Backache (Chronic Low Back Pain)

Understanding Chronic Backache

Chronic low back pain (CLBP) — pain >12 weeks, lumbosacral region, with/without radiculopathy. Aetiology: non-specific (85–90%) — myofascial, facet, discogenic, sacroiliac, ligamentous; specific: disc herniation, stenosis, spondylolisthesis, fracture, infection, neoplasm, inflammatory (AS). Central sensitisation: pain amplification, allodynia, hyperalgesia, widespread hypersensitivity. Psychosocial: fear-avoidance, catastrophising, depression, anxiety, kinesiophobia. Yellow flags predict chronicity. Red flags: trauma, age >50/<20, cancer history, weight loss, fever, neurological deficit, saddle anaesthesia, bowel/bladder dysfunction.

Homoeopathy treats the constitutional back pain diathesis — remedies selected by pain character (aching, stitching, burning, drawing), radiation (local, buttock, thigh, below knee), modalities (posture, motion, heat, cold, rest, weather), associated symptoms (stiffness, muscle spasm, fatigue, sleep, mood) and miasmatic syphilitic/psoric tendency. Treatment addresses disc hydration/facet inflammation/myofascial trigger points, reduces central sensitisation, improves core stabilisation and fear-avoidance behaviours. Complements exercise (McKenzie, core, aerobic), CBT, manual therapy, NSAIDs, neuropathic agents (if radiculopathy) — reduces chronification and disability.