Back Pain

Back Pain

 

Low Back Pain

Low back pain can have a significant impact on your everyday life and function. It can impair activities of daily living, work, and your hobbies or sporting activities. Proper care begins in the early stages and is essential in progressing through the stages of healing. The ultimate goal is being able to fully return to all your activities, sport and hobbies that you performed pre-injury. Proper advice from your Physiotherapist at Your Health Domain Sydney CBD will help ensure you have the smoothest recovery possible. They will educate you in how to best manage your particular injury. There are many different type of back problem and a tailored approach to resolving your back issue is best for getting you back to the specific activities you wish to resume.  

What causes the pain?

Our lumbar and pelvic regions contain the vertebral column, facet joints, intervertebral discs, and spinal nerves. Each of these structures can be injured individually or combined and can create low back pain. Additionally, we have numerous ligaments and muscles that attach into this area that can become inflamed and produce back pain. If any of these structures become overloaded, it is important to know which positions/movements to restrict in order to unload these painful structures. It is important to know which exercises to perform so that you 1) relieve the loading of the painful structures in your back, and 2) re-teach the body to move properly so that we reduce the risk of back pain in the future.

Keep moving!

Remaining still and avoiding activity can result in stiffer joints and weaker muscles. This makes it harder to resume activity once the acute phase of the injury has subsided. 
Proper exercise as directed by your physiotherapist ensures that you rehabilitate the back as quickly as possible, but do not aggravate it in the process.

Tips On Rehab

Some general tips that help in starting the rehab process

  • Standing with spine straight and “tall”
  • Sit upright on the two “sit bones” of your pelvis, position your bottom fully back in the chair and use the backrest to support your spine.
  • Ensure any desk work is done with the monitor at eye-level and the keyboard/mouse at elbow level.
  • The best resting positions are usually
      1.  lying on your back with your knees bent or a pillow under the knees, or
      2.  side-lying with a pillow between the knees
  • Minimise lifting until your back pain has resolved
  • Use heat to relax excessive muscle tension or cold for an acute strain can also alleviate pain. Non-steroidal anti-inflammatory drugs may also be indicated once an injury has occurred. Check with your GP or Physiotherapist.

Take care of your back … as soon as possible!

Research has shown that early physiotherapy intervention results in decreased pain and increased patient satisfaction. Early intervention also ensures a speedy return to work and leisure activities. The sooner you address the problem, the less chance it has of becoming more complicated and self-limiting. Proper timing of interventions for either acute or the long-term chronic low back pain is essential in treating it successfully.

Download our back care brochure for further information
 

Call us on 9251 5111, email  This email address is being protected from spambots. You need JavaScript enabled to view it.   or click here to arrange an appointment with one of our experienced Physiotherapists today. We can assist you with your back pain from the acute phase with hands on therapy through to the final stages of your rehabilitation with Pilates and exercise based sessions and ergonomic workstation assessments.

 

Sciatica

Sciatica is a set of symptoms that include pain felt in the lumbar region, buttock and/or leg caused by irritation or compression of the sciatic nerve. The sciatic nerve originates from your lower back, in particular L4-S3. Symptoms may include pain, altered sensation (pins and needles and numbness), muscular weakness, or reduced flexibility in your back or leg.

Presenting symptoms of sciatica will vary depending on where the pressure on the sciatic nerve has occurred. The irritation can be at any of the nerve roots branching from the spinal cord “nerve root irritation or compression”, or along the nerve itself which passes through the buttock area and extends down the leg.

Consequently symptoms of sciatica will vary from person to person, so it is important to know that the cause and therefore treatment will also vary.Causes of sciatica include disc bulges or disc herniations, spinal canal stenosis, osteophytes (bony growths), piriformis syndrome, spondylolisthesis, or pregnancy.

 

Disc Herniations

Disc herniations/prolapse/bulges are the most common cause of sciatica. Discs are like the “shock absorbers” between each bony vertebrae. Each disc is made up of a thick, fibrous outer ring called the annulus fibrosus, surrounding a jelly-like centre called the nucleus pulposus.

A disc bulge occurs when the outer ring bulges out, usually out the back or to the side. A disc herniation or prolapse is when the jelly-like centre, the nucleus, bulges out through the annulus fibrosis, usually because the outer fibres are damaged or torn. Think of your discs like jelly doughnuts: if you sit with a poor, slumped posture, you will be putting pressure through the front edge of the “doughnut” causing the jelly to be pushed out the back. It is so important to maintain good posture with correct alignment of your spine. Make sure you are maintaining the natural S-curves of your back to ensure the discs remain in their correct position.

 

Core Stability

Evidence shows that once you have an acute episode of low back pain there is an 86% recurrence rate within 12 months. Addressing the underlying muscle weakness of the deepest layer of abdominal musculature will reduce your recurrence rate, whatever the initial cause.
By following some simple advice on strengthening the muscles of your lower back and the abdominal muscles in your trunk, it will reduce your likelihood of injury.

Your abdominal muscles

The abdominal muscles are made up of several layers. The outermost superficial layers consist of the ‘six pack’ and oblique muscles, which are powerful and designed for movement such as twisting, turning and flexing of the trunk.

The deepest layer of abdominal muscle is called the transversus abdominis and this muscle wraps around the abdominal contents and acts like a corset to draw in your lower abdomen. This increases the intra-abdominal pressure, contributing to stabilising your spine. The transversus abdominis is often referred to as the ‘core stabiliser’.

To activate this stabiliser, imagine you are putting on a pair of trousers that are just a little too tight around your lower tummy. Breathe in, out, pause a moment, and while in pause, slowly and gently draw in your lower tummy as you would to help do up the button on your trousers. Hold this tension for 5-10 seconds while resuming a normal breathing pattern. Try this exercise when you are lying down, sitting up or standing. The more you practise gently holding in your lower abdomen, the more stable your spine will be.

It is important that you consciously activate your transversus abdominis every time you perform any movements that involve the trunk or limbs. Every time you squat down, pick up an object, reach out, or carry something heavy, draw in your lower abdomen beforehand to stabilise your spine, protecting it from damaging forces. If under heavy load, your larger outer muscles should come into action to help perform the activity.

 

Sacroiliac Joint (SIJ) Pain

The Sacroiliac Joint or “SIJ” is where the sacrum joins to the ilium (pelvis). The sacrum is the supportive section of bone between the base of our spine and our coccyx (tail bone). We have two SIJs, one either side of the sacrum, and each SIJ is reinforced with strong ligaments. The role of the SIJ is to support the spine and allow the gentle twisting movement of our pelvis as we walk, run, or play sport.

SIJ pain, often referred to as SIJ dysfunction, may be caused by inflammation within the joint, and is usually due to the joint being hypermobile (overly mobile) or hypomobile (stiffness). Pain will most commonly be felt on one side or down one leg. The abnormal function in the SIJs may cause lumbar, buttock, hamstring, or groin pain. The pain may be sharp or a dull ache and it may cause difficulty rolling in bed, getting out of the car, or putting on shoes and socks.

During pregnancy our bodies produce a hormone called Relaxin which allows the ligaments to loosen up to allow room for the growing baby, and for during delivery. The SIJs often becomes hypermobile before, during and after pregnancy; in fact relaxin can stay in your body for up to 9 months after giving birth. If you are having any low back/pelvic or hip pain during or post pregnancy, speak to your physiotherapist, as you may have SIJs that need a bit of extra support.

Up to 50% of people suffering from low back pain also have a pelvis dysfunction which will be contributing to their pain. It is essential that you have you pelvis assessed as part of your complete treatment for your low back pain in order to prevent re-occurrences.

 

Acute Low Back Pain

80% of people will experience low back pain at some stage in their life. Acute low back pain is the sudden onset of pain in the lumbar region centrally, on one side, or radiating out to both sides. It may radiate to the buttocks, hamstrings or lower leg. Causes may include relatively minor movements, prolonged bending, heavy lifting, awkward positions, exposure to cold and wet conditions, working on unstable surfaces, trauma from slipping, or fatigue/lack of control during a movement. These in turn may cause muscle strains, ligament strains, disc problems or sciatica.

The best thing to do if you are suffering acute low back pain is to find a position that is most comfortable. The best resting positions are usually
•    Lying flat on your stomach
•    Lying on your back with your knees bent or a pillow under the knees,
•    Side-lying with a pillow between the knees

 Avoid forward bending, prolonged sitting, and minimize lifting until your back pain has resolved. Generally heat will help to relax excessive muscle tension, but cold for an acute strain may also alleviate pain. Non-steroidal anti-inflammatory or muscle relaxant drugs may also be indicated once an injury has occurred. Check with your GP or Physiotherapist for further advice.

Download our information brochure on Low Back pain for more information

Call us on 9251 5111, email  This email address is being protected from spambots. You need JavaScript enabled to view it.   or click here to arrange an appointment with one of our experienced Physiotherapists today. We can assist you with your back pain from the acute phase with hands on therapy through to the final stages of your rehabilitation with Pilates and exercise based sessions and ergonomic workstation assessments.

Chronic Low Back Pain

Back pain is considered chronic when it has been present for 3 months or more. Pain can be felt in any form including, dull ache, sharp, tingling, burning, defined, vague, intense, mild, etc. The pain may have originated from an injury, surgery, disease, but a lot of the time the source of the pain is not known. In fact, the injury or condition that initially triggered the pain may be completely healed and even undetectable on scans, but you may still be experiencing pain.

When a ligament, joint, muscle or any other structure in our body is injured or diseased, the nerve endings in this structure will send pain signals up the spinal cord to the brain. Your brain registers the feeling as pain. This is your body’s way of protecting itself against further harm.

Chronic pain is thought to be when these pathways from nerve ending to brain become sensitized, and your brain becomes so good at perceiving the signal as pain, that even the smallest stimuli can set off a big pain feeling. These signals are real, but due to the complex and increased sensitivity of your nervous system, your brain is unable to distinguish what is from structural changes in the tissues and what are pain signals. Chronic pain can cause not only physical disability, but psychological stress.

Think of your body as an orchestra – the more you practice a piece of music, reading each note on the sheet in front of you, the more precise and fluent you become. You will get to a point where all you need to hear is the first note of the song, and you can automatically play the rest – without even having to look at the page! With chronic pain, your brain gets so used to playing the same pathway of pain, that even the smallest stimuli can set the brain off to “play the pain” song.

It is important for your body to recognize what is helpful and what is harmful, and understanding that sometimes your brain may register something you are doing as painful, even when it is doing no harm to your body. The good news is you can learn how to retrain your brain which can help you cope with chronic pain. Be aware that thoughts, emotions, and moods are nerve impulses too, so these can trigger off feelings of pain. Try to stay positive.  If you feel stressed discuss this with your GP.  They may be able to help.

Your Health Domain physiotherapists in the Sydney CBD are here to help you get your body moving again, and retrain you to move in the correct, pain-free way. Set positive goals with your physiotherapist, and see how you can be in charge of your body! There may be underlying causes contributing to your back pain inclusive of poor posture and poor back ‘habits’ that leads to ongoing stress to one area of your spine Being more aware of your posture and the muscles that support your spine, as well as the stresses you place your spine under during the day can help your symptoms

Call us on 9251 5111, email  This email address is being protected from spambots. You need JavaScript enabled to view it.   or click here to arrange an appointment with one of our experienced Physiotherapists today. We can assist you with your back pain from the acute phase with hands on therapy through to the final stages of your rehabilitation with Pilates and exercise based sessions and ergonomic workstation assessments.

 

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Pitt St. City Practice

Address:
Level 7 60 Pitt Street Sydney 2000
Hours of Operation:
Mon - Fri 7:30am - 6:00pm
Telephone:
(02) 9251-5111

King Street Practice

Address:
Fitness First - The Zone / 94 King Street Sydney 2000
Hours of Operation:
Mon - Fri 7:30am - 6:00pm
Telephone:
(02) 9251-5111