Lower back pain is one of the most common forms of mechanical pain that people experience, and is a condition that we commonly see in practice.
At Balmain Osteopaths, after taking a case history and performing relevant tests, our practitioners will assess your lower back range of motion and function in order to identify the structures most likely contributing to the problem. The osteopath will consider the age of the individual, the nature of the problem and likely causes for its onset, and select treatment techniques appropriate to the person, the condition and the age group.
In approaching musculoskeletal lower back pain, the osteopath aims to address the restricted and painful areas identified in the examination. Treatment may involve a combination of any of the following: mobilisation or articulation of joints; soft tissue massage; stretching of tight musculature; or the use of muscular contract-and-relax techniques to encourage better motion and to decrease pain (1). Gentle application of spinal manipulation may be used for the lumbar spine if deemed appropriate.
The osteopath will explain the likely cause and expected course of recovery. However, as individual cases differ, the osteopath may be better able to advise on prognosis after evaluating the response to a course of several treatments. The patient will often be advised to keep moving within their pain limits, or may be prescribed exercises, which are relevant to the person’s capacity.
Lower back pain is one of the most common forms of mechanical pain that people experience, and is a condition that we commonly see in practice. Estimates from the Australian Bureau of Statistics 2014–15 National Health Survey show that 1 in 6 Australians have back problems and it is estimated that 70–90% of people, which is most of us, will suffer from lower back pain at some time in our lives (2).
Lower back pain is subdivided by time frame (3):
- Acute lower back pain lasting 0-4 weeks
- Sub-acute lower back pain lasting 4 to 12 weeks
- Chronic lower back pain lasting more than 12 weeks.
The exact cause of the pain can be a challenge to identify as it may arise from any combination of pathology involving the vertebrae, discs, facet joints, ligaments, and/or muscles (3). In osteopathic practice, we often find that the cause involves a combination of these structures as they are intimately linked by their anatomy. If the cause is suspected as non-mechanical or requiring further investigation then referral can be made to your GP.
In 2017 the American College of Physicians, which is the largest medical specialty organization in the United States, recommended in an evidence based clinical practice guideline that “physicians and patients should treat acute or subacute low back pain with non-drug therapies such as superficial heat, massage, acupuncture, or spinal manipulation.”
And for patients with Chronic lower back pain, among the non-drug modalities recommended were exercise, acupuncture, low level laser therapy, and spinal manipulation (4).
At Balmain Osteopaths our practitioners offer a combination of modalities which include but are not limited to soft tissue massage, dry needling, Low Level Laser Therapy and spinal manipulation.
Osteopathy is an integrated treatment approach, which uses a diverse range of manual techniques and advice which may be of benefit in lower back pain. Randomised controlled clinical trials have reported that patients receiving osteopathic treatment were more likely to achieve moderate to substantial improvement in chronic lower back pain after six treatments compared with placebo (5) and observed significant pain reductions during short, intermediate, and long-term follow-up (6).
*the above is intended to give an overview of the osteopathic approach at our practice, however please note that not all of the above may be offered in one consultation.
- Greenman PE. (2003). Principles of Manual Medicine. 3rd ed. Philadelphia: Lippincott William & Wilkins, 2003. Retrieved from https://www.racgp.org.au/afp/2014/april/osteopathy/
- Australian Institute of Health and Welfare (AIHW). (2018). Back problems snapshot. Retrieved from
- BMJ (2019). Musculoskeletal lower back pain, BMJ Best Practice
- American College of Physicians (ACP), (2017). American College of Physicians issues guideline for treating nonradicular low back pain. Retrieved fromhttps://www.acponline.org/acp-newsroom/american-college-of-physicians-issues-guideline-for-treating-nonradicular-low-back-pain
- Licciardone, JC. Minotti, DE. Gatchel, RJ. Kearns, CM. & Singh, KP. (2013). Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomised controlled trial, Annals of Family Medicine, Mar-Apr; 11(2):122-9
- Licciardone, C. Brimhall, AK. & King, LN. (2005). Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomised controlled trails. BMC Musculoskeletal Disorders Aug 4;6-43