Back pain is one of the most common complaints we deal with as physiotherapists. There are many reasons for why we get back pain. Some have to do with pathological conditions while others are related to our posture or our ergonomic setup. Let's take a closer a look at some of these common reasons. Then in our next blog we'll examine effective treatment options which are available for each one.

Disc bulge

If we think of the anatomy of our spine, we have the vertebrae (bony prominences felt along the spine) and discs which are situated between the vertebrae. Occasionally these discs can bulge out which leads to the narrowing of the intervertebral disc spaces.

A disc can bulge out when too much pressure is placed on it (this commonly happens when we lift something heavy, spend a lot of time sitting with poor posture or when have to bend down/twist repetitively). Depending on the degree of the disc bulge occasionally it can lead to pressure being placed on the nerves which run through the intervertebral disc spaces. This, in turn, can result in pain being referred down the legs/into the groin.

Facet joint irritation

Let's slightly expand the anatomy crash course we touched on above. The facet joints are the joints which connect the top and bottom vertebrae. Unlike discs, which generally don't like flexion (forward bending), facet joints become irritated with extension (bending backwards). Hence facet joints can become irritated if we naturally have an excessive arch in our back. Facet joint irritation is also quite common in pregnancy. This is due to our centre of gravity shifting in pregnancy which results in a change to our posture. Some sports also involve bending backwards and hence lead to facet joint irritation. Dancing and gymnastics are common examples.

Weak core stabilizers

When the lower back core stabilizer muscles (transversus abdominis and multifidus) are weak, the result is insufficient protection for our lower back. Consequently any load placed on our back (e.g. lifting, bending, twisting) will go through our lower back rather than through the muscles.

Pelvic instability

Our pelvis is in the form of a basin and is composed of two halves. When the muscles which stabilize/support the pelvis are strong these two halves remain stable despite movement. Conversely when these muscles are weak the two halves can separate when we move. This, in turn, leads to lower back pain as well as well as sometimes groin pain.

Poor posture

A common cause of back pain is what's knows as the "postural syndrome". This refers to pain only being felt when we are in a certain posture for a prolonged period of time. At other times there is no pain. With the postural syndrome pain is generally worse in the evening/at the end of the day.

Incorrect ergonomic setup

This is another common reason for back pain and generally happens with sedentary jobs. Back pain will always be worse when you work and better when you are out and about.