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.
How physiotherapy can help
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 progressive strengthening exercises.
3) Progressive strengthening exercises that focus 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.
Why would I need physiotherapy for back pain?
If you have back pain that’s causing significant problems or doesn’t get better after a few weeks, it could be worth seeing a physiotherapist. Physiotherapy can be useful for different types of back pain. It may help with the following.
- Non-specific lower back pain – where no cause (such as an underlying medical condition or injury) has been identified.
- Sciatic pain – this spreads from your back down your legs and may be caused by a prolapsed disc (when a disc in your spine bulges out of its normal shape and presses on a nerve).
- Back pain caused by ageing of the discs in your spine (degenerative disc disease).
- Spinal stenosis – when the space around your spinal cord narrows, putting pressure on your spinal cord and causing pain.
Your GP may refer you to a physiotherapist or you can arrange an appointment yourself. For more information on this, see our section on finding a physiotherapist below.
Your GP or physiotherapist may recommend physiotherapy as part of a treatment package that includes hands-on manual therapy, an exercise programme, painkillers and psychological support. Having a combination of treatments like this may give you the best chance of getting rid of your back pain. Your physiotherapist will also help you to understand what’s causing your pain so you can take steps to manage it.
Physiotherapist, osteopath or chiropractor?
Physiotherapists, chiropractors and osteopaths are all health professionals who treat back pain with manual therapies, but their approaches to treatment are slightly different.
- Physiotherapists focus on restoring movement and function to your whole body after you’ve been affected by illness or injury. They look at how the nerves, muscles and bones in your body are affected, and how treatment with exercise therapy and manual therapies can help. They’ll encourage you to take an active part in your rehabilitation, rather than relying on passive treatments.
- Osteopaths look at the health of your body as a whole and aim to make sure all your bones, muscles and joints are working smoothly together. They focus on manual therapies to get your body back to a state of balance.
- Chiropractors have a specialist interest in neck and back pain. They look at your body as a whole and how problems with your bones, muscles and joints affect your nervous system and general health. Their focus is on manipulation of the spine – but they may use other techniques too.
You can choose which type of practitioner you see. But if you’re seeking NHS treatment, it will depend on the services available in your area. In some parts of the UK, you can refer yourself for physiotherapy. In others, you will need to be referred by your GP or hospital doctor. Osteopathy and chiropractic are not generally available on the NHS.
If you’re booking treatment privately, think about what you’re hoping to gain, and which approach appeals to you most. It’s worth contacting a few different practitioners to discuss your circumstances. If you have health insurance, contact your insurance provider to see what you are covered for.
What will happen when I see a physiotherapist?
When you first see a physiotherapist, they’ll take a detailed medical history. They’ll ask you about any medical conditions you have, your lifestyle, your work environment and any medications you take. They’ll also want to know what symptoms you’ve had, and what tends to trigger them. Next, they’ll do a detailed physical examination, including looking at how you move and how your back is working. They may also do a neurological assessment to see how well your nerves are working. You may need to remove some clothes when you go for physiotherapy, so that your physiotherapist can see and feel your back. You can ask to have a chaperone if you prefer.
Your physiotherapist will explain the treatment they recommend, and how they expect this to help your back pain. They should also warn you about any potential risks of the treatment. If you’re unsure about anything, don’t be afraid to ask. It’s important that you fully understand what your physiotherapist is recommending because you’ll be asked to give your consent to go ahead with treatment.
The benefits of physiotherapy in everyday life
Many people consider healthy livelihood as a good way of living. It is said that physiotherapy is important in this aspect.
Physiotherapy helps people with situations whereby their movement and functions are vulnerable due to the process of ageing, injury or being infected by a disease. This method of healing uses non-surgical methods in the treatment and/or management of numerous and physical conditions such as strokes, back pains, heart disorders, asthma and lifestyle conditions.
Physiotherapy comes a long way and its advancement to the present day owes much to research based practice.
“Physiotherapy offers holistic and patient-centred treatment and management to a whole range of conditions. It addresses both health and well-being aspects of an individual,” said Oakantse Makabanyane a physiotherapist at Zeta Clinic.
The benefits of physiotherapy include improved joint mobility, better sleep and enriched quality of life. It also prevents lifestyle related conditions such as stroke, high blood pressure through physical exercises and healthy living education.
With every health profession, side effects are bound to emerge perhaps once in a while depending on the individual that is being treated for a particular condition. “Physiotherapy treatment techniques and modalities are generally very safe with little to non-existent side effects. All the treatment modalities used (at least by qualified physiotherapist) are well evidence based (researched) with known outcomes. However, due to the nature and/or the administration of certain treatment modalities some side effects can be experienced by patients,” highlighted Makabanyane.
Side effects may be increased or exacerbation of symptoms, minimal skin burns and allergic reactions. Side effects can be avoided if and when conscientiousness is put into effect.
The universally practiced methods (electrical) include Transcutaneous Electrical Nerve Stimulation (TENS), Therapeutic Ultrasound and Interferential Therapy. Physiotherapy techniques comprise of hands-on physiotherapy techniques (which might be a massage or joint mobilisation), neurodynamics, therapeutic exercises, acupuncture and dry needling, sport physiotherapy and therapeutic massage.
“Manual therapy is a group of techniques used in physiotherapy for the treatment and management of patients with mainly musculoskeletal problems,” noted Makabanyane.
Examples of manual therapy involve joint mobilisation, spinal manipulations, traction techniques and therapeutic massage.
“A physiotherapist decides on the manual therapy technique to execute based on the assessment and nature of the condition under treatment,” says Makabanyane.
The duration of a physiotherapy session depends on the physiotherapy setting. For instance, in an outpatient department or private clinic setting it lasts about 30 minutes.
“With today’s lifestyle and tendencies, physiotherapy is viewed as essential. Whether one works in an office or is an athlete, a visit to a physiotherapist is predestined. The beneficiaries vary from children with cerebral palsy, early developmental problems, athletes (sports injuries), lifestyle problems/diseases (stroke, backache) and even patients in Intensive Care Unit (ICU).
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