The Back

The Back

Low back pain is one of the most common presentations to a PT clinic. Fortunately, most occurrences of low back pain resolve within a few days, only a smaller percentage being more serious. The spine is made up of 4 regions, the cervical (neck), thoracic (mid back), lumbar (low back) and sacral (base of spine). The bones that make up the spinal column are called vertebrae, with discs in between. These are spongy pads of cartilage that allow flexibility through the spine and act as shock absorbers. Ligaments, muscles and tendons surround the spine to provide support and stability, and control movement.

Back injuries can be classed as acute or chronic. Acute back pain generally lasts a few days or weeks, and is often mechanical in nature and caused by some form of trauma e.g lifting a heavy object, a fall, sports injury or prolonged activities such as gardening or sitting at a desk. Chronic back pain last for a longer period of time, generally more than 3 months, and may be more degenerative in nature.

Common injuries

Disc bulge (sometimes called herniated or ruptured disc)
The disc between the vertebrae may become damaged and bulge slightly, causing pressure on the surrounding nerves. This can cause symptoms of back pain, leg pain, pins and needles and possible numbness. Physiotherapy treatment is usually indicated, and occasionally further investigations such as an MRI scan may be required.

The term used to refer to pain originating from pressure or irritation to the sciatic nerve. This nerve exits the spine in the lower back and travels down the leg. Causes of sciatica may include a disc bulge, muscle spasm or poor posture.

Ligament or joint sprain and muscle spasm
Often caused by heavy lifting, prolonged bending or sports injuries.
Pain usually felt in lower back, sometimes one sided. May cause pain to radiate into buttock or leg. Movement is often restricted. Physical Therapy treatment for this type of back injury usually give good results and can reduce recovery time and prevent ongoing problems.

Postural back pain
Poor posture can be one of the most common causes of back pain, and is a frequent presentation in a Advantage PT. Sleeping position, work desk set up and standing posture may all be contributing factors. Back pain and injuries are often caused by weak abdominal and back muscles, contributing to poor posture and reduced ‘core strength’

Degenerative changes
Back pain and stiffness may develop from ‘wear and tear’ to the spinal joints and discs. This can be degenerative in nature, be gradual in onset, and may become chronic. Early morning stiffness and pain with prolonged standing is a common complaint.

Physical Therapy
A physical therapy assessment for back pain will allow accurate diagnosis of the problem, and a treatment plan to be formulated. Treatment may involve joint mobilizations, massage, stretches, and exercises. Physical therapy for a back injury may involve a graded exercise program to strengthen postural muscles and improve flexibility. Advice on back care, back injury prevention and a strengthening program is a core part of PT treatment for back pain.