Lower Back pain
Lower back pain is the most common musculoskeletal complaint treated by clinicians in Australia. Millions of Australians have lower back pain and it affects the lives of up to one in four Australians at any one time.
What causes lower back pain?
Lower back pain is a common condition that can be caused by a variety of factors, including:
Muscle or ligament irritation: these structures can become stressed when the back is put into a loaded position beyond its stabilising capabilities. It is very unlikely that you will tear any back muscles, however they often get tight or spasm as a result of an injury to other structures, or by being overloaded. Any muscle will get sore if it is overused beyond its capacity, such as a day of moving heavy furniture. Physiotherapy can help with this by teaching you appropriate stretches or with manual techniques such as massage or needling, and by giving you exercises to strengthen these weak muscles. When the ligaments that support the joints in the spine are irritated or stretched, then this can be the driver of back pain and subsequent muscle spasm. In this case physiotherapy rehabilitation aimed at improving the joint stability/mobility should help settle the secondary spasm.
Herniated or bulging discs: Discs are the shock absorbers that sit between each of the vertebrae (bones) in our spines. They help to disperse force and allow movement of the back. Discs don’t slip! But they can bulge to different degrees and they can herniate, where a weak spot forms in the disc’s tough outer ring and some of the softer inner is pushed out. This can cause pain due to inflammation in the area and in severe cases result in nerve compression. If a nerve is compressed this can in turn cause weakness, pain or altered sensation in the leg, and will usually only affect one side (on the side of the bulge). As debilitating as a disc injury can be, the good news is that most of the time these can be managed with medication and physiotherapy rehabilitation, they rarely require surgery. Depending on the severity of your pain, usually it is recommended you see a doctor to get the pain under control with medication which will allow you to be effective with your rehabilitation. Most of the time we see improvements within 2-3 weeks and full recovery within 6-12 weeks.
Arthritis: Osteoarthritis is a condition that occurs when the cartilage that cushions the ends of your vertebrae gradually deteriorates causing inflammation. This can cause both neck pain and stiffness. Rheumatoid arthritis is a systemic inflammatory condition that affects multiple joints in the body but can also affect the joints especially in the upper neck. It can cause inflammation and degeneration of the joints and stabilising connective tissue in the neck causing pain and instability. It often presents as a dull or throbbing ache in the back of your neck around the base of the skull which is worse in the evening/night time and extra stiff in the morning.
Spinal stenosis: This occurs when the spinal canal narrows and puts pressure on the spinal cord or nerves as they exit the spine. This can be the result of inflammatory conditions or arthritis that causes extra bone to grow and take up space in the bony tunnels through which the nerves run.
There are many other factors that increase the risk of developing back problems, such as age, poor physical fitness, smoking, being overweight, and the type of work a person does. Recent studies have also shown that back problems can have a significant genetic component to lower back pain.
How can physiotherapy help manage lower back pain?
Physiotherapy can help manage lower back pain in several ways, including:
Accurate diagnosis and education on the condition.
Pain and symptom management: We can use a variety of manual therapy techniques (mobilisations, massage, needling) and biomechanical modification (changing the way you move your body) to reduce pain. This in turn reduces the need for or reliance on medication. It should be noted however that sometimes prescription medications are required and if a medical review is indicated we will always refer to when necessary.
Graded exercise rehabilitation: Movement is medicine so figuring out how to move safely and what exercises you should be doing in what order is the key. We will tailor exercises specifically to you and your symptoms depending on the driver of your back pain. We will work on a range of exercises for mobility, posture, strength and endurance in the back and surrounding muscles to improve function and reduce pain.
Functional rehabilitation: Ultimately the goal of any rehabilitation program is to get back to doing the things you love as well as the basics that you need for day to day life. We will work with you to create a personalised program that will help you to regain your functional abilities
Prevention of further injury: Recurrent lower back pain is common. A successful physiotherapy rehabilitation program ensures that you are not at risk of repeated or additional injury. Checking that you have dealt with the underlying cause of an injury and then incorporating functional training to reduce reinjury risk is the final stage of rehabilitation.
What can I expect during my physiotherapy treatment?
During your initial assessment, you will receive a comprehensive assessment to determine the drivers of your pain and dysfunction. We will then work through your goals to make a rehabilitation plan. Rehabilitation is always individualised and varies from person to person. Sessions will generally last between 30 and 60 minutes and may include hands-on modalities such as massage as well as education, exercise therapy and functional goal related rehabilitation. We will closely monitor you throughout the rehabilitation journey, making any changes and adjustments to your rehabilitation plan as necessary.
At Best Physiotherapy, our team provides empathetic, expert care. We understand that lower back pain can often be scary and the rehabilitation process frustrating. We pride ourselves on having the skills and knowledge to help you achieve your rehabilitation goals.
Contact us today to learn more about how we can help you manage your back pain and improve your quality of life at Best Physiotherapy, 72 Maribyrnong Street, Footscray.
