Chronic Low Back Pain

Chronic Low Back Pain (CLBP) consists of a multifactorial disorder influencing the physical, psychological and sociability aspects of the patient (Bekkering et al., 2003; Koes et al., .2010; Koes, can Tulder and Thomas, 2006). The potential outcomes of CLBP patients without physiotherapy treatment may include: reduced the functional ability in terms of active daily living (ADLs), decreased mobility, impaired quality of life, social isolation and work absenteeism.

CLBP may have an idiopathic aetiology. It can have different causes such as arthritis, spondylothesis, lumbar instability and sciatica issues (Manchikanti et al., 2014). The physiotherapist needs to identify the psychological aspect to ensure the correct and most suitable management and treatment options for the situation.

Waxman 2006, estimated that the prevalence of low back pain among adults in the United Kingdom ranged from 6.3% in 1994 to 11.1% in 1997 (Waxman, Tennant and Thomas, 2006). Non-specific low back pain (NSLBP) is the most common in the UK (NHS, 2017). The prevalence of low back pain occurs mainly in working-aged adults between 40 – 60 years of age. Of all chronic pain conditions, it affects 44% of females and 37% of males in the UK. Within the National Health Service (NHS), more than £1000 million per year was spent in 1998 (Nice.org.uk, 2019). Within the United States of America, Preamer used the 1988 survey to assess chronic impairments. The back impairment was more common in women (70.3 per 1000 population than in men (57.3 per population) (Praemer et al.,1999,pp.1-99; Andersson,1999).

In the literature, lifetime recurrences tend to occur in 85% of people (Skovron, 1992). Schneider suggested gender prevalence and incidence difference may be due to various factors, including family roles and work (Schneider, Randoll 2006; Buchner, 2006). It is one of the leading causes of disability, it is not only costly, but it also has strong associations with anxiety and depression (Strong, Tooth and Unruh, 1999). In order to avoid LBP, people avoid and fear specific movements which may impede their recovery.

Physical Activity:

The recommended physical activity (PA) levels, for adults between 18 - 65 years old, is to complete 150 minutes of moderate-intensity aerobic exercise per week or 75 minutes of vigorous-intensity per week and two sessions of strengthening (WHO Physical Activity and Adults, 2015). Rainville discussed the findings of the recommended PA levels for the targeted population with CLBP. Exercise for strength and mobility have been proven to decrease pain for NSLBP (Gordan & Bloxham, 2016). However, the physicians adjusted the level of physical activity based on the patients' needs, demands and severity of pain suitable for their management programme (Rainville et al., 2000)