Physiotherapy for Lower Back Pain: Chronic and Acute
Introduction
Lower back pain (LBP) is one of the most common musculoskeletal complaints worldwide, affecting people of all ages. It can result from muscle strain, ligament injuries, disc problems, poor posture, or chronic conditions such as degenerative disc disease.
Physiotherapy is a cornerstone in managing both acute and chronic lower back pain, offering non-invasive strategies to relieve pain, restore function, and prevent future episodes. Unlike medication alone, physiotherapy addresses the underlying causes, improving long-term outcomes and quality of life.
Understanding Lower Back Pain
1. Acute Lower Back Pain
• Duration: Less than 6 weeks
• Causes: Muscle strain, ligament sprain, sudden lifting or twisting movements
• Symptoms: Sharp or localized pain, limited mobility, muscle spasms
2. Chronic Lower Back Pain
• Duration: More than 12 weeks
• Causes: Degenerative disc disease, spinal stenosis, poor posture, or repetitive strain
• Symptoms: Persistent dull ache, stiffness, reduced flexibility, sometimes radiating pain to the legs
Goals of Physiotherapy in Lower Back Pain
1. Pain Reduction: Alleviate discomfort using manual therapy, modalities, and exercises.
2. Improve Mobility: Restore flexibility and range of motion in the spine and surrounding muscles.
3. Strengthening Muscles: Core and back muscles support the spine and prevent further injury.
4. Posture Correction: Reduce stress on spinal structures.
5. Prevent Recurrence: Education and exercises to avoid future flare-ups.
Physiotherapy Techniques for Lower Back Pain
1. Pain Management
• Heat or cold therapy: Ice for acute injuries, heat for chronic stiffness
• TENS (Transcutaneous Electrical Nerve Stimulation): Blocks pain signals
• Manual therapy: Soft tissue massage, joint mobilization to relieve tension
2. Stretching Exercises
• Hamstring stretches to reduce tension on the lower back
• Hip flexor and glute stretches to improve pelvic alignment
• Gentle spinal twists to enhance flexibility
3. Strengthening Exercises
• Core strengthening: Planks, bridges, abdominal exercises to support the spine
• Lower back muscles: Superman exercise, bird-dog exercise
• Glute and hip muscles: Squats, hip abduction, and clamshells
4. Postural Training
• Ergonomic advice for sitting, standing, and lifting
• Use of lumbar support or correct chair positioning at work
• Awareness of spine alignment during daily activities
5. Functional and Mobility Training
• Walking and low-impact aerobic exercises
• Balance and coordination exercises to improve overall stability
• Gradual return to normal activities with safe lifting and bending techniques
6. Hydrotherapy (Optional)
• Warm water therapy can reduce pain and stiffness
• Allows safe movement for patients unable to exercise on land
Practical Tips for Patients
• Consistency: Daily exercises yield better long-term results.
• Avoid prolonged bed rest: Movement prevents stiffness and muscle atrophy.
• Correct posture: Maintain neutral spine during activities.
• Use supportive devices if needed: Lumbar belts or cushions.
• Monitor pain levels: Stop exercises if sharp or severe pain occurs.
Case Example (Illustrative)
A 35-year-old office worker developed chronic lower back pain due to prolonged sitting and poor posture. Physiotherapy included:
• Core strengthening and lumbar stabilization exercises
• Stretching of hamstrings, hip flexors, and glutes
• Postural education and ergonomic adjustments at work
• After 8 weeks, he reported significant pain relief, improved flexibility, and could perform daily activities without discomfort.
Benefits of Physiotherapy in Lower Back Pain
• Reduced pain and muscle tension
• Improved spinal flexibility and mobility
• Enhanced strength and support of core muscles
• Better posture and ergonomics
• Reduced risk of recurrent episodes
• Increased confidence in performing daily and work-related activities
Conclusion
Physiotherapy is a highly effective, non-invasive approach for managing both acute and chronic lower back pain. Through a combination of pain management, stretching, strengthening, postural training, and functional exercises, patients can achieve significant relief, restore mobility, and prevent future injuries. Consistent rehabilitation and education empower individuals to take control of their spinal health and maintain long-term wellness.
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