Physiotherapy Treatment Options for Low Back Pain (Part I)

Experiencing pain in the lower back is a very common complaint experienced by about 80% of the population in some point of their lives. Back pain is often caused by poor posture when standing or sitting, such as hunching over the computer throughout the day, or slouching when waiting for a cab. Lifting heavy objects constantly such as boxes of products and even sleeping posture such as sleeping on the stomach can be harmful to the back as it places unwanted pressure on joints and muscles. So what are the options for people suffering from lower back pain?

There is a wide variety of treatment options for Low Back Pain. Some of the more treatments available include

• Joint Mobilisation/Manipulation
• Core  Strengthening Exercises
• Postural Correction and Advice
• Mckenzie Therapy
• Traction
• TENS
• IFS
• Ultrasound
• Myofascial Release

Joint Mobilisation/Manipulation

Low Back Pain sufferers tend to have very stiff joints either a cause or result of low back pain. Minimal body movement to avoid further straining the back encourages the joints to stiffen up. Joint mobilisation helps to loosen these stiff joints; by physically mobilising or moving the bones that make up the joint.

There are different grades of mobilisation (Grade 1 to 4) that reflect how vigorously the physiotherapist moves the joint. Manipulation is a form of mobilisation (Grade 5) where the physiotherapist moves the joint extremely fast over a small range of motion. One typically hears “clicking” and “popping” sounds.

Core Strengthening Exercises

One of the common reasons behind chronic low back pain is weak core muscles. Core muscles are your deep trunk muscles that support and help stabilise the spine. The physiotherapist help strengthen these muscles by retraining specific trunk muscles through a set of exercises.

These exercises may include using a gym-ball or foam roller to simulate instability to help train the core muscles. Experienced and creative physiotherapists may not need these equipments. During the exercise, the physiotherapist will assist the patient to contract the deep muscles for as long as possible in various situations so as to enjoy better mobility and experience less fatigue, increased range of movement and flexibility overtime.

Postural Correction and Advice

Poor posture often leads to low back pain, neck pains and even tension headaches. In such cases, the physiotherapist will assess and correct your posture always as advice on maintaining good posture and correct posture. The physiotherapist might also advise you on how to create an ergonomic environment to improve posture and relieve pain. Patients who follow the right steps to maintaining good posture daily will experience fewer symptoms overtime.

Mckenzie Therapy

This is a broad approach to exercise that advocates the effectiveness of self-treatment rather than manual therapy to relieve back pain as well as neck pain. It is recommended for people with acute low back pain and those whose back pain had spread to the arms and legs.

Mckenzie advocates centralised phenomenon, which is to help patients to reduce pain in buttocks and legs arising from back pain. The physiotherapist will thoroughly assess the patient’s movements when doing daily activities before prescribing a set of exercises.

The physiotherapist suggest certain activities, movements and recommended postures to the patient to centre the spine and centralise the pain. Overtime, pain in buttocks and legs will be reduced or disappear altogether. Depending on the complaint and problem, patients doing the Mkenzie therapy will take anywhere from a few weeks to months to expect significant relief.

.. continue in Part 2