Customized Physical Therapy Can Ease Lower Back Pain
Raj Suppiah, MScPT
Last week, we talked about getting in to see your physiotherapist as soon as you experience back pain. This week, we’ll talk about the variety of ways physiotherapy can help. A recent article in the Journal of Orthopedic and Sports Physical Therapy described the ways to treat back pain based on the best research evidence. LOW BACK PAIN IS SO COMMON THAT 8 OF 10 PEOPLE EXPERIENCE IT AT SOME TIME IN THEIR LIVES. Although the pain in your back may feel severe to you, most low back pain is not due to a serious problem. Physiotherapists should be able to assess, diagnose and intervene without the use of diagnostic imaging.
Back pain manifests itself in many ways. Localized pain is felt in the lower back (above your tailbone) and buttocks. Radiating pain occurs when there is pain in the back as well as down the leg or foot. This can also occur in the form of numbness and/or tingling and is usually the result of nerves being irritated. Sometimes, symptoms can occur in the leg, without actually being felt in the back. This is called referred pain. More often than not, back pain results from lifestyle factors, such as sitting too much, being in poor physical condition, and bending and lifting improperly.
As discussed last week, early treatment is the key to decreasing your pain and getting back to full activity. Treatment that focuses on exercise, mechanics and posture improves symptoms quickly and reduces your chance for recurrence. A physical therapist will tailor treatment to your specific problem, based on a thorough examination and the probable causes of your low back pain. The good news is if you seek out a physiotherapist immediately after getting back pain, treatment is extremely effective. The longer symptoms linger, the harder it becomes to treat. Staying active is important, and bed rest should be avoided. Based on your examination, the best treatment options for low back pain are:
1) Manual therapy (hands-on mobilization of the joints in your back). Physiotherapists skilled in manual therapy use precise hands-on techniques to relieve stiffness and improve movement of the joints and muscles of your spine. 2) Movement exercises that restore motion and decrease radiating or referred pain. Most physiotherapists prescribe these exercises, using a protocol called the McKenzie method. If your pain is chronic, do not fear; physiotherapy can still help! Along with the first two options, chronic low back pain is best managed with 3) Progressive strengthening exercises that focuses on core stability and endurance. You’re probably wondering whether you should bother doing any of these and why not just wait it out? Unfortunately, waiting it out will reduce symptoms, but may not actually fix the reason you got back pain in the first place. That is why it is always important to be assessed by a physiotherapist before attempting to manage back pain yourself. A detailed assessment noting the type of pain, how it occurred, what makes it better and what makes it worse will allow the physiotherapist to prescribe the right treatment option for you.