Lower Back Pain Physiotherapy Treatment
Acute back pain can be extremely painful. You may remember doing a movement or event that triggered it or you may just wake up with it or gradually develop it. We know back pain now affects up to 80% of the population at some stage.
The good news is most episodes of acute back pain are simple strains that produce a lot of pain. When we manage these episodes of back pain effectively most calm down over a few days to weeks. Fortunately the spine is a very strong resilient structure, unfortunately it is often very sensitive to load or movements it may not be use to or like!
There is a very small percentage of back pain sufferers that do have some structural or sinister cause but through a detailed physiotherapy assessment, this can be ruled out. When in doubt we will refer you on for further investigations.
We often have people ask about needing to get a scan or presenting with scan results from doctors or previous practitioners. They may be x-rays to more detailed CT's or MRI scans. They are most often not required and or useful but if we do think they are required we won't hesitate to refer you in the right direction.
It's interesting to know though that reported 'abnormal' findings on scans are very common in the pain-free population. See chart below!. Therefore we know through a better understanding of pain science that even though you may have these changes on scan it's not often these structural changes that are causing the pain.
Scan findings in pain free people
Most findings on scan can be thought of as normal aging process' like grey hair'.
Why is my back pain continuing for months?
After anything serious is ruled out we know that back pain can continue if not managed well. Acute pain can progress to more persistent pain due to a number of reasons. Pain lasting more than a few months is no longer due to the initial strain but ongoing sensitivity in the area due to a large number of reasons. They include but are not limited to:
Decreased normal movement of your spine that leads to stiff and sensitive structures reproducing the pain. You may or may not be aware of your decreased movement or you may be fearful of moving in worry of making things worse or reproducing the acute pain that started the problem!
We know through studies that rest and avoiding normal movement is actually not beneficial causing more pain and dysfunction. Lack of movement and activity usually leads to certain muscle group tightness and weaknesses with abnormal movement patterns.
Other factors which can have a large impact on back pain and all injuries include poor sleep patterns, lack of general exercise and stress.
Psychological factors such as too much focus on pain, fear of re-injury, anxiety and low mood can amplify back pain. Interestingly our nervous system can work like an amplifier turning pain levels up and down depending on mood and thoughts.
It may be one issue that is leading to ongoing pain or a combination of the above issues. A skilled physiotherapist can assess these factors and work out what is contributing to your ongoing pain.
Common terms used in back pain
discogenic lower back pain
disc injuries protrusions, bulges, annulus wall tears, extrusions
internal disc disruption
osteoarthrtic back conditions
strains and sprains
spinal canal stenosis
sacroiliac joint disorders