Low Back Pain
the history of low-back pain
The statistics show that
- 80% of people will suffer an episode of low back pain at least once in their life
- 60% of the normal population have experienced some degree of low back pain in the last year
- 5% of the population will take time off work as a result of back pain.
- Low back pain causes the greatest problem in the middle years of life with a peak age of about 40 years.
Low back pain is one of the most common complaints treated by physiotherapists. A systematic approach of assessment, diagnosis and management is necessary to provide the right treatment at the right time. Management of low back pain must consider not only the acute episode but also address those factors that predisposed the person to having the injury.
the common sources of back pain are:
The intervertebral disc - a fibrous cushioning between each spinal segment
The facet joint - joints at the rear of each level that provide stability
Nerves - exit the spinal cord and run through a space called the intevertebral foramen
Soft tissues - extensive soft tissues lie around the spine and usually help to support the spine
Muscles – rarely cause pain but often aren’t working to support the spine
common incidents that cause acute low back pain include:
- Repetitive bending
- Poor posture and prolonged sitting
- Weakness in core stabilising muscles
At Core Physiotherapy and Pilates studios we utilise the McKenzie method as a first line of assessment for low back pain. Unique to the McKenzie Method® is a comprehensive and logical step-by-step process to evaluate the patient's problem quickly.
Assessment includes a subjective and physical examination and may consider radiological investigations.
management of low-back pain
Once a diagnosis has been made that clearly defines the likely cause of Low back pain a clear treatment plan can be set out. This plan will involve a series of steps to get the patient from injury to full recovery and involve the client managing their own symptoms as much as possible.
step 1 – reduce the acute symptoms
- Initial hands on treatment to settle symptoms and improve mobility (may include joint mobilisation, massage, dry needling, manipulation)
Home exercises to help maintain the improvement from treatment
Advice on posture and activity to help take the pressure off the injured tissue
step 2 – maintain improvement
- Prescription of structured exercises to maintain improvement prevent continued aggravation
Strengthening exercises designed to improve core stability
Adjustment of posture, ergonomics and lifting technique
step 3 – return to function
Rehabilitation/strengthening via exercise designed to simulate normal day to day activities and movement patterns
Stretching of spine tissues in all directions to produce healthy normal tissue mobility
Waddell. G. 1987 A new clinical model for the treatment of Low-Back Pain Assessment
McKenzie.R. Treat your own back
McKenzie.R. Mechanical Diagnosis and therapy of the lumbar spine