Disc problems are a common source of low back pain. Symptoms may include diffuse low back pain, numbness, tingling or “pins and needle” sometimes radiating into the hip, thigh or lower leg. Radiating leg symptoms may suggest the disc is bulging and placing pressure on a nerve root. Pain may worsen when activities such as sitting, bending forward, improper lifting, coughing or sneezing increase the pressure within the disc.
Causes may include injury trauma, chronic poor sitting posture, improper lifting and bending, and poor mechanics of other areas of the spine or hips. These factors lead to micro-tearing of the ligament-like material of the disc, allowing the disc to bulge. Although an acute episode of pain may occurfor no apparent reason, the underlying cause is usually repetitive damage to the disc stemming from weakness, muscle imbalance, or stiffness.
Manual therapy and exercise have proven very effective in relieving discogenic low back pain. These techniques include joint and soft tissue mobilization, passive stretching, and myofascial release,often with an extension-focused exercise program. Education on techniques to avoid stressing the injured disc while it’s healing, along with taping, ice and electrical stimulation, can help relieve pain and promote recovery. A specific exercise program to re-educate the core abdominal and back muscles has been shown to significantly reduce the likelihood of recurrence.
Most back pain is not serious. According to the APTA, the majority of low back pain is caused by strain, overuse or injury, and is rarely caused by a more serious condition such as a herniated disc or osteoarthritis.
However, prior injury, prolonged poor sitting or standing postures, improper or excessively heavy lifting and poor overall conditioning can lead to low back pain. Along with low back pain, symptoms can include numbness or tingling that can radiate into the hip and thigh. “These factors can lead to excessive stress and strain to the supporting structures in the back. Although an acute episode of pain may occur for no apparent reason, the underlying cause is often poor motor or movement control, muscle imbalances, or associated stiffness,” says Craig O’Neil, VP of Learning and Affiliations at Results Physiotherapy.
Facet syndrome is often described as “my back went out,” according to the experts at Results Physiotherapy. A sharp pain is felt when the injury initially occurs, with symptoms that include local pain and stiffness and a dull ache radiating to the buttock or hip.
Range of motion can be limited, and the pain is usually felt more on one side when leaning, causing a “pinching” of the joint.
If you’ve heard of people who’ve complained of a sciatica – or Lumbar Radiculopathy – that’s when the sciatic leg nerve becomes compressed or irritated. “It’s a burning or shooting pain that’s usually caused by a bulging or herniated disc place increased pressure on the nerve root,” says O’Neil.
Most people with back pain focus more on the symptoms, rather than the cause of their pain. "What they might not know is that movement often provides the best long-term relief for pain,” says APTA spokesperson Mary Ann Wilmarth, PT, DPT, OCS, chief of physical therapy at Harvard University. “As movement experts, physical therapists can help restore mobility, reduce pain, and improve quality of life," she adds.