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About Low Back pain treatment
Low Back pain Treatment
Low back pain can arise from a range of contributing factors rather than just one specific structure. Often there are multiple reasons for lower back pain than just one structure. It's important to understand the structures as well as the cause of the complaint to give you appropriate management and tools to manage your complaint.
Our approach is to:
1) Identify what may be the cause of your pain
2) Address what is contributing to your symptoms
3) Gain confidence in movement and activity by slowly building strength and tolerance within your pain limits.
Low Back Pain
Common Types
Of Low Back Pain
Acute lower back pain
Acute lower back pain is a sudden onset of pain you feel with movement. Typically it can be from a combination of bending forward with rotation, sometimes it can gradually build up after you have over-loaded the lower back. It doesn't always take a big 'trauma' or 'rip' for the onset of symptoms - it can be from something as simple as putting on socks. Often this type of pain is from more than one structure that's inflamed. It can be from discs, facet joints, muscles and sometimes other structures such as the hips or scar-iliac joints that can be involved.
Sometimes this type of pain can also refer down the leg, which can be called sciatica or radiculopathy.
For more information, see our blog: Understanding Acute Low Back Pain
Chronic and Long Term Lower Back Pain
Chronic or persistent pain, is where the complaint has been present for a longer duration and can involve a different approach to management. Chronic pain is a complex process, while there can be an underlying issue involved - sometimes the nervous system and muscles can become too protective. In these cases, a slow graded approach to management with a focus on building confidence and resilience to movement is needed.
We also recognise that there can often be other processes occurring such as arthritis or degeneration of discs or joints. Our focus is to give you support that will assist you, so in cases whether you would benefit more from additional allied health or pain management input we will inform you.
Pelvic Pain or Sacro-iliac Joint Pain
Sometimes the lower back may be where the pain is felt, when there might be a problem in another location. Sometimes when your body has adapted to other complaints such as hip arthritis or sacroiliac joint problems, the pain is felt in the back, while the 'problem' exists elsewhere.
Because of this we tend to also assess and ask questions about other spots of stiffness, weakness or pain to better understand your symptoms.
Potential causes for Lower back pain
Common Causes for Lower Back Pain
The lower back has a large role in transmitting force from the lower body to the upper body. Sometimes when areas are weak, balance is poor or when you have prior injury - the muscles are not supporting you effectively.
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Weakness of the abdominal musculature, hip stabilising muscles or poor balance
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Ergonomic factors such as:
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Heavy labour jobs
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Desk posture
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Repetitive overloading from lifting
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Poor lifting technique
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Being sedentary
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History of previous trauma to the lower back.
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When your nerves that signal pain are easily sensitised or quick to react. Often a common issue when you have had a long history of neck pain. The nerves can adapt over time and what may be a light pressure or 'stimulus' becomes interpreted as pain.
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Changes in the muscle, disc or joint structures over time
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Instability of the lower back.
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Movement patterns which over-load the muscles of the back and underutilise the core muscles of the abdomen.
When Should You Seek Treatment For Low Back Pain?
While many episodes of lower back pain can settle on its own, there are times where assessment can be helpful to guide management and reduce ongoing issues.
Here are some simple tips to guide whether further assessment may be helpful:
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Pain that is persistent and not improving after 1-2 weeks
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Recurrent episodes of low back pain
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Pain spreading into the glutes or leg
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Increasing stiffness or restriction in movement
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Uncertainty in how to manage symptoms
If you are unsure, an assessment can help clarify what's contributing to your symptoms and how to best move forward.
HOW WE MANAGE YOUR COMPLAINT
How We Support Lower Back Pain
Screening And Assessment
We will thoroughly screen your complaint and try to understand why your complaint is there, as well as factors that lead to your symptoms. We then will aim to address whether you have specific goals for us to achieve.
We also will review the history of your back issue, prior procedures, what was effective and what wasn't to guide the next steps in management.
Manual Therapy Support
There are often times where manual therapy can be useful. We use manual therapy as a tool to assist you in managing the tightness and stiffness that may be contributing to your symptoms.
We can use techniques such as traction, soft tissue massage, dry needling as well as muscle energy technique and mobilisation where appropriate.
We may also perform techniques to address tightness of hips or pelvic muscles if this is contributing to your issues.
Education and Exercises
We aim to give you tools to manage your symptoms. Obviously in acute complaints this can be a faster recovery timeframe. Where the complaint is more persistent or has been chronic, then we may require a longer duration of treatment.
Our focus is on advice, guidance and prevention of flare ups. In cases where you may have stiffness of the hips or instability, a key focus will be on giving you tools to strengthen.
Exercises will depend on the underlying drivers of your symptoms.
When to seek medical attention first
important reasons to visit your doctor for Low Back pain
Sometimes neck pain does require GP or medial assessment. The list below includes reasons to see the GP or seek further medical attention for neck pain first.
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When you have any weakness of the legs or are experiencing a problem called foot drop (where you cannot lift the toes when you walk)
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If you have issues with continence (bowel or urinary) or if your complaint is making toileting difficult (constipation or urinary retention)
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If you have had a severe lower back trauma - if you have had a fall, are on blood thinning medications or have low bone density
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If you have been experiencing pulsating pain in the abdomen, abnormal bowel habits such as altered stool colour or blood present
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If you have any pains that wake you at night
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If you notice any rashes along-side your lower back pain, whether it's over your body or along a strip
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If you have had a history or cancer or have noticed any loss of weight, night sweats or deep bone pain
Blog posts: Neck Pain