What is in a name? Low Back Pain – the scary diagnosis

Back sprain, Disc bulge. Sciatica. Spondyloslisthesis. Pinched nerve. Slipped disc. Back spasm. The types and terms of back pain are endless and to be honest, a little scary-sounding! One of the important things physiotherapists get taught at Uni is to be very careful about diagnosing a client with a specific ‘term’ when it comes to low back pain. This is for a number of reasons. One - the research is endless and ongoing. There are constantly new names and new developments and a number of different terms to diagnose the same issue. Second – it is very hard to be so specific with it comes to diagnosing low back pain (LBP). SO much so that a large umbrella of low back injuries are actually termed ‘Non-specific low back pain’ – that’s a thing! It covers a myriad of different low back symptoms. Thirdly – it’s to prevent patients from hearing some big scary name, panicking and then doing everything wrong (mainly guarding their back) because they are paranoid it’s going to get worse.

Nevertheless, I understand how frustrating it is to not really understand what it is you have or what has to be done. The bottom line is that majority of low back injuries need to be treated in similar ways. There are a few MAIN types of back pain you are likely to experience.

1. Pain in the lower back, bottom and down both legs (above the knee)

This is most commonly due to positioning of the lower back and tightness of the hip and gluteal muscles. Treating it involves improving movement in the upper back, the bottom and decreasing excessive movement in the lower back. Hands on physiotherapy will help release tight muscles but strengthening and improving the biomechanics of the spine is what will really fix this.

2. Pain down one leg, bottom and perhaps with pins and needles and numbness

This again is due to either muscles being really tight in the bottom and hamstrings (back of the legs) and pushing on a nerve travelling down the leg or the nerve getting inflamed as a result of poor positioning or control of the low back.

This involves dry needling or hands on therapy if required to release spasming structures and gapping techniques to offload the area getting pinched. Most importantly postural re-training and core strengthening to improve control and position of the spine to prevent it from happening again.

3. Pain across the low back or on one side of the low back

Most commonly this is a muscular issue either from doing too much activity (common in paddlers or rock climbers) or it is a protective spasm response to a mobility issue (too much or too little) of the area underneath the muscles. Treatment for this requires loosening up the spasm and improving mobility or control of the area underneath should it be the underlying cause. (via pilates)

So you can see, a lot of common back injuries, whilst in theory are quite different, require a few hands on techniques to get the spine back to a more optimal state before a strength and postural re-training program to re-teach it the ideal position to prevent recurrence down the track. This would be the approach I would take with pretty much every single person walking in with Low Back Pain prior to considering any other more invasive options.

Suffering from low back pain? Book in to see one of our physio's today! Book online here, or call us on (08) 9448 2994.

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