The Bespoken Word

Rx: Low Back Pain


Rx: Low Back Pain


Low back muscle strains happen when there is an overload of poorly conditioned tissues, leading mild structural damage to the tissue which brings on pain, inflammation, loss of motion and difficulty with tasks such as standing, bending, lifting and squatting. While these tissues (muscles, ligaments, etc.) will heal with time, the first 24-72 hours can be particularly challenging. Your body has amazing abilities for adaptation to pain with movement, but during this initial period it is advisable to reduce activity and modify movement to allow for maximum recovery. Rarely ever is complete bed rest called for; instead, be selective with how you move and increase your rest, but don’t lay in bed for a prolonged period as the deconditioning you’ll experience will often be worse than the effects of moving with some back pain.

Back pain is complicated, and in the even that you aren’t feeling an improvement in symptoms after 3-4 days, it’s best to check in with a healthcare provider as there may be something more than a muscle strain present.  



[Mechanism of Injury + Affected Tissues]

Most low back pain injuries are mechanical in nature. In other cases, there are a majority of low back pain injuries that are associated with spondylosis (degeneration of the spine associated with normal wear & tear that occurs in the discs, bones, &  joints of the spine as people age)

Some examples of mechanical causes of low back pain may include:

Sprain and strains (most cases of low back pain) – may occur from over stretching or poor form with movement. May cause muscle spasm around the lower back

Traumatic injury – may injure ligaments, tendon or muscles surround the spine or even future the intervertebral disc

Herniations or bulging discs – intervertebral discs become compressed or bulge. May lead to radicular or referring pain

Radiculopathy – can be caused by inflammation or injury to a spinal nerve root. Results in shooting, numbness, or tingling pain that moves or radiates along the pathway of the nerve. Radicular pain may also be caused by a tumor or cyst that presses on the nerve.”Sciatica” or sciatica nerve pain is a common form of a radiculopathy. Sciatica results from compression of the nerve that travels through your butt and may cause a burning or shooting pain down the leg

Stenosis – narrowing of the spinal column that may result in pressure on the spinal cord leading to numbness or weakness in the lower extremity

Spondylolisthesis – when the vertebrae slips out of place irritating the nerves that exit the spinal column

Spine abnormalities – such as scoliosis or lordosis or other congenital abnormalities

Low back pain may also be related to other underlying conditions such as infections, cauda equine syndrome, tumors, inflammatory disease, fibromyalgia, kidney stones, abdominal aortic aneurysms, osteoporosis, and/ or endometriosis.




While there are many different types of low back pain, the underlying principles of treatment are pretty much the same. You want to avoid movements that are painful, while encouraging those that are not. Don’t stop moving, just move more intelligently. Reduce loading where necessary.

When your pain does start to decrease, it’s important that you work to regain your mobility, strength and ensure that your movement patterns are free of compensation.

This is especially true after a muscle strain, because you may notice that you have started to move differently as your body naturally tries to reduce pain.

The exercises in our instagram post Rx: Low Back Pain are mainly targeted towards recovery from a lumbar muscle strain. If it’s related to trauma or discogenic, the approach may differ.

Physical Therapy should focus on:

Modulating the pain

Mobilizing the soft tissue surrounding the joint (low back, hips and pelvis)

Postural alignment changes made by your Physical Therapist

Strengthening the muscles surrounding the joint (low back, hips and pelvis)

Making the proper  modifications to promote pain free activities & movements


[Healing Timeline]

There really is no timeline for low back pain healing. It is completely dependent on the cause of the injury and the treatment associated with the injury. No matter how fast it takes you to feel better, the overall goal is create a more durable body so the pain does not come back.



Worldwide, back pain is the single leading cause of disability, preventing many people from engaging in work as well as other everyday activities.

Back pain is one of the most common reasons for missed work. One-half of all working Americans admit to having back pain symptoms each year.

Back pain accounts for more than 264 million lost work days in one year—that’s two work days for every full-time worker in the country.

Experts estimate that up to 80% of the population will experience back pain at some time in their lives.

Back pain can affect people of all ages, from adolescents to the elderly.

Back pain is the third most common reason for visits to the doctor’s office, behind skin disorders and osteoarthritis/joint disorders.

Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

Most people with low back pain recover, however reoccurrence is common and for small percentage of people the condition will become chronic and disabling.

Worldwide, years lived with disability caused by low back pain have increased by 54% between 1990 and 2015.

Low-back pain costs Americans at least $50 billion in health care costs each year—add in lost wages and decreased productivity and that figure easily rises to more than $100 billion.

Stats from American Chiropractic Association

Check out our Instagram post for a short Low Back Pain rehab guide – @BespokeTreatments Rx: Low Back Pain

*This does not constitute medical advice. If you have pain or injury please consult a medical profession in person