Low back pain (or lumbago) is a common musculoskeletal disorder affecting 80% of people at some point in their lives. It accounts for more sick leave and disability than any other medical condition. Low back pain can arise from many causes including arthritis, muscle strains, ligament strains, joint impingement, disc lesions, osteoporosis, sciatica and stress. Often little or no trauma is involved but can be due to minor insignificant events such as putting on your shoes or picking up a pen. Many cases of low back pain and sore backs in general are caused by stresses on the muscles and ligaments that support the spine.
Lumbar Facet Joint Pain is one of the most common causes of low back pain. The facet joints are located on either side of each spinal level and can impinge with simple twisting or leaning backward movements. Lifting or contact sport can also cause facet joint injury. The facet joints may also become arthritic with aging. Pain is the most common symptom and is usually one sided with associated muscle spasm and tension. The pain is aggravated by standing or periods of long sitting. If the injury becomes chronic, adverse neural tension may develop causing referred pain down the leg.
Sacroiliac Joint Dysfunction is a common cause of unilateral low back pain. This joint in the pelvis located between the sacrum and ilium can be painful itself, or otherwise cause stress and eventual pain in the structures of the lumbar spine due to mal-alignment.
Lumbar Disc Disorder is a condition that involves deterioration, herniation, or other dysfunction of the lumbar intervertebral disc. With ageing and/or trauma, the disc can weaken and thin (disc degeneration or herniation), which may result in the disc bulging outwards and exerting pressure on one or more of the closely associated spinal nerves.
Compression of a spinal nerve by a disc fragment can cause referred pain down the leg with possible weakness of the muscles controlled by that spinal nerve, pain in the distribution of the nerve root, or sensory changes such as numbness, tingling, or hypersensitivity in the same area.
Sciatica is a term used to describe symptoms including pain in the distribution of the sciatic nerve, a major nerve in the leg made up of several spinal nerves from the lower spinal cord. In addition to pain, which is sometimes severe, there may be numbness, muscular weakness, pins and needles or tingling and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body. A disc fragment touching or indenting the nerve is one of the most common causes of sciatica.
Lumbar Nerve Root Compression Syndrome (trapped nerve) is a medical condition caused by direct pressure on a single lumbar nerve at the point where it exits the spine. It is commonly caused by a disc lesion or degenerative changes associated with arthritis. Its symptoms include pain, tingling, numbness, loss of muscle power and reflex changes along the distribution of the nerve.
Spinal Canal Stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves. This is usually due to the common occurrence of spinal degenerative changes associated with arthritis that occurs with ageing. It can also be caused by spinal disc herniation, osteoporosis or a tumour. Lumbar spinal stenosis results in low back pain usually aggravated by prolonged standing and walking. It can also be associated with tingling, numbness, weakness and loss of bladder / bowel control.
Stress Fractures (spondylolysis) are often seen in sports that involve repeated lumbar extension (bending backwards) and rotation with loading, such as with fast bowlers in cricket, gymnasts, tennis players and javelin throwers. The fracture usually occurs on the opposite side to the one performing the task. The general consensus is that the injury is from overuse related to poor core stability, muscle imbalance and incorrect technique with the task at hand. Repeated stress fractures between the ages of 6 to 16 may lead to a cartilaginous healing and chronic nonunion, which could eventually result in a spondylolisthesis defect.
Spondylolisthesis describes the anterior displacement of a vertebra in relation to the vertebra below. This slippage is mostly caused by nonunion of stress fractures of the lumbar spine, but can also be a result of degenerative changes in the spine, congenital defects of the spine, or trauma. Symptoms include pain, numbness, tingling and weakness caused by spinal nerve compression similar to those seen in spinal canal stenosis. It is most commonly seen in children between the ages of 6 and 16 years of age.
How can we help your low back pain?
In most cases, physiotherapy alone offers an effective solution for most low back injuries. On your first visit, our physios will establish a correct diagnosis to direct the most effective care to your lower back injury. Establishing the correct diagnosis early is imperative as several injuries mimic symptoms yet have different treatment protocols. We use our unique ‘phase-based rehab system’ to ensure all aspects of a full and lasting recovery are delivered. We will tailor a treatment plan to suit your needs, with you involved in the decision making. Our physios will use hands on therapy techniques to improve joint mobility and muscle flexibility. We will nearly always at each session provide home exercises of stretches and strength work so that you keep improving between sessions. Early treatment will be focused on reducing pain and swelling and regaining range of motion. The physiotherapist will then prescribe an exercise program to improve the strength and coordination of your core muscles, which are important for preventing re-injury. We use real time ultrasound to ensure you correctly recruit your core muscles. Hydrotherapy, massage, dry needling and our gym may also be used for best outcome. We will correct your posture, advise you on an optimal workstation set-up and improve your lifting technique to ensure an optimal recovery from your back injury. Towards the end of the treatment program you will be given prevention strategies to keep the pain away. The sooner we begin your lower back rehabilitation, the faster your recovery and back to the things you love doing.
Why choose us for your low back pain?
- We listen, we care and we get results
- We provide physiotherapy to fix the cause of your low back injury and not just the symptoms
- Our physios have extensive experience in dealing with all types of low back pain problems
- We can advise you of the ideal workstation set-up to help your low back pain when sitting
- We can correct your posture in sitting, standing and lying.
- We can provide a running assessment if your back pain is related to running
- We provide bike fitting if your back pain is cycling-related
- Our therapists have completed further education on best practice lower back injury management
- We can prescribe practitioner only natural supplements for pain and inflammation
- Our gym helps with late stage strength rehabilitation
- Our massage therapists can help sort out any tight muscles
- Hydrotherapy can help restore joint range particularly in the early stages of rehab
- We can provide dry needling for pain management and accelerated healing
- We use real time ultrasound to ensure you correctly engage your muscles with dynamic core stability work We have back braces and sacro-iliac belts to help support your low back injury
- We can refer you for further investigations such as x-ray or MRI if required
- Our therapists have been recognised for their expertise having been national sporting team consultants
- We give you cross training activities so you can maintain your fitness whilst injured
- We provide you with the tools to look after your health long after you leave our care
- We provide you with a guided return to work and sport
- We have lumbar supports and posture support braces to help improve your sitting posture
- We can assess your lifting technique and provide measures to ensure you protect your lower back when lifting
- We can recommend referral to a medical specialist if we feel your back pain may need surgery