Should I worry about my lower back pain (LBP)?


Current evidence-based practice shows that most of the time the answer is no. For the majority of cases of lower back pain (LBP) having a better understanding of the causes and getting some expert guidance from your physio you can fully resolve the problem.

Written by Michael Bushell, Senior Physiotherapist



We are often dealing with lower back PAIN and not lower back INJURY. Physiotherapist’s use an evidence-based approach for the management of LBP by way of a biopsychosocial model. This means we need to consider the BIOLOGICAL tissues that are involved in the episode of LBP, the clients’ PSYCHOLOGICAL perceptions and emotions related to the episode of LBP and the SOCIAL context in which this episode of LBP relates to. Taking this is biopsychosocial approach is vital as we know that in most episodes of LBP the physical factors alone are not the only causative influences and that there is significant influence from our body systems. In LBP the structural tissues involved need to be viewed as a source of input that potentially generates a response of pain. This input is open to interpretation and modification by our central nervous system that can either magnify or inhibit the potential pain according to how our body, physically and physiologically, and our mind, emotionally and psychologically, perceives the input as either dangerous or innocuous. This central nervous system process of interpretation and modification is directly influenced by:

  • sleep quality
  • emotional stress, moods
  • fatigue
  • nutrition
  • other health problems
  • physical activity levels
  • mental illness
  • context of symptoms eg. home, work, sport
  • personality types eg. fearful, depressed, anxious

Simply put, when we are tired, run down or stressed our pain thresholds are often reduced. For these reasons, the treatment of LBP needs to be dealt with regarding entire body systems including the hormonal, metabolic, psychological and immune systems and not just the involved structural tissues of the musculoskeletal system.


Written by Michael Bushell, Senior Physiotherapist
Comments for this post are closed.