Slipped or prolapsed discs are a common cause of unrelenting and chronic LBP. Widespread availability of MRI scanning has made diagnosis of disc prolapses much easier. Did you spot the prolapse in the picture?
Notice how the dark black colour encroaches beyond the body of the vertebrae above and below it. This is at the L5 S1 intervertebral disc, an extremely common site of disc prolapse. Symptoms of this type of disc prolapse include back pain, with or without pain down the leg or into the buttock. The pain may be made worse by sitting and may be particularly sore changing from sitting to a standing position. Back pain caused by a prolapsed disc may be increased by coughing or sneezing as the increase in abdominal pressure associated with these activities puts increased pressure on the disc.
Standard treatment of this type of condition would include six weeks of physiotherapy. In the event of the patient not responding to this treatment, injections or spinal surgery may need to be considered to help the patient recover. Thankfully the majority of this type of back pain responds and settles with physiotherapy and there is rarely need for further intervention.