Back Pain

The onset of back pain can be debilitating. The lower back is a complex structure made up of interconnecting bones, discs, joints, nerves, ligaments, discs and muscles working together to provide a base of support for the body. This complex structure is susceptible to injury and pain and needs to be stable, flexible and strong.

Lumbar pain may present in a number of ways depending on the underlying cause. Symptoms of the pain may include a dull ache, shooting or piercing pain, or a burning sensation. Pain may be localised in the back or radiate into the buttock, groin, legs or feet. You may also experience pins and needles, numbness or paraesthesia in the buttock, legs or feet. The pain may also worsen by certain postures such as prolonged sitting or prolonged standing, or when moving such as walking, or from sit to stand.

Back pain is often categorised by type of onset and duration. Episodes may be classified as acute (0-6 weeks), subacute (6-12weeks), and if pain persists for more than 12 weeks is considered chronic.

Types of low back pain is commonly classified into:

  1. Mechanical pain is primarily from muscles, ligaments, joints (facet joints) and is often associated with pain localised in the lower back, buttocks and groin.
  2. Radicular pain (sciatica) involves nerve tissue that is either impinged or inflamed. This pain will often radiate into the buttock or down the leg. This pain is often described as a burning sensation, shooting pain and can be also be associated with pins and needles/numbness and sometime weakness in the leg.

Pain can also be classified as traumatic or sustained overload injuries. Traumatic may be when a person bends awkwardly to lift a heavy load, that tears or damages structures, or sustained overload injuries are more related to positional stress or postural fatigue that overloads the back structures over an extended period of time causing injury and dysfunction.

The source of pain is commonly:

  1. Muscle – muscle tissue pain may be a result of muscle strains, muscle spasm, and muscle imbalances
  2. Ligament sprains
  3. Joint pain is often a result of facet joint irritation, stiffness or dysfunction.
  4. Bulging discs, herniated discs or degenerate disc disease can all contribute commonly to radicular pain where nerve tissue is irritated or impinged. Discogenic pain can also cause muscle spasm and associated facet joint irritation.

Other sources of pain may include lumbar spinal stenosis, osteoarthritis, infection, tumours, deformity/fractures, osteoporosis, inflammatory conditions such as ankylosing spondylitis or rheumatoid arthritis. Lower back pain may also be a secondary pain related to medical conditions in organs of the body such as kidney or pancreas.

Physiotherapy Treatment

Although some episodes of lower back pain can resolve by themselves, physiotherapy can help achieve a faster recovery, with a reduction in pain and an increase in mobility and function, hopefully reducing the severity and length of the episode.

Physiotherapists are experts in the assessment of musculoskeletal injuries. A thorough and detailed assessment will help to ascertain what is responsible for your pain. At Wisdom Physiotherapy, your physiotherapist will help give you a better understanding of your body structures that may be contributing to the pain and educating you why this has occurred. This will then assist you to help manage the current episode and prevent future issues.

Physiotherapy short-term goals are to reduce pain and inflammation, promote healing, restore range of motion and strength, and increase function. Long-term goals are to restore full function to your activities and get back to moving safely. Education and an ongoing exercise program will help with trying to reduce the risk of recurrence.

Your physiotherapist will discuss the appropriate treatment plan and may involve:

  • Joint mobilisation and manipulation
  • Soft tissue massage
  • Neural mobilisation
  • De-loading taping techniques and postural supports
  • Dry needling
  • Stretching (both passive and active)
  • Strengthening exercises
  • Clinical Pilates
  • Advice on recommended positions and postures at home and during work
  • Optimising work station positions and manual handling techniques.

Stretching and specific strengthening exercises will speed up recovery from acute lower back pain by regaining the range of motion and strengthening the back and abdominal muscles. Exercise prescription must take into account the diagnosis and clinical presentation. Depending on your muscle recruitment pattern, the physiotherapist will prescribe the best exercises for you. We find this is best done under our guidance in our Clinical Pilates studio.

So don’t put up with the pain, be proactive in your recovery and seek the expert advice from Wisdom Physiotherapy, we are here and can help!

At Wisdom Physiotherapy Nedlands we treat the cause of your pain and also help to prevent recurrent episodes. Make an appointment today and get some relief. Call (08) 6389 2947 or click here to book online.