Back Pain

Back pain

Low back pain can happen suddenly (acute) or gradually over time. There are many structures that are potential sources of pain in the back, including: facet joints, discs, nerves, ligaments and muscles. Leg pain, pins and needles or numbness may also be associated with back pain.

It is important that your back pain is managed in its early stages to prevent it becoming chronic (long standing).   Physiotherapy research has shown that once you have experienced one episode of low back pain there is over a 70% chance that you will experience further episodes.   Therefore, it is recommended that you seek sports and/or musculoskeletal physiotherapy assessment and treatment immediately, even if it is only your first episode of pain.

Your physiotherapist may use varying techniques in your management including  soft tissue therapy, joint mobilisation, neurodynamic (neural mobilising) techniques, exercises to strengthen and increase the movement of the back, clinical pilates and ergonomic advice.

Low back pain

Low back pain can happen suddenly (acute) or gradually over time. There are many structures that are potential sources of pain in the back, including: facet joints, discs, nerves, ligaments and muscles. Leg pain, pins and needles or numbness may also be associated with back pain.

It is important that your back pain is managed in its early stages to prevent it becoming chronic (long standing) .

Physiotherapy treatment of low back pain is dependent upon your sports or musculoskeletal physiotherapist’s assessment and diagnosis and may include soft tissue therapy, joint mobilisation, neurodynamic techniques, exercises to strengthen and increase the movement of the back, ergonomic advice and ultimately, your return to sport or activity.

Postural assessments

Postural assessments observe how your body naturally rests, as well as how you use your body functionally. These assessments are integral in identifying areas of weakness, areas of stiffness or reduced flexibility and areas of increased injury risk. Commonly, strengthening exercises, control strategies and stretching are effective in resolving postural issues and these are often used in conjunction with manual therapy.

Nerve pain and neurological symptoms

Nerve pain, pins and needles or numbness are all neurological symptoms caused by injury to or irritation of a nerve. The most common times one may experience neurological symptoms are following an injury to the lower back or neck where there may be irritation or swelling that adversely affects one of the cervical or lumbar nerves.  Neurological symptoms may also be experienced if there is “neurodynamic” compromise which occurs when the pathway of a nerve is affected along its journey to a peripheral limb.  Muscle spasm/tightness, swelling from injury or altered biomechanics can all impact the neurodynamic pathway of a nerve.

Depending on the origin of the neurological symptoms, management often takes time as nerve irritation and recovery can be very slow.  Physiotherapy treatment aims to unload the structures surrounding the nerve to reduce symptoms and improve neurodynamic mobility.  These treatments may include soft tissue and myofascial techniques, joint mobilisations, neurodynamic techniques and exercises, taping to offload structures and ultimately, strengthening exercises to prevent the reoccurrence of neurological symptoms.

Pregnancy related pain

While you are pregnant, there are many changes that occur in your body in response to hormonal and physical changes. Common areas that are susceptible to pregnancy related pains are the low back, pelvis and hips. The reason for this is that these areas bear the majority of load going through the body. Postural changes related to the growth of you abdomen may also occur and can be a source of pain.

Exercising while you are pregnant is a great way to prevent and manage pregnancy related pain. Your physiotherapist will guide you through safe ways to exercise so that you and your baby remain healthy. Massage and specific braces or belts may also be useful in managing your pain.

Disc injuries (cervical, thoracic, lumbar spine)

A disc is a structure that sits between the bones of the back (vertebrae) and its role is to enhance spinal movement and absorb and transmit force. The disc has a fibrous, sturdy outer layer and an inner core made up of 80% water.

Discs are at the most risk of injury when there is excessive force being transmitted through them and this depends on their location in the spine.  Below are the most common movements that place areas of the spine at most risk:

  • Lumbar spine discs: bending and twisting activities, particularly when there is an added weight (e.g. lifting).
  • Cervical (neck) discs: after a long night’s sleep with the neck in an awkward position.
  • Thoracic discs are rarely injured as the ribs also attach nearby to the discs protecting them from injury.

Common symptoms of disc injuries are pain, immobility and compensatory muscle spasm. Your physiotherapists have detailed expert knowledge to assess, diagnose and manage your disc injury and treatment may involve soft tissue work, joint techniques, mobilising and strengthening exercises.

Post-operative rehabilitation

All orthopaedic surgery requires rehabilitation to assist the recovery from surgery to appropriately guide and progress activity levels without compromising the surgery just undertaken.

Post-operatively, there is often pain and swelling and these must be controlled immediately to minimise any inhibition of surrounding muscles and therefore prevent compensatory muscle and biomechanical activities developing.

Your sports physiotherapist works in conjunction with your surgeon’s wishes to ensure a safe and appropriate return to activity.  Your treatment will involve swelling and pain management strategies, biomechanical retraining, strengthening and ultimately a return to your chosen activity.