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Categorizing Your Low Back Pain

Low back pain is the single leading cause of disability1, preventing people from participating in work as well as other everyday activities. Experts estimate that up to 80% of the population will experience back pain at some point in their lives.2 Since almost everyone suffers from back pain at some point, it is safe to assume that most people would like to know what is causing their pain and what they can do to get rid of it. Listed are the topics that will be discussed:

  • What are the three main categories of low back pain?
  • What does each category mean?
  • What can people in those categories do to feel better?

Low back pain is one of the most common impairments that we treat in the clinic. Although there are various reasons why people may suffer from low back pain, most people can fit into one of three categories.

First Category: Disc-Related Low Back Pain

The first category involves people who suffer from disc-related low back pain. This can include disc herniations, bulging discs, etc. Herniated discs can occur at any age, but they are most common between the ages of 30 – 50 years old.3 A herniated disc, also known as a “slipped disc” or “disc prolapse”, is a common condition that can be painful and debilitating which can lead to pain, numbness, or weakness in the lower extremities. However, some people with this condition may not experience any pain at all, especially if the disc is not pressing on any nerves. 

For those that do suffer from pain, they will find that sitting and bending forward causes increased pain, whether it be in their back or radiating down either of their lower extremities. On the other hand, they will find that walking and standing decreases their pain and makes them feel better. For example, many people will find that their pain increases when they bend over to tie their shoes or on their drive to work, but once they stand up and start walking around their pain decreases. In order to recover, people in this category should avoid movements that cause pain and focus on the activities that decrease their pain, such as standing, walking, and performing exercises and stretches prescribed by a healthcare professional. 

Second Category: Joint-Related Low Back Pain

The second category involves people who suffer from joint-related low back pain. People in this category may be familiar with the terms arthritis, spinal stenosis, and disc degeneration. Aging of the spine is normal; degenerative changes are seen in up to 95% of people by the age of 50.4 Spinal stenosis is the narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine. As with disc herniations, some people with spinal stenosis may not have symptoms. Those that do have symptoms may experience pain, tingling, numbness and muscle weakness. Spinal stenosis most often occurs in people over the age of 60. 

People in this category will find that walking and standing increases their pain, while sitting and bending forward will relieve their pain and help make them feel better. For example, these people may find that when they stand and walk for extended periods of time, the pain in their back or legs will increase, but once they sit down their pain decreases. In order to recover, people in this category should avoid movements that cause pain and focus on activities that relieve their pain, such as sitting (with proper posture), bending forward, and performing the exercises and stretches as prescribed by a health care professional. 

Third Category: Lumbar Instability

The third category involves people who suffer from low back pain due to what we call “lumbar instability.” Lumbar instability generally occurs when the muscles surrounding the back are not strong enough to support it, which causes increased stress and pressure. Also, lumbar instability can occur when the person lacks hip mobility, which causes the back to compensate and forces it to bend and rotate past the point that it should. 

People in this category will find that they have pain when staying in one position for an extended amount of time, whether it be standing or sitting. Rolling in bed is also usually a painful activity, as well as laughing, coughing, sneezing. On the other hand, constantly moving and changing positions will decrease their pain and make people in this category feel better. For example, playing golf or pickleball will be pain-free, but standing for a couple hours will increase their pain and make them feel worse. In order to recover, people in this category will need to increase their core strength and hip mobility, which will allow them to take the pressure off of their back and will decrease their pain. 

If you are interested in getting a more customized approach then click the link below. Buffalo Rehab Group is currently offering free consultations by our Physical Therapists. If you are currently suffering from low back pain and would like to know more about which category you may fall into, then a free discovery visit is your next step!

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Hoy D, March L, Brooks P, et al. The Global Burden of Low Back Pain: Estimates From the Global Burden of Disease 2010 Study. Annals of the Rheumatic Diseases

Rubin D. Epidemiology and Risk Factors for Spine Pain. Neurol Clin. 2007;25(2):353-71.

Jordan, J. Herniated Lumbar Disc. BMJ Clinical Evidence. 2009.

Lumbar Spinal Stenosis. OrthoInfo. 2013.