Mechanical back pain

What is it?

The spine consists of a series of bones stacked up like building blocks.  Between each bone and the next is the disc at the front and two smaller joints at the back.  Effectively, these are all bits of the same joint.  These joints are worked by a variety of muscles.

How do you get it?

Like all joints, they can wear.  The disc does not contain articular cartilage, but there is a process very similar to osteoarthritis.  Your overall back function is greatly influenced by the range of movement and muscle strength. A stiff spine with weak muscles will cause lots of problems, even if there is no wear in the joints.

What symptoms do you get?

Pain is the main symptom.  It may be centrally in the lower back, in the buttock or sometimes into the thigh.  Pain is typically worse with activity, such as bending or sitting.  Usually lying is comfortable.

What happens without treatment?

This is variable.  Some people will settle spontaneously, but some people will continue to have symptoms if their back is stiff and their muscles are weak.

How do you treat it?

If the structure of the spine is intact, then good back function will be achieved with a physio programme to get the core muscles strong and the spine mobile.  If there is structural damage to the spine, such as wear in the joints or other structural problems, then this will limit what can be achieved with physiotherapy.