Back pain

The most common reason for taking time off work. Back pain is complex, painful, debilitating and will affect 80% of us at some point in our lives.

There are many structures in the spine that can emit pain. As clinicians we can be 90% sure that we have identified the problem structure. Many structures in the spine respond to similar treatments therefore making intervention very effective.

When presented with a spinal problem our therapists will perform a thorough assessment and examination. This is to identify and exclude problems that would require further investigation. Through this process we can decide the best and most effective way to treat your back pain. In addition to treating the problem we can educate you about the pain and condition and help you to recover. We tend to group back pain into categories of mechanical or non-mechanical.

Symptoms

• Pain can be centred around the low back; may spread to the buttocks; upper, front and back of thigh, groin or into the lower leg and foot where the nerve is involved.
• If the nerve is irritated or compressed then pins and needles can appear and there may be muscle weakness.
• Pain may be a constant ache, sharp upon movement or there may be a loss of movement.
• Pain may occur only when walking or sitting down.
• Low back pain may make it difficult to get comfortable at night and the region is generally stiff after sustained postures and on rising in the morning.
• Pain caused by the mid section of the back could manifest in chest pain. Chest pain is first and foremost a complaint that should come to the attention of your GP, particularly where it is associated by palpitation, breathlessness and general malaise. However, this pain is often associated with the spine and can be successfully treated.
• Mid back or upper ‘Thoracic’ pain will additionally be characterised by stiffness and difficulty straightening up in the back.

Causes

• Disc sprain
• Disc herniation/slipped
• Facet inflammation
• Sciatica
• Muscle spasm
• Rib sprain
• Ligament sprain

Treatments

Manual therapy, including manipulation and mobilisation, is supported through scientific evidence in the treatment of lower back pain. The difference being the force of application, where manipulation is a sudden thrust, mobilisation tends to be a graded and repetitive movement.

Electro-therapy is useful for the reduction of inflammation and pain, and includes TENS, ultrasound and interferential. Massage is also helpful in reducing painful spasms and acupuncture can be beneficial as it stimulates the release of endorphins and natural anti-inflammatory chemicals within the body.

Rehabilitation following low and upper back pain is important in the reduction of recurrent problems. Exercises and postural training restore to the core regions and enhance the body’s awareness in space.