth
- Long hours sitting, driving or lifting at work, which can aggravate any of the above
Most lower back pain is called non-specific, which means no single structure can be blamed. That is why a careful assessment matters more than a quick label.
Warning signs: see a doctor promptly
- Numbness around the groin or buttocks, or new trouble controlling your bladder or bowels
- Leg weakness that is getting worse
- Fever, unexplained weight loss, or a history of cancer
- Pain after a major fall or accident
- Severe pain at night that does not ease with rest or changing position
What research says about non-surgical care
- Doctors' guidelines in the US list spinal manipulation, exercise, superficial heat and massage among first options for recent lower back pain, before medication (Qaseem, Annals of Internal Medicine 2017).
- A review of 26 trials found spinal manipulation led to modest short-term improvements in pain and function for recent lower back pain (Paige, JAMA 2017).
- For long-term lower back pain, a review of 47 trials found spinal manipulation gave similar results to other recommended care such as exercise (Rubinstein, BMJ 2019).
- UK guidance recommends exercise, and manual therapy only as part of a package that includes exercise. It also advises staying active rather than resting in bed (NICE NG59).
In short, hands-on care works best alongside exercise and staying active. That is why our chiropractors and physiotherapists plan care together.
How BP Chiro helps with lower back pain
- A full assessment first: your history, then muscle and joint, neurological, spinal segmental and orthopedic exams
- Chiropractic adjustment, or gentler Activator therapy where it suits you better
- Physiotherapy rehabilitation exercises to build strength and control
- Soft tissue therapy, dry needling and modalities such as shockwave or laser, depending on your assessment
- Practical advice on sitting, lifting and sleeping between visits
While you wait for your visit
- Keep moving gently. Short walks are usually better than lying in bed.
- Try a warm pack on the sore area for 15 to 20 minutes.
- Change position often if you sit for long periods.
Related reading:
Back pain care in Kuala Lumpur, Johor Bahru and Penang
Every first visit at BP Chiro starts with a full spinal assessment. Choose the clinic nearest you:
- Chiropractor in Johor Bahru (Uda Utama and Johor Jaya)
- Seri Kembangan, for south Kuala Lumpur, Puchong and Putrajaya
- Kepong, for north Kuala Lumpur
- Kluang
- Penang
References
- Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-2367.
- Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.
- Paige NM, Miake-Lye IM, Booth MS, et al. Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: systematic review and meta-analysis. JAMA. 2017;317(14):1451-1460.
- Rubinstein SM, de Zoete A, van Middelkoop M, et al. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ. 2019;364:l689.
- National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management (NG59). 2016, updated 2020.