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What Causes Low Back Pain?

Why Pain?

Pain is the language your body uses to notify your brain about the presence of a threat to your body. In the actual sense of it, pain is really not a bad thing in itself. However, not responding to this "SOS" message might lead to a critical situation. Interestingly, the degree of pain isn't directly proportional to the level of damage, so just because the pain you feel is severe doesn't mean the damage is a lot and feeling mild pain doesn't mean there isn't any damage.

So what causes of low back pain?

What does this kind of pain mean? Where exactly are the signals coming from? How do you respond to them? Is there anything to be worried about? What kind of treatments can give relief from low back pain? How can physiotherapy or visiting a physiotherapist help?
Firstly, let's look at the back. What structures actually make up the back?

What makes up the back?

There are 33 small bones called vertebrae that make up what is called the vertebral column. The vertebral column starts from the neck, just below the skull (head) to the pelvic girdle. The vertebrae in the neck area are called the cervical vertebrae and they are seven in number. Next are the thoracic vertebrae, which constitute the upper back and are 12 in number. There are five lumbar vertebrae in the lower back. Finally, you have the triangular shaped sacrum (sacral vertebrae) made up of 5 bones fused together and the coccyx (tail bone) made up of 4 vertebrae at the end of the vertebral column.

The intervetebral discs are ligament-like structures that are located between every two vertebrae all the way down the vertebral column. So the vertebrae don't just sit directly on easy other but are separated by shock absorbers or cushions called inter vertebral discs. Movement in your backbone is "cushioned" by these discs.

Spinal Cord
"The cord from which all nerves in the body originate" is refered to as the spinal cord. The spinal cord is actually encased and protected by the vertebral column.

Muscles are part of the supporting structures of the vertebral column. These muscles are responsible for all your back movements and support your back in assuming various postures such as sitting, standing, running and so on.
Other structures in the back are the spinal nerve roots, ligaments and facet joints.
So now that you have an idea of what makes up your back, having an idea of what causes back pain will be much clearer and easier to comprehend.

What is Low Back Pain?
Low back pain is one of the top five reasons why people see a doctor. According to S.Kinkade, low back pain is "pain that occurs posteriorly in the region between the lower rib margin and the proximal thighs". (Proximal - upper)

Common causes of low back pain

  • Arthritis of the vertebral facet joints also called spondylosis is a cause of low back pain. Spondylosis is more common in older people as degenerative changes take place occur with use and age.
  • Disc Prolapse or disc bulge is another cause of low back pain. This can occur as a result of increased pressure in the intervetebral discs. Actions such as lifting heavy loads increase the disc pressure. Nerve root compression resulting from a disc prolapse can produce severe discomfort.
  • Degeneration of the intervetebral disc negatively affects its shock absorbing properties. A degenerated disc is reduces the intervetebral disc space which can also lead to arthritis.
  • Increase in body fat affects the spine or back biomechanics. Obesity puts excess strain on structures of the back. It's important to note that your deep abdominal muscles also serve the function of supporting the back. So having a "pot belly" alters the lordotic curve (lordosis) or the "small of your back" by exaggerating the curve.
  • In the workplace setting, standing or sitting for more than two hours at a time, can cause a strain on your back. Driving for long hours and  lifting heavy loads are also causes of low back pain.

What is Specific Low Back Pain?
When low back pain is specific, it simply means that the cause of the pain is specific or there is an underlying pathology. Common causes of specific back pain are cancer, fracture, spinal stenosis or disc bulge.

Non Specific Low Back Pain
Most people that complain of low back pain present with the non specific type. Non specific back pain is any type of back pain in the lower back (lumbar region) that doesn't have a specific cause or serious underlying pathology (disease).


Have You Read These?

Which Countries Pay the Best Physiotherapy Salary?

We always hear about physiotherapy being a "hot" profession and that physiotherapists are saught after all over the world and that gives us the confidence to go for international jobs. Interestingly, though, I have noticed that physiotherapists move around alot, and we're about ro find out if it's for "greener pastures" , inner fulfillment or just sheer restlessness. I know of physiotherpists that move from Australia to Canada, and others from Canada to Australia...the other day a colleague of mine told me about a physiotherapist that had just devided to leave Australia for Singapore, while he stays put in South Africa.
Many physiotherapists want to know which countries pay the best salaries to help get some motivation to move or jump ship, so let's first try to analyse places that have the best paying physiotherapy jobs or simply put, the highest salaries.

A physiotherapist's salary in Ireland ranges from $27000 to $60000 a year andthis wil…

How to Get Licenced to Practice Physiotherapy in Dubai and Abu Dhabi

Here's a quick summary on how to get a physiotherapy practising licence in Dubai and Abu Dhabi:

A foreign trained physiotherapist should at least have a B.Sc in physiotherapy, with at least two years work experience.

The physiotherapist must be a graduate from a National and/ or International recognized college/University.

For graduates from the UAE universities, the program and university must be accredited by the Ministry of Higher Education and Scientific Research (MOHESR).

Higher diploma certificates from The Higher Colleges of Technology in the UAE will be equivalent to Bachelor degree as per MOHESR standard

A Master degree or PhD (in the area of specialty) will reduce one (1) year from the required experience for licensing provided that the Master’s/ PhD degree is not mandatory to obtain the selected title.

Qualifications acquired through honorary nature, correspondence or distance learning are not counted towards the PQR requirements.

All non-UAE national graduate physiothe…

How to Get a Physiotherapy job in Singapore

Physiotherapy is on the skills shortage list in Singapore and is classified as an Allied Health Profession.

You as a physiotherapist should apply directly to the Ministry of Manpower  or the Human Resources department in the hospital of your choice.
Once your registration is approved you'll need a work permit and you need to have a job to get it. There are two types of work passes the EP and the S pass. You can get more information on the Ministry of Manpower website.

Part of the criteria for a foreign trained physiotherapist to to be able to practise in Singapore is to pass the MOH qualifying exam.

The qualifying exam (QE) is an assessment of the equivalence of the knowledge and skills of the foreign trained physiotherapist and the physiotherapy practise in Singapore.
The exams are conducted four times a year in January, April, July and October and you need to be in Singapore to take the exams. The results of this exam are usually released four weeks after the exam was taken.


Getting Study Materials for the DHA, HAAD Physiotherapist Exam

The licensing exam for practicing physiotherapy in Dubai or Abu Dhabi is computer based and multi choice (mcq).
Getting past questions for this DHA, HAAD exam has become a very expensive venture with many websites offering sample questions at a cost.

The Dubai Health Authority has however made it clear that it doesn't sell or make available such past questions and that any one who encounters such should report to them.
So I won't be putting up any names of websites who claim to sell sample questions or offer subscriptions to those who want to rehearse the exam online.

If you want to know how to prepare for these exams or have an idea of the syllabus then you can do one of these two options:
1. Get in contact with a medical recruiting agency with experience.
2. Use the recommended textbooks to prepare for the exam.

I really don't see why you can't go for option 2.
Give yourself a month to go through the textbooks to refresh your memory... It's an mcq exam and pass …

Want to Migrate to Australia as Physiotherapist? Read this first.

If you are a physiotherapist interested in migrating to Australia, reading this first will be highly beneficial to you.

Yes physiotherapy is on the Australia immigration skilled occupation list, but my observation is that there are still very few going through their skill select process.

The Australian skill select process (where Canada got the inspiration for Express entry) is supposed to be a stress free process. It's simply a DIY (do it yourself) kind of thing; fill in your information, upload your English scores and you skills assessment and submit your application for immigration.

Twice every month there are selection rounds and successful applicants are invited to apply for a skilled migration visa.

But this is not actually the case for physiotherapists because you need a skills assessment.

Here are the requirements for applying for a skills assessment:

·         A qualification that is included in theApproved Programs of Study list

·         A Certificate of Substantial Equ…

Areas of Specialization in Physiotherapy

When it comes to talking about specialty areas in physiotherapy or what physiotherapy areas you'll like to specialize it should be based purely on your strengths and interests.
Most physiotherapists specialize in musculoskeletal or sports physiotherapy either for lack of better ideas or job prospects ( not that these are totally wrong reasons).
I think some things you should consider when deciding to specialize are -

What really are your interests? Would you rather work with the young or the elederly? I personally don't like seeing children in the hospital so paediatrics is definitely not my thing.What skills have you gathered over the years and which of your skills are you likely to harness? Have you seen yourself coming up with successful rehabilitation programs for patients that suffered from musculoskeletal injuries, for example, over and over again? Are there particular cases or conditions that your superiors or colleagues have associated you with because of your achievem…

Working Abroad: Getting a Physiotherapy Job in US

It's okay to look out for something different after being a physiotherapist in your present location for so long. Or maybe you are a fresh graduate seeking adventure and consciously plotting an international pathway for your career...Hmmm or maybe you graduated with a degree in physiotherapy and haven't really done much with it...The question remains the same....

How can I get an international job? Are there really jobs for physiotherapists abroad or is this career just overhyped?
Are you kidding me?
The key to plotting the right graph for your career is information, so I will do my best to point you in the right direction so you can achieve your dream of getting an international job.

Are there actually best countries for physiotherapy jobs?
Well there are quite a number of places abroad where physiotherapists are seriously sought after, but I would start with what I call the big five: United States, Canada, Australia, Dubai and Ireland... Then maybe Singapore and …