The Low Down on Low Back Pain | Fighting Fit Physiotherapy

Why does my Back "Hurt"?

If you have not read my first blog in this series then head back and check it out HERE!

The blog covers three really important things:

What is Low Back Pain?
Who gets Low Back Pain?
How does back pain happen?

If you don’t like reading then CLICK HERE where Dean and myself sit down to chat about Low Back Pain.

In this blog we will dive into where we left off in that last blog and cover why our back “hurts” and start to understand of the experience of pain in our low back.

Following on from my previous blog around some potential mechanisms when we injure our lower back.

I want to touch on and educate you around the experience of pain.

This might at times be confusing to read and challenge your beliefs on what pain is and that’s ok.

Keep an open mind and keep working through it.

Now…

I want YOU to understand that pain is complex
I want YOU to understand that pain is an interpretation of information received by the brain

To do that I need to lay some very basic descriptive groundwork.

1. Nociception

Nociception is a signal of information that gets sent from an injured tissue along spinal pathways to the brain for processing.

Below is a basic picture to help with the concept of nociception.

Basically we hurt our tissues, a nociceptor picks up on it and sends a small electrical signal along the pathway up to the brain.

2. Pain Processing

When nociception travels to the brain, the signal bounces around like a pinball between various area’s in the:

The Limbic system: This is the part of the brain that deals with fight or flight, emotion, motivation, learning and memory (good and bad memories)
The frontal cortex: where planning, decision making and behaviour occurs relative to the information received and the situation we are involved in
The motor and somatosensory cortex: These areas deal with localising the nociception to a part of your body and is responsible for the immediate withdrawal of what the body believes is a threat (eg hand pulling away after the hammer strikes it)

Above is a picture of the area’s of the brain responsible for pain processing and modulating.

Did you know the brain is one of the most powerful pain relievers we have? It releases it’s own opioids!!

Now lets put it all together!

The nociceptive system passes information from the injured part of the body up the spinal cord and into the brain.

That information bounces around like an INPUT to the brain and is influenced by our current situation, perception of what just happened, past experiences of self and others, sleep status, mood at the time, stress levels at the time, a pain memory, thoughts and behaviours or “am I threatened and in danger”.

ALL that information is processed by the brain and the output is PAIN felt by you in the area of injury ie the back.

Remember the body is very good at protecting itself think of pain like an alarm system going off to warn you of danger or the potential for danger/injury.

“Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” International Association for the study of Pain (IASP 1979)

What's this got to do with my Back?

When we experience tissue failure like the model in my previous blog (eg lifting something too heavy for us once or rearranging the garage spontaneously).

We will experience local inflammation and sensitisation within and around one or more of the structures the low back, these maybe the intervertebral disks the muscles surrounding your spine the facet joints, ligaments, or the nerves themselves.

The nociceptors in and even around our back will pick up this information from the tissues and send the signal to the brain that something is up.

Brain will interpret this nociceptive information and we will feel lower back pain.

Over time many other complex interactions occur in our pain processing pathways and this is where the best management results in the best outcomes with back pain!

Here is what do we do when acute back pain strikes?

Rest is ok, but movement is also important!
Move enough to not overly aggravate and stimulate more pain, a low and comfortable level is enough to get tissues moving and healing.
Schedule and allow rest periods or breaks with regular movement, we call this RELATIVE REST.
Avoid listening to conversations that start with “I know someone with that exact same thing and they…” or end in “it worked for really me”, no two backs are the same just like no two people are!
Seek advice & reassurance if in doubt from “real health professionals” on treatment and avoid quackery!
Treatment reduces the time to return to normal function, eases & modulates pain but will not speed up healing time or provide magic fixes.

Here is some EXTRA simple steps to reducing your Pain Intensity!

Quit smoking as this reduces pain experienced by up to 10%
Improve your sleep hygiene as this will result in a reduction of pain intensity the following day
Alter diet away from inflammatory foods such as high fat, processed, starchy & high sugar
Reduce caffeine intake reduces pain experienced by 10% as caffeine is a nervous system stimulant. The pain experience lies within our nervous system!

When should I see someone when I have Back Pain?

In our professional opinion it is straight away!

By doing so we can tell you:

What is going on,
Ease fears, concerns and worries,
Provide techniques designed to ease pain and
Begin you on a plan to returning normal function again following injury.

Kyle Wells

Kyle Wells is a Physiotherapist at Fighting Fit Physio.

He has a special interest in arthritis, neck pain and tendinopathy. Just to name a few.

Kyle loves cross fit and has an exceptional eye for technique and performing exercise correctly.

He use exercise to improve patient results and get them moving better for the long term.

Dean Phelps

Dean is a registered Gold Coast Physiotherapist with undergraduate and postgraduate studies in Human Movement and Exercise Science. His background has developed his vision for Fighting Fit Physiotherapy to focus on optimal health and peak physical performance for every single patient. Utilising his many qualifications, in depth knowledge of the body and passion for exercise he can provide a holistic approach to your treatment and exercise prescription to get the best outcome.

Brenda Samosa

05:52 07 Nov 24

I had a really bad shoulder and had been seeing a different physio for 3 months (from a different place) I got told Tyson was good. After just a few sessions the movement was coming back. I’m 66 and was worried I would have to stop surfing. But with a lot of help from Tyson I’m back in the waves ( thank you so so much)

Cyana Ferguson

08:16 30 Oct 24

Steve Harris

22:33 15 Oct 24

Great team, all friendly, super helpful and first class clinical advice and a big shout out to my Physio Noah with my shoulder issue

Andrea Bell

05:33 19 Sep 24

These guys are the best in the biz 🎉

Ryan Brockett

04:20 18 Sep 24

Shout out to Max from fighting fit physio. He helped me out massively straight after shoulder surgery and back into work and sports in no time. Couldn’t recommend anyone better!

Scotty

08:31 31 Jul 24

Five star service from Max & the team!
Professional & very thorough, you know that patient outcomes are of the highest priority.
I highly recommend this business.

Riley Wilson

08:27 14 Jul 24

Be AWARE they’ll immediately try to commit you to multiple follow up sessions after your initial consultation. This happened to me and then I later found out that as it just so happens, they have a cancellation policy that says you have to pay 100% of the consultation fee for cancelling. They failed to tell me this when they were pushy in committing me to 6 sessions after my consult, so that was a really nice little surprise.

I was already uncomfortable with how pushy they were in having me commit to so many sessions, so when I heard about the policy I just cancelled all together. So, I can’t speak further to the quality of their service throughout therapy phase. FYI this was also a few months ago now, it’s possible (though unlikely) they may have changed the policy. Just ask the question.

Megan Shelley

06:51 03 May 24

Fighting Fit Physiotherapy is hands down the best physio I've encountered. Having tried multiple physios for various injuries, I always find myself coming back to them. Their expertise consistently exceeds expectations, helping me get back to my sport faster than I thought possible. Their personalized approach and attention to detail make all the difference. I could not recommend a better or more exceptional physio team!

Gina Matthews

08:41 24 Mar 23

Can't recommend this place high enough. I was in so much pain with my knee an had been for months through advise an exercises I'm now looking forward to returning to gym an back riding my horses in endurance thank you so much

Courtney Halse

01:36 29 Nov 22

Kyle was knowledgeable, personable and professional. He saw me through my second pregnancy and continued to work with me until 6 months post partum on issues with my back. Would recommend anyone to go and see him.

Also shout out to Georgia on the front desk. She makes you feel welcome and brings a sense of warmth to the place!

Alli Davenport

08:07 04 Nov 22

After hip replacement surgery in February I wanted toget back into weight training legs, I started with Mitch 18 weeks ago and after a lot of hard work and sweat I am able to safely train again, I cannot thank Mitch enough for his support,encouragement and knowledge. The staff are friendly and helpful and I always looked forward to my session's

Robert Parkinson

10:50 15 Aug 22

This is the second time I have been treated by the team at FFP.
As a health professional myself I have been impressed with the level of care I have received from all members of the team.
The personalised treatment and rehabilitation programs have produced excellent results and I have completed both programs pain free and feeling stronger than before my injuries.
During the program there was constant communication and follow up and they were very accommodating with my work schedule.
All in all it was a very holistic experience and I would highly recommend the service.

Kiri Canavan

07:30 08 Jun 22

Tyson was amazing! We came up with an 8 week plan at my first consultation with weekly check ins and updates to exercises. 8 weeks later, I am pain free and able to train harder than ever. Highly recommend and the staff are all fantastic and super accomodating!

Why does my Back "Hurt"?

1. Nociception

2. Pain Processing

Now lets put it all together!

What's this got to do with my Back?

Here is what do we do when acute back pain strikes?

Here is some EXTRA simple steps to reducing your Pain Intensity!

When should I see someone when I have Back Pain?

The Desk Worker’s Guide to a Pain-Free Neck

Hip Osteoarthritis: Why It Hurts and How Physio Can Help

The #1 Mistake Athletes Make After an Ankle Injury

The Secret to Beating Back Pain? Walk This Way!

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