LOW BACK PAIN CAUSES
Low back pain can be extremely debilitating and can have many causes:
- The back is made up of a complex network of spinal muscles, nerves, bones and discs or tendons
- Irritation or a problem with any of the nerves, muscles, bones or discs between the spine can cause lower back pain OR pain that is felt in other parts of the body.
- Older adults (over 60 years) are most likely to suffer from
> Pain related to joint degeneration (for example Osteoarthritis
> Or Spinal Stenosis
> Compression fracture
Many lower back problems can cause back muscle spasm where the pain is unbearable while a degenerative disc might only cause mild, intermittent discomfort.
Typical causes of back pain include:
The large nerve roots in the lower back that go to the legs may be irritated
The smaller nerves that supply the low back may be irritated
The large lower back muscles may be strained
The bones, ligaments or joints may be damaged
The intervertebral disc may be degenerating
RISK OF INJURY
- Back pain and lower back pain is something most of us will experience at some time in our lives
- Clients suffering from most types of low back pain are usually referred for Physiotherapy for a number of sessions
- Initially the therapy will be Conservative (Non-Surgical). This will always be considered first before any more aggressive therapies that might include back surgery.
The goals of physical therapy are to decrease back pain, increase function and educate the client in a maintenance programme to prevent future back problems.
COMMON FORMS OF PHYSIOTHERAPY FOR BACK PAIN INCLUDE
- Passive Physical Therapy (modalities):
These might include things like Heat application or Ice Treatment and Electrical Stimulation.
- Active Physical Therapy:
This focuses on specific exercises and stretching. For most low back pain treatments, active exercises are the focus of this mode of treatment
- The McKenzie Method of treatment and exercises for back and neck pain
The McKenzie approach and exercises are best guided by a physiotherapist and concentrates on extending the spine and in doing so help ‘centralize ‘the client’s pain by moving it away from the extremities (legs or arms) to the back. The long-term goals of this approach are for clients to maintain the benefits and use the exercises for life to help:
- Reduce the pain
- Return to normal functioning in daily activities
- Minimize the risk of recurring pain (avoiding painful postures and movements)
By centralizing it to the back it allows the source of the pain to be treated rather than the symptoms.
4. Spinal Decompression
There are several symptoms that are fairly consistent for people with lower back pain or neck pain from degenerative disease.
Most patients with degenerative disc disease will have some underlying chronic low back pain OR neck pain.
In general the pain here should not be continuous and severe. IF Pain is continuous and severe then it might be something else and you should consider urgent appointment with a physician.
Symptoms can include:
- Pain that is usually related to activity and will flare up at times but then return to low grade pain or pain will go away entirely
- The amount of chronic pain – referred to as patient’s baseline level of pain- this is quite variable between individuals and can range from almost no pain OR just a nagging level of irritation to severe pain.
- Severe episodes of back or neck pain that w ill generally last from a few days to a few months before returning to a more constant chronic pain level
- Chronic pain that is completely disabling from degenerative disc disease
Before Treatment Activities or Positions that may reduce or help the back pain
- Activities that involve bending , lifting or twisting will usually make a patient’s pain worse
- Certain positions will usually make the pain worse, for example lumbar degenerative disc pain. Here the pain is usually made worse with sitting, since this position puts extra pressure (3 times more pressure) on the lumbosacral disc.
- Walking and even running may actually feel better than prolonged sitting or standing.
- People will often feel better if they can change positions frequently .
- People suffering lumbar Degenerative Disc Disease (ODD) will generally feel better in a lying, reclined position (for example with legs propped up in a recliner ) or lying down with a pillow under the knees , as these positions relieve stress on the lumbar disc space.
EXERCISE BENEFITS FOR LOW BACK PAIN
Better understanding of the back and abdominal muscles and their roles and then strengthening these areas through exercises can help reduce or prevent low back pain reoccurring.
Lumbar Spine (low back) and its stability is largely dependent on the supporting abdominal (stomach) and low back musculature.
The abdominal muscles playing a role in stabilising support through their ability to absorb pressures from the abdomen which is then exerted to the spine.
In turn the low back muscles stabilize the spine and provide posterior support.
PHYSICAL THERAPY BEFORE AND AFTER BACK SURGERY
There is evidence that now supports the benefits of Physiotherapy BOTH before and after back surgery.
The strength and stability that a course of Physiotherapy can provide here can significantly reduce a client’s recovery time.
For anyone with low back pain it is usually advisable to consult a physician first to provide diagnosis and rule out any serious contraindications for Physiotherapy for example fracture or tumour.