LOWER BACK PAIN
If you have lower back pain, you are not alone. About 80 percent of adults in UK experience low back pain at some point in their lifetimes.
If you suffer from lower back pain, there is no reason why you have to stay in pain.
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On this page you will find information on the condition along with symptoms and potential diagnosis pathways to manage and treat the condition from an anatomical point of view.
Common condition
A common condition that Physio's treat in the lumbar spine is a Lumbar Disc Herniation.
Although people often refer to a disc herniation as a slipped disc, the disc doesn't actually slip out of place. Rather, the term herniation means that the material at the centre of the disc has squeezed out of its normal space.
This guide will help you understand:
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How the problem develops
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How Physio's diagnose the condition
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What treatment options are available
Symptoms
Back pain can have many symptoms, including:
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a dull aching sensation in the lower back
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a stabbing or shooting pain that can radiate down the leg to the foot
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an inability to stand up straight without pain
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a decreased range of motion and diminished ability to flex the back
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Back pain is chronic when symptoms have been present for longer than three months.
Back pain symptoms that may indicate a serious problem
See your doctor if back pain doesn’t improve within two weeks of developing. There are times when back pain can be a symptom of a serious medical problem. Symptoms that can indicate a more serious medical problem are:
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loss of bowel or bladder control
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numbness, tingling, or weakness in one or both legs
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onset following trauma, such as a fall or a blow to the back
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intense, constant pain that gets worse at night
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presence of unexplained weight loss
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pain associated with a throbbing sensation in the abdomen
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presence of fever
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Let your doctor know if you have any of these symptoms.
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Diagnosis
Diagnosis begins with a complete history and a physical examination. When you first visit us, we will ask questions about your symptoms and how your problem is affecting your daily activities. These will include questions about where you feel pain and whether you have numbness or weakness in your legs. Our Physiotherapist will also want to know what positions or activities make your symptoms worse or better. We rely on your report of pain to get an idea about which disc is causing problems and if a nerve is being squeezed.
Then our physiotherapist will physically examine you to determine which back movements cause pain or other symptoms. Your skin sensation, muscle strength, and reflexes are also tested.
Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the Physiotherapist will advice treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.
Our Treatment
Non-surgical Rehabilitation
Unless your condition is causing significant problems or is rapidly getting worse, treatment for lumbar disc herniation usually begins with non surgical treatment. Most people with a herniated lumbar disc get better without surgery. As a result, it is usually recommended that patients try non operative treatments for at least six weeks before considering surgery.
At first, your Physiotherapist may want your low back immobilized. Keeping the back still for a short time can calm inflammation and pain. This might include a period of bed rest. Lying on your back can take pressure off sore discs and nerves. However, we usually advise against strict bed rest and prefer their patients to do ordinary activities using pain to gauge how much is too much. In rare cases in which bed rest is prescribed, it is usually used for a maximum of two days.
A back support belt is sometimes used for patients with lumbar disc herniation. The belt can help lower pressure inside the problem disc. Our patients are encouraged to gradually discontinue wearing the support belt over a period of two to four days. Otherwise, their trunk muscles begin to rely on the belt and start to weaken and atrophy (shrink).
Our Physiotherapy treatments focus on relieving pain, improving back movement, and fostering healthy posture. The first goal of our treatment is to control symptoms. Your Physiotherapist will help you find positions and movements that ease pain. Treatments of heat, cold, ultrasound, and electrical stimulation may be used in the first few sessions. In addition, our Physiotherapist may use hands-on treatments such as massage or spinal manipulation. These forms of treatment are mainly used to help reduce pain and inflammation so you can resume normal activity as soon as possible.
Your physiotherapist will show you how to keep your spine safe during routine activities. You'll learn about healthy posture and how posture relates to the future health of your spine. We will teach you about body mechanics, how the body moves and functions during activity. Our physiotherapists teach safe body mechanics to help you protect the low back as you go about your day. This includes the use of safe positions and movements while lifting and carrying, standing and walking, and performing work duties.
The next part of our program will include a series of strengthening exercises for the abdominal and low back muscles. Working these core muscles helps our patients begin moving easier and lessens the chances of future pain and problems. Aerobic exercises such as walking or swimming are used for easing pain and improving endurance.
We will work closely with your doctor and employer to help you get back on the job as quickly as reasonably possible. You may be required to do lighter duties at first, but as soon as you are able, you'll begin doing your normal work activities. We may suggest changes that could help you work safely, with less chance of re-injuring your back.
A primary purpose of your Physiotherapy is to help you learn how to take care of your symptoms yourself and prevent future problems. We'll provide you with a home program of exercises to continue improving flexibility, posture, endurance, and low back and abdominal strength. Our Physiotherapist will also discuss strategies you can use if your symptoms flare up.
When patients simply aren't getting better during their therapy program, or if the problem is becoming more severe, surgery may be suggested.
Post Surgical Rehabilitation
Rehabilitation after surgery is more complex. Some patients leave the hospital shortly after surgery. However, some surgeries require patients to stay in the hospital for a few days.
During recovery from surgery, patients should follow their surgeon's instructions about wearing a back brace or support belt, and should be cautious about overdoing activities in the first few weeks after surgery.
Although recovery time varies for each patient, as a guideline you may expect to see our Physiotherapists for one to three months, depending on the type of surgery. At first, your Physiotherapists may use treatments such as heat or ice, electrical stimulation, massage, and ultrasound to help calm pain and muscle spasm. We provide reassurance to help you deal with fear and apprehension about pain. Then our Physiotherapists will teach you how to move safely while putting the least strain on your healing back. Exercises are used to improve flexibility, strength, and endurance.
When your recovery is well under way, your regular visits to us will end. Although we will continue to be a resource, you will be in charge of doing your exercises as part of an ongoing home program.