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Pain in this region is a very common both in the general population as well as among athletes. The reason for lower back pain can be multifactorial therefore careful examination is important to determine the origin. Common origin of symptoms is due to articulations, intervertebral disks and ligament or muscular causes. Sedentary lifestyle as well as occupation that demands high load manual handling are associated with high incidence of lower back pain. 

An experienced clinician will proceed to a thorough history taking followed by specific examination to investigate the origin of your symptoms. If required radiographic investigation will be proposed before concluding to a diagnosis, however in the vast majority the clinical examination is sufficient.  There is no single treatment that covers all causes of lower back pain, the treatment modalities used are tailored to each individual. 

Nerve root irritation

Nerve root irritation causes pain radiating to the leg and can be present with or without back pain. This may be a result of disc prolapse resulting in direct mechanical compression or a result of chemical irritation of the nerve root. Another reason for nerve compression can be a result of osteophytes formed in the vertebrae as part of degeneration. Nerve pain is experienced as an electric shock or a tight narrow band in the lower leg. It may cause sensory disturbances in the leg and/or muscular weakness. Treatment includes a mixture of hands on and exercise prescription, taping or other therapeutic modalities depending on the nature of symptoms. 

Facet joint pain

Facet joint are a common cause of pain and can be irritated due to prolonged sustained positions. It is very common in the general population due to the increase of sedentary lifestyle. Changes in the muscle length and structure are gradually developing due to prolonged sustained positions. These changes may give initial discomfort but can also progress into disabling pain for some individuals.
An experienced physiotherapist can identify the cause of pain and rule out any other pathologies. Treatment can include soft tissue techniques in combination with specific exercise programs as well as daily adaptations.  

Spondylolysis

This condition refers to confirmed lesions in an area of the vertebrae called “Pars interatricularis’’. In the general population there is a low chance of this condition, although in the athletic population it is more common.  The pain is normally localised in the lower back and has a gradual onset and is often present with changes in trainings. Occasionally the pain can refer to the buttock and hamstring region.
The treatment techniques vary depending on the type and severity of the injury. The aim is to reduce pain and restore function. 

Spondylolisthesis

This condition refers to the forward translation of one or more vertebra. There is usually family predisposition and it is usually present at a young age. It is commonly seen in the ages of 9 and 14 years old. Even though this condition may be present, it is not predictive of lower back pain although there is a higher chance of pain with sport involvment.