Acute low back pain is pain that ranges from 0-12 weeks in nature that may or may not radiate beyond the back. Typically, the pain is nonspecific and has a progressive onset over time. In situations where the individual does not demonstrate significant trauma, major or progressive motor or sensory deficits, new onset of bowel or bladder incontinence, history of cancer or suspicion of a spinal infection, medical imaging is typically NOT necessary.
Is all back pain the same?
Not at all. The latest research suggests sub-grouping types of low back pain into categories that are best suited to their signs and symptoms.
- Mobilization/Manipulation:
+ More recent onset (<16 days), no pain radiating past the knee, low fear avoidance score
– Symptoms past the knee, increasing frequency of pain, radiating symptoms with motion testing, no pain with spring testing
Stabilization:
+ Hypermobility with spring testing, aberrant (abnormal) motion, increasing frequency of pain, <40 years old, 3+ episodes of main, greater straight leg raise ROM
– Minimal discrepancy in SLR ROM, low fear avoidance
Specific Exercises:
+ Preference to certain direction, localizing pain with motion testing, radiating symptoms in direction opposite to localizing pain
– LBP only, status quo with all movements
So, what if I have a few of those?
No system is perfect so think of the Treatment Based Classification System as being more grey than black and white. Individuals can change categories over a course of treatment or healing and that isn’t a bad thing! We are looking to change the pain that is specific to each individual but may emphasize one category to begin with.
What are things I can start with?
Although all acute low back pain isn’t the same, we can start with these 4 exercises to get you moving a little bit easier again:
1) Walking
2) Prone press up on elbows
3) Low back rotation
4) Figure 4 stretch
