• What is low back pain?
• When to See a Physician
• When to See a Physical Therapist
• What Causes Low Back Pain?
• PhysioDynamics' Approach to Treatment
• Maintaining a Healthy Back

What is low back pain?

Back pain is the most frequent disability in people under 45 years old, and the second most frequent reason for seeing a doctor. Most people experience low back pain sometime in their lives. While low back pain can range from a dull pain to a severe disabling pain, most can be effectively treated by an experienced physical therapist, while some types of pain are best treated by physicians.

When to See a Physician

Low back pain caused by compression of the nerve roots as they exit the spine is best treated by your physician.  The most common symptoms, with or without back pain, are “needles and pins”, muscle weakness, or numbness in ONE leg/foot (rarely both).  In this case, your physician may initially prescribe pain killers, muscle relaxants (which treat the symptoms, not the source) and bed rest.  If the pain or foot/less numbness subsides within 2 weeks, you should then consider physical therapy to learn how to maintain a healthy back to prevent the condition from recurring.  If the pain does not subside, however, your physician may recommend surgery which would most likely be minimally invasive and has a 90% success rate with this type of condition.

When to See a Physical Therapist

Low back pain that stems from the muscles, tendons, ligaments and joints that support the spine can be effectively treated with physical therapy. If there are no pins and needles, muscle weakness or numbing in one leg/foot as described above, it is likely that the source is musculoskeletal and not neurological.  This category of back pain responds well to physical therapy treatment and can eliminate 99 percent of possible surgical interventions. In fact, with proper physical therapy treatment, the need for surgery is one in 500! Surgery should be the last resort when it comes to options for treating this type of back pain.

What Causes Low Back Pain?

The back is a remarkable example of the engineering beauty and complexity of the human anatomy. It is composed of the spinal column (24 bony vertebrae standing on the base of the sacrum), the spinal cord (a bundle of nerves which runs vertically through the center of the entire length of the column from the brain to the base of the spine), and a supportive system of hundreds of muscles, tendons, and ligaments. The spinal column, however, is not absolutely straight; there are natural curvatures in the lower (lumbar) area and in the upper neck (cervical) area which enable us to effectively balance the weight of our bodies.

The lower back bears great stresses and strains during every­day activities. Few people realize that greater pressures are exerted on the discs between the lumbar (lower) vertebrae while sitting than while standing!

While pain can occur from any of the structures of the back-the bones (vertebrae), discs, ligaments, or muscles, it most frequently emanates from the lower back region. Most back pain, and most low back pain, is caused by mechanical or physical problems such as those resulting from lifting improperly, sitting or standing for prlonged periods in poor positions, or excessive bending or twisting. The stress and anxiety of daily life, long term overeating, and a lack of exercise also play a significant role in increasing low back pain.

Physiodynamics' Approach to Treatment

After a thorough evaluation, treatments may include spinal mobilizations and manipulations, postural corrections, manual therapies and myofascial release, stability and strengthening exercises, ergonomic re-education (how to use your back safely at work, at work and at leisure), weight loss management, stress management (which may cause muscle tension) and electrical modalities.

Maintaining a Healthy Back

PhysioDynamics' preventive approach includes a few simple but effective activities that can be integrated into your daily routine to keep your back flexible, strong and safe:

• Stand tall! Think of it as “make your spine as long as possible."
  
• Sit tall! Sitting puts more pressure on the lower back than standing, yet we sit a lot – at work, at home and at leisure.  Reduce this stress by standing at least every 20 minutes even if it is only for a few seconds to stretch your back backwards and sit down again. Sit leaning back 110-120 degrees and support the hollow in your lumbar area at all times. Move your legs and shift your weight while you are sitting.
  
• Lifting: Bending our knees when lifting. Remember the heaviest thing that you will ever lift is your own body weight, so even of you are lifting something light bend your knees. Minimize lifting as much as you. Store the heaviest things at knee to waist level and when lifting hug the object as close to you as possible.
  
• Most of our daily activities—especially working at a computer-- require staying in one position for more than 20 minutes with our arms forward and leaning forward. Our bodies need movement and changes in position to improve the transport of nutrients. So change positions often or stretch backwards, look over your shoulder, reach up. stretch!!!!
  
• Here are a couple of things to do to keep your back strong and flexible:
  Push-ups
  Sitting sideways on both sides
  Long sit
  Crawl
  Squat
  Walking on uneven soft ground, e.g. grass, hills, sand, pebbles
  Dance!

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