From the Guidelines
Mechanical low back pain is a common condition characterized by discomfort in the lower back resulting from abnormal stress and strain on muscles, ligaments, and vertebrae. It typically occurs due to poor posture, improper lifting techniques, overuse, or sudden movements that strain the back muscles. Treatment usually involves a combination of rest, physical therapy, and pain management. For acute episodes, over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help reduce pain and inflammation 1. Apply ice for the first 48-72 hours (20 minutes on, 20 minutes off), then switch to heat therapy. Gentle stretching exercises and maintaining proper posture are crucial for recovery. Most cases resolve within 2-6 weeks with conservative management. If pain persists beyond 6 weeks, radiates down the legs, or is accompanied by numbness, tingling, or weakness, medical evaluation is necessary to rule out more serious conditions like herniated discs or nerve compression. The pain occurs because mechanical stress disrupts the normal function of muscles and ligaments that support the spine, leading to inflammation and pain signals being sent to the brain. Some key points to consider in the management of mechanical low back pain include:
- The importance of staying active and avoiding bed rest, as recommended by guidelines 1
- The use of exercise, such as motor control exercise, Pilates, or yoga, to improve pain and function 1
- The consideration of psychological therapies, such as cognitive behavioral therapy, for patients with chronic low back pain 1
- The limited role of imaging and other diagnostic tests in the evaluation of mechanical low back pain, except in cases where a specific underlying condition is suspected 1
From the Research
Definition of Mechanical Low Back Ache
Mechanical low back ache is a type of low back pain that arises intrinsically from the spine, intervertebral disks, or surrounding soft tissues 2. It is usually nonspecific or mechanical in nature.
Causes and Characteristics
The elements comprising the lumbar spine, such as soft tissue, vertebrae, zygapophyseal and sacroiliac joints, intervertebral discs, and neurovascular structures, are prone to different stressors, and each of these, alone or in combination, can contribute to low back pain 3. Mechanical low back pain can be caused by an injury or derangement of an anatomic structure in the low back 4.
Key Features
Some key features of mechanical low back ache include:
- Arises from the spine, intervertebral disks, or surrounding soft tissues
- Usually nonspecific or mechanical in nature
- Can be caused by an injury or derangement of an anatomic structure in the low back
- May be associated with red flags such as progressive motor or sensory loss, new urinary retention or overflow incontinence, history of cancer, recent invasive spinal procedure, and significant trauma relative to age 2
Diagnosis and Treatment
Diagnosis of mechanical low back ache typically involves patient history, physical exam, and diagnostic testing 5. Treatment options may include nonsteroidal anti-inflammatory drugs, opioids, and topiramate in the short-term treatment of mechanical low back pain 2. Other treatment modalities such as physical therapy, yoga, and spinal manipulative techniques may also be effective in managing mechanical low back ache 2, 3.