Back pain is one of the most common and most debilitating issues in the Western world, with more than nine out of ten people experiencing back pain at some point in their lives. Not only this, but chronic pain associated with this costs more than $200 Billion each year in Australia alone!
This is something that annoys many in the allied health care field – why do we treat your back so differently to many other areas of your body?
You might be wondering what I mean by this…
I mean that when people come in with say, knee pain, we aim to reduce the pain, increase the mobility and then gradually load the joint back up to better than pre-injury levels, or as I like to tell my patients – we calm stuff down and then build it back up. With this in mind, back pain Physio should be no different…read on below to find out more!
Why don’t we treat low backs this way?
The back seems to be a problem area for many therapists across all disciplines. I’ll admit that it can seem to be a complicated joint when you look at every single little thing that could go wrong. It can be overwhelming! Your back moves in many different ways and is incredibly strong, whilst incredibly mobile! Just think of the incredible feats of strength you see people doing WITHOUT injuring their backs!
I think that this may be the reason that it typically isn’t treated effectively and if you’re reading this then I can almost guarantee that you have, or have had, frustrating low back pain. So if you’d humour me for a few minutes, let me offer a solution to your pain… there is HOPE for you yet – take it from a back pain Physiotherapist!
Your low back is built to move!
It kills me when I hear people say, “Ohh I just can’t do that anymore, my low back can never get better – my Physio told me to change my lifestyle to avoid certain activities.” This is a nonsense and lazy approach to treating low backs!
The truth is your back CAN and SHOULD be able to go through the full range of movement and, by avoiding movements, you will develop more stiffness, pain and decrease movement in your low back further. Avoid all movements that hurt suddenly doesn’t seem like such great advice anymore does it?
Back pain is more often a sign that you need to move your back more, albeit with a graded loading protocol to help you to achieve this. What you may notice that seems weird, is that when you have lower back pain and you lay down, your back pain decreases, however when you get up from this position your back pain feels even worse than it did before. On the contrary, when you go for a gentle walk with lower back pain, initially it may feel slightly worse, however by the end of the walk you feel much better.
Movement is medicine – you are made to move!
What about my scans?
Throw them in the bin….Seriously! Have a look at this fascinating graph below from Adam Meakins (The Sports Physio). What this shows is that degeneration and pain in your low back are not interrelated!
Forget muscle pain or nerve pain or joint pain, it’s all pain and it all needs to be dealt with accordingly. We have so much amazing research now, which I won’t bore you with, that gives us the tools to help you decrease and be in control of your pain. Your perceptions about your pain will be far more important than ANY structural damage!
In fact, think of degeneration as you think of wrinkles and grey hairs – annoying, maybe; but painful? No!
So let’s put the scan away and focus on what really works to FIX YOUR LOW BACK… Manual therapy, exercise and strengthening!
So what does help my low back?
Manual Therapy – This is such an effective tool to reduce your low back pain initially and to get you feeling like you can move again, BUT…it shouldn’t last forever and if it does, I hate to say it but that therapist is taking you for a ride!
Mobility – It’s so ESSENTIAL that we get your low back moving, and moving well, through all planes of movement as soon as possible so prevent further issues that you may face in the future from not using it! Have you ever had your arm or leg in a cast? How incredibly hard was it to bend your elbow/knee when you got it off? It was so STIFF and PAINFUL right? It’s the same with your back, if you guard the movements, everything else around it will tighten up and then normal back movements will BECOME PAINFUL!
Strength – I say it over and over, but that’s because no proper low back treatment can be complete without a strengthening program. In order to FIX YOUR BACK PAIN and prevent future issue, we need to work together to strengthen the muscles that support your back. When your back muscles are weak, they get tired easily and that makes them spasm and, what happens when muscles are overworked and spasm? You got it! They become painful! And contribute to YOUR BACK PAIN!
Should I lift with a straight back?
One of the most common misconceptions is that your back is fragile and you must always lift with a perfectly straight spine with your ‘core muscles’ activated perfectly…
This is a myth
There is no good research to show that activating your core muscles will help your back in everyday movements. This however is not the same as bracing your body prior to a movement or a lift, which you may find will help to decrease pain around your spine in the short term and this is achieved by what is known as increasing intra-abdominal pressure.
In real life, there is nothing functional about always lifting and moving with a straight lumbar spine (lower back), it’s just not possible or practical. Our lumbar spine was built to handle load whilst rounded, with injury arising when we add too much load without conditioning our body to be able to sustain it.
As part of your Physiotherapy treatment, we will work with you to strengthen your spine under load and to break through any fears that may be associated with your injury in order to get your body back to how it felt pre injury, or even better!
Physiotherapy Treatment for Lower Back Pain
When you first present for Physiotherapy treatment for your spinal pain, our main aim is to get you out of pain as fast as possible & we will achieve this through:
- Manual therapy
- Mobilisation (gentle treatment on your spinal vertebrae also known as facet joints)
- Soft tissue massage
- Dry needling
- Gentle exercise
In your initial consultation, we will also develop a treatment plan with you to ensure you understand what your physiotherapy journey will look like together.
The next phase of your physiotherapy treatment is to increase your mobility and strength. During this phase we will be work on your control of your spine through different ranges of motion, which usually involves addressing some fears and spine myths as mentioned above. Throughout this phase we will continue to load your spine with strengthening exercises in order to increase your tolerance, ensuring that we’re moving towards our end goal of a resilient body!
The next phase of physiotherapy treatment is to gradually return to the activity that you would like to be doing, following a progressive loading program. As part of this phase of treatment, we include exercises that will help to get your spine to stronger and better than pre injury levels, to ensure your body can handle the load that caused the injury if it were to happen again future.
Our aim is to not only fix your spinal pain, but to make sure it doesn’t come back again.
Click here to book a time to see an expert back pain Physio in Adelaide today!
What to expect at Physio Fit Adelaide
Initial assessment with a physiotherapist includes thorough discussion of the nature of your pain (where, type of symptoms, duration and intensity of symptoms) as well as a bit about you! We can’t help you get better if we don’t know what it is you want to get back to! So we will also discuss your work, physical activity and other life demands to determine what management you need to get back to those things stronger and more robust than before!
We will then conduct a thorough physical assessment. This will involve both hands on assessment from the therapist but also practical assessment. This will include things related to your specific history, for example: bending, twisting, lifting, squatting and definitely that exercise in the gym or work that gives you your pain.
We will also make sure we keep track of how things are changing and add or subtract things from your program when necessary to make sure you’re always getting the best care possible! We’ll provide you with a management plan to help you understand your condition and your path forward to become pain free!
Don’t delay your recovery – Take action today!
The occasional niggle or tightness may be nothing to worry about, but failing to pay attention to sharp or lingering pain may end up causing you a lot of problems in the future. If your low back pain is stopping you from doing what you normally love to do, then it is time to get it looked at by one of our experienced physiotherapists. In general, low back pain that is affecting your day to day life is a sign that something needs to be looked at.
Often we just assume things will get better by themselves or with enough rest, but this is rarely the case, so take action and get back to doing what you love as soon as possible!
Physio Fit Adelaide proudly offers quality care to the local Modbury, Findon, Flinders Park, Seaton, West Lakes, Beverley, Hope Valley & Para Vista residents.