Back pain

Back pain is very common with about 80% of people reporting LBP during their lifetime. The good news is that the majority of LBP resolves within eight weeks. Between 10% and 20% of back problems, however, do not resolve on their own.

How can physiotherapy help?

For recent low back pain, evidence has recently emerged to suggest that there are a group of patients that respond very well to manipulation in order to increase the speed of recovery from low back pain. These patients can be identified at assessment, and respond very well to manipulation, especially when accompanied by a home exercise program to promote flexibility and strength.

For long term low back pain it is important to understand more about the forces that individuals put through their spine during daily activities. This can be done at the initial assessment by observing how you move and feeling the way your spine moves to identify any areas of stiffness that can be mobilised to ‘free up’ (like oiling a rusty gate) or any areas that are very mobile. .

By understanding the biomechanics of movement we can help you to understand that by subtly changing the way you move it is possible to reduce the stress on painful tissue (which will result in a noticeable reduction in your pain) and allows them to heal.

In recent years massage therapy has lost favour with many physiotherapists. There is good evidence, however, to suggest that massage therapy performed by a qualified practitioner is highly effective at reducing pain and increasing flexibility in patients with recent and long term back pain. Often when assessing patients with back pain it is easy to feel spasm and ‘ropey’ muscle tissue that is exquisitely painful to the touch, with appropriate treatment these areas become much less painful. Often the longer the pain has been present the more areas of muscle spasm are present. This treatment must be accompanied by an exercise program to increase flexibility and improve control over the area.

Core stability. Research into the activity of the back and abdominal muscles shows that following back pain the deep muscles are impaired. This means that they are a little slow to fire during certain activities. There has been a focus in recent years on the retraining of these muscles in order to re-educate them to fire more quickly in order to protect the spine. This program can be very effective when used in conjunction with other forms of treatment as described above and recent research suggests that a certain group of patients respond especially well to this treatment. These people can be identified at assessment.

The most important things to remember when suffering from a recent episode of low back pain are;

• Avoid bed rest for more than 1-2 days. Bed rest for more than 2 days slows down recovery.
• Try and stay active
• Avoid remaining in one position for too long.
• Taking NSAID’s will increase the likelihood of improvement in the first week.
• If you are off work try and return to work as soon as possible.

You should consult your GP immediately (today!) if you experience any of the following symptoms;

• Numbness or altered sensation in the area between your legs (the saddle area).
• Altered function in your bladder and bowel, for example a loss of control, or following urination a sense of incomplete evacuation or needing to go and being unable to.
• Loss of sexual function (loss of erectile function in men and loss of sensation in women).