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A Physiotherapist’s Guide to Understanding and Managing Acute Low Back Pain

Writer's picture: Ozgur SobeOzgur Sobe

Acute low back pain (LBP) is a common complaint that affects a large portion of the population at some point in their lives. Whether it's triggered by lifting a heavy box, bending awkwardly, or sometimes seemingly without cause, the sudden onset of back pain can be both debilitating and frustrating.


As a physiotherapist, over the years I’ve seen first hand how this condition can disrupt daily life, and I’m often asked how best to manage and treat acute low back pain. In this blog, I’ll share some insights on the causes of acute low back pain, and offer evidence-based strategies to help with recovery.



Acute lower back pain

What is Acute Low Back Pain?


Acute low back pain is pain that appears suddenly and lasts for a short period, typically up to six weeks. This form of back pain is often associated with specific events or activities, such as bending, twisting, or lifting, though sometimes the cause is not immediately apparent. It’s important to note that the majority of cases of acute low back pain are not related to any serious underlying medical condition. Most of the time, it’s a result of strain or irritation to the muscles, ligaments, discs, or joints in the lower back.


Common Causes of Acute Low Back Pain


Muscle Strain: One of the most common causes is a muscle strain, which occurs when muscles or ligaments in the back are overstretched or torn. This can happen when lifting something too heavy or twisting awkwardly.


Herniated Disc: A disc between the vertebrae may bulge or rupture, putting pressure on nearby nerves. This sometimes to pain that radiates down the legs, but it can also cause localised pain in the lower back.


Facet Joint Dysfunction: The facet joints in the spine can become irritated or inflamed, often due to poor posture or repetitive movements. This can lead to stiffness and discomfort in the lower back.


Sacroiliac Joint Dysfunction: The sacroiliac joint connects the spine to the pelvis. If this joint becomes inflamed or irritated it can lead to sharp, acute pain in the lower back and pelvis.


Symptoms of Acute Low Back Pain


Symptoms of acute low back pain can vary but typically include:


  • Sudden pain or stiffness in the lower back

  • Difficulty moving or bending forward

  • Muscle spasms or tightness

  • Pain that may radiate into the buttocks or thighs

  • Limited range of motion


In some cases, the pain may improve with rest, but in others, it may worsen with certain movements or activities.


Treatment for Acute Low Back Pain: A Physiotherapist Approach


When you visit a physiotherapist with acute low back pain, the primary aim is to reduce pain, restore movement, and prevent the pain from recurring. Here’s a breakdown of some effective treatment methods:


1. Early Movement and Activity

Although it may seem counterintuitive, it’s crucial to stay active in the early stages of acute low back pain. Bed rest for more than a day or two can actually make the situation worse. Gentle movement helps to maintain flexibility, improve blood circulation, and reduce stiffness. Physiotherapists often perform some mobilisations and recommend exercises to do in the early stages of pain recovery, which initiates restoring movement without getting spasms and sharp pains prevent the muscles from weakening or becoming too stiff.


2. Manual Therapy

Manual therapy, which includes hands-on techniques like mobilisation, can be beneficial in managing acute low back pain. These techniques aim to relieve pain, improve joint movement, and reduce muscle tension. For example, a physiotherapist might use gentle techniques to mobilise the spine and restore normal movement, which can help alleviate pressure on the discs and joints and spasms.


3. Posture and Ergonomics Education

Many cases of low back pain are exacerbated by poor posture or habits or body biomechanics groups. During your sessions as the pain is getting better, a physiotherapist will assess those causes and help you make adjustments in your daily activities and motions to prevent further strain. Small changes can make a significant difference in both the immediate and long-term management of back pain.


4. Strengthening Exercises

Once the acute phase of pain starts to subside, strengthening exercises are crucial to prevent future episodes. A strong core is key to supporting the spine and maintaining good posture. Your physiotherapist will likely guide you through exercises to strengthen the muscles of the back, abdomen, and hips. These exercises improve stability and prevent the muscles from becoming weak and prone to injury.


5. Pain Relief Techniques

In some cases, additional treatments may be recommended to manage pain, particularly if it’s severe. Physiotherapists can assess your pain understand the nature and cause of it and can recommend methods you can do which can lower the pain intensity and severity like when to apply cold or hot how to position yourself when sleeping and sitting.


In some instances, a physiotherapist can guide you about when to seek for further pain relief and see the GP for stronger pain relief or muscle relaxants if the pain is intense and if the nature of pain is appropriate for this.


strengthen exercises

Preventing Future Back Pain


Once you’ve managed to overcome acute low back pain, the next step is to prevent it from returning. This involves a combination of strategies:


Strengthening the Core: Engaging in exercises specifically targeting the core muscles helps to provide stability and protect the spine. But those exercises should be appropriate for you and your needs a physiotherapist can help by assessing your core needs and guiding how to deliver those exercises and how to progress with them.


Ergonomic Adjustments: At home and at work, ensure that your workstation is ergonomically designed, with proper chair support, desk height, and monitor positioning.


When to Seek Further Medical Help


While most cases of acute low back pain improve with physiotherapy and self-care, there are some red flags that indicate the need for further medical investigation. These include:


  • Pain following a fall or injury

  • Numbness, tingling, or weakness in the legs

  • Pain that is accompanied by unexplained weight loss or fever

  • Difficulty controlling bladder or bowel function (a sign of potential nerve involvement)


In these cases, it’s important to consult with your GP or a specialist for further investigation.


Conclusion


Acute low back pain is a frustrating but often manageable condition. With the right treatment plan tailored to your individual needs, most people recover fully and can return to their usual activities.


As E4 Physio physiotherapists, our goal is to help you navigate the recovery process, offering guidance on safe movement, pain management, and long-term prevention strategies by finding possible causes of this back flare up. Remember, early intervention and a proactive approach are key to a speedy recovery and reducing the likelihood of future back issues.


If you are experiencing acute low back pain, you can seek help from a qualified physiotherapist who can guide you towards recovery by booking an appointment here.

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