FAQs

Back Injuries: A Physiotherapist's Guide

Back injuries, encompassing muscle strains, ligament sprains, bulging discs, bone injuries, and the impact of poor posture, are a prevalent health concern. This guide, written from a physiotherapist's viewpoint, offers insights into these injuries and practical advice for management and prevention.

Back Muscle Strains

Easing Muscle Strains with Physiotherapy

Muscle strains are often due to fatigue, excessive loads, or improper lifting techniques. Strengthening your back muscles is crucial for joint stabilisation and injury prevention. Physiotherapy plays a key role in recovery, offering tailored exercises to enhance muscle strength and flexibility.

For more detailed information, visit Back Muscle Pain.

Ligament Sprains

Recovering from Ligament Sprains

Ligaments, the fibrous bands that limit spinal movement, can tear when overstretched. Common causes include awkward lifting, sports, and accidents. Physiotherapy accelerates healing through targeted treatments, reducing pain and aiding a quicker return to normal activities.

For additional insights, explore Back Ligament Sprains.

Bulging Discs

Managing Bulging Discs Effectively

Intervertebral disc injuries, or bulging discs, occur when the disc's outer fibres weaken, pressing against spinal nerves. Symptoms can include pain, spasms, and numbness. Physiotherapy offers non-invasive solutions to alleviate symptoms and promote disc health.

Further reading available at Bulging Discs.

Bone Injuries

Addressing Bone Injuries and Osteoporosis

Spinal fractures can result from traumatic force or conditions like osteoporosis. Physiotherapy assists in pain management and rehabilitation, focusing on safe, bone-strengthening exercises.

Learn more at Osteoporosis.

Poor Posture

Correcting Poor Posture to Prevent Back Pain

Poor posture, whether sitting, standing, or lifting, can lead to significant back strain. Physiotherapists can guide you in adopting healthier posture habits, thereby reducing the risk of back pain.

Explore more at Poor Posture.

Conclusion

Embracing a Pain-Free Back

Back injuries, while common, are manageable and often preventable. Embracing physiotherapy, along with lifestyle changes, can significantly improve back health and quality of life.

What to Do?

Seeking Professional Advice

If you're experiencing back pain or injury, consulting a physiotherapist or doctor is a wise step. They can provide a comprehensive assessment, personalised treatment plan, and practical advice to aid your recovery journey.

Back Pain Info

• Common Causes of Back Pain
• Back Pain Products & FAQs

What is the Best Back Pain Treatment Approach?

Back pain is a common issue affecting many people. Treatment for back pain should be tailored to individual needs, considering factors like underlying causes, genetics, and overall health. This article discusses effective treatment options for back pain and the importance of personalised care.

As physiotherapists, we follow the latest Low Back Pain Clinical Standards as the basis of your individualised back care assessment and treatment. These guidelines were updated in 2022.

Low Back Pain Clinical Care Standards

1. Early Clinical Assessment

Assessing patients early in each new presentation of back pain is crucial. During the initial clinical assessment, consider:

• Targeted history: Document pain, past history, functional capacity, and health comorbidities. Identify any signs of specific or serious pathology.
• Physical examination: Evaluate movement, functional capacity, and pain interference.
• Neurological examination: Focus on patients with back pain that extends to the legs.

2. Referral and Monitoring

Refer or conduct investigations if there's a suspicion of serious underlying pathology. Immediate referral to an emergency department is necessary for suspected cauda equina compression, spinal infection, or acute severe neurological deficit. Consider imaging if there's a suspicion of a fracture.

Imaging for Serious Pathology

Imaging is vital for identifying serious pathology when suspected. It's not recommended for those without features indicating serious pathology, as it often doesn't change management plans and can cause unnecessary concerns. MRI is preferred over CT and X-ray due to better sensitivity and safety.

3. Psychosocial Factors

Screen for psychosocial factors using risk assessment tools like STaRT Back or Örebro. Assess elements that might delay recovery, including:

• Patient concerns, beliefs, and pain-related fears
• Avoidance and protective behaviours
• Pain-related distress, lifestyle factors, and social stressors
• History of mental health issues

4. Patient Education and Advice

Educate patients about the positive natural history of back pain and the low risk of serious underlying disease. Encourage relaxed, graded movement and activity, and returning to work and social activities. Explain that movement won't cause harm and there are no "bad" movements or postures. Provide written explanations and tailored educational resources to reinforce key messages.

5. Self-Management and Physical Activity

Advise patients to maintain or gradually return to normal activities, including spinal movement and physical activity. Prolonged bed rest should be discouraged. Support patients to self-manage symptoms by:

• Prioritising active management strategies
• Mapping out a plan for graded movement and activity
• Setting SMART goals (specific, measurable, achievable, relevant, and time-bound)

6. Physical and Psychological Interventions

Based on psychosocial risk assessment findings, advise active coping strategies to optimise physical and psychological health. For most with new back pain, additional therapies aren't necessary as the pain usually improves naturally. Offer hands-on therapies as an adjunct to facilitate independent symptom management.

7. Judicious Use of Pain Medicines

Physiotherapists can't provide specific advice on pain medication. Patients with severe, distressing pain should consult a GP for pain management. The goal of pain medicines is to reduce pain to support continued physical activity and work, not to eliminate pain completely. Combine pain medicines with physical activity and self-management strategies to improve function and mobility.

8. Review and Referral

If pain persists or worsens, reassess to reconsider diagnosis, check for alerting features (red flags), and review psychosocial factors and self-management engagement. Refer to ED if new concerning features are identified. For disabling back or leg pain, refer to:

• GP for review and pain management
• Specialist physiotherapy for high levels of pain-related fear and distress
• Psychologist for psychological comorbidities
• Imaging and surgical review if severe neurological signs and symptoms persist

Conclusion

Personalised care is essential in back pain treatment. An early assessment, patient education, and a mix of physical and psychological interventions can significantly improve outcomes.

What to Do?

If you're experiencing back pain, seek advice from your physiotherapist. They can guide you through personalised treatment options and help you manage your back pain effectively.

Back Pain Treatment FAQs

1. What is the best treatment for back pain?

Personalised care involving early assessment, patient education, physical activity, and a mix of physical and psychological interventions is considered the best treatment for back pain.

2. What is the fastest way to relieve back pain?

The fastest way to relieve back pain often involves a combination of limited rest, active movement and physical therapy. Consult your physiotherapist for tailored advice.

3. How can physiotherapy help with back pain?

Physiotherapy helps by assessing your condition, providing personalised treatment plans, and guiding you through exercises and self-management strategies to reduce pain and improve mobility.

4. What are the best exercises for lower back pain?

Yes, graded exercise therapy and regular physical activity can help relieve back pain. A physiotherapist can guide you through exercises tailored to your condition. Exercises like gentle stretching, core strengthening, and low-impact aerobic activities are often recommended. Your physiotherapist can provide exercises tailored to your needs. Not all exercises suit every type of lower back pain. Personalised advice is your fastest solution to resolving your back pain.

5. When should I see a physiotherapist for back pain?

You should see a physiotherapist if your back pain persists for more than a few days, interferes with daily activities, or if you experience symptoms like numbness or weakness. More severe symptoms like loss of bladder or boqwel control and leg weakness should be investigated by a visit to an Emergency Department.

6. Can weight loss help reduce back pain?

Yes, losing excess weight can reduce the strain on your lower back and alleviate pain. Combining a healthy diet with regular exercise is highly encouraged. Seek professional guidance if you would like a safe and steady transition to an active pain-free lifestyle.

7. How do you treat severe back pain?

Treating severe back pain may require a combination of physiotherapy, medications, and lifestyle changes. Your physiotherapist can create a specific treatment plan based on your condition. Certain red flags may require an ED appointment.

8. When should I seek medical attention for back pain?

Seek medical attention if you experience severe pain, neurological deficits, or symptoms of serious conditions like cauda equina syndrome. Early assessment and appropriate referral are crucial.

9. Is imaging necessary for back pain?

Imaging is necessary only if there's a suspicion of serious pathology. For most people with back pain, imaging doesn't change the management plan and can cause unnecessary concerns.

10. Can psychological factors affect back pain?

Yes, psychological factors like stress, anxiety, and depression can affect back pain. Addressing these factors through appropriate interventions can enhance recovery.

Related Articles

1. Lower Back Pain - Discusses common causes and treatment options for lower back pain.
2. Sciatica Treatment - Explains effective treatments for sciatica pain.
3. Core Stability Exercises - Offers exercises to strengthen core muscles and support the lower back.
4. Posture and Back Pain - Explains the link between posture and back pain and offers solutions.
5. Acupuncture for Back Pain - Discusses how acupuncture can help relieve back pain.
6. Massage Therapy Benefits - Details the benefits of massage therapy for muscle relaxation and back pain relief.
7. TENS Machine for Pain Relief - Explains how TENS machines can help manage pain.
8. Preventing Back Pain Recurrence - Offers tips on preventing recurring back pain.
9. Physiotherapy Techniques - Explains various physiotherapy techniques used to treat back pain.
10. Spinal Stenosis: Understand spinal stenosis and the best ways to manage it.
11. Chronic Pain Management: Strategies to manage chronic pain effectively.
12. Causes of Back Pain: Different causes of back pain and how to address them.

Recurrent Back Pain

Breaking the Cycle of Pain

Recurrent back pain often presents a persistent challenge, impacting work, leisure, and overall quality of life. Understanding the contributing factors and adopting effective management strategies are crucial steps towards breaking this cycle of pain and discomfort.

Recurrent Back Pain Incidence

A research study of 250 back pain suffers found that within 12 months after back pain recovery, 69% had a recurrence of an episode of low back pain. The median time to recurrence of an episode of low back pain was 139 days. Frequent exposure to awkward postures, longer time sitting (> 5 hours per day), and more than two previous episodes were predictive of recurrence episode. (da Silva et al 2019)

Understanding the Nature of Recurrent Low Back Pain

Characterised by episodes that reoccur over time, recurrent low back pain may initially stem from muscle strains or poor posture. However, its persistence often signals underlying issues such as muscle imbalances, age-related changes, or degenerative conditions.

A Physiotherapist's Approach to Assessment

A thorough assessment by a physiotherapist is the first step in addressing recurrent low back pain. This process typically includes an evaluation of your posture, movement, joint function, and muscle strength. In some instances, additional imaging like X-rays or MRIs may be necessary, but this is not always required.

Contemporary Pain Management Strategies

Pain management encompasses a range of strategies, from heat or cold therapy to over-the-counter medications. However, it's essential to consult with a spinal physiotherapist or doctor to determine the most suitable approach for your specific situation.

Lifestyle Modifications for Long-Term Relief

Adjusting your lifestyle can significantly reduce the recurrence of low back pain. This includes improving sleep quality, reducing prolonged sitting, and incorporating regular breaks into your daily routine.

Back Exercise: The Key to Strengthening and Flexibility

Tailored exercise programs designed by physiotherapists can strengthen core muscles, enhance flexibility, and correct muscle imbalances. Consistency and adherence to these exercises are vital for long-term relief.

The Importance of Posture and Ergonomics

Poor posture is a common factor in recurrent low back pain. Making ergonomic adjustments at work and maintaining proper posture can significantly alleviate back strain.

Mindfulness and Stress Management

Stress and anxiety can worsen low back pain. Techniques like yoga, meditation, and deep breathing exercises not only manage stress but also positively influence your overall experience of pain.

Weight Management: A Crucial Element

Maintaining a healthy weight is essential in managing recurrent low back pain, as excess weight adds extra strain on the spine. A balanced diet and regular physical activity are key components of effective weight management.

Regular Physical Activity for a Healthier Back

Incorporate activities such as walking, swimming, or cycling into your routine to improve overall fitness and spinal health. Choose exercises that are suitable for your specific condition.

Empowering Yourself Against Recurrent Back Pain

Overcoming recurrent low back pain requires a combination of professional guidance, targeted exercises, lifestyle changes, and stress management. Consistency and a commitment to long-term well-being are fundamental to success.

What to Do? Seek Professional Advice

If recurrent low back pain is affecting your life, consulting with a physiotherapist is a crucial step. Our physiotherapists at PhysioWorks can develop a personalised plan tailored to your unique needs and goals, guiding you towards long-term relief and improved quality of life.

Related Articles

1. Lower Back Pain - Understanding & Managing - Physio Tips: Offers insights into the prevalence of low back pain and various treatment success stories. It emphasises the importance of seeking professional advice for musculoskeletal disorders.
2. Back Pain Physiotherapy: Your Guide To What To Expect: Discusses the effectiveness of physiotherapy in managing back pain, covering treatments for disc-related injuries, back joint injuries, nerve-related injuries, pelvis-related injuries, and systemic diseases affecting the back​​.
3. Core Stability Training For Effective Low Back Pain Relief: Highlights the benefits of core stability training in reducing low back pain, including a discussion on recent research and the importance of a personalised core stability program​​.
4. Effective Back Exercises And Core Strength: Physio Insights: Provides information on exercises and core strength development for low back pain relief, emphasising the role of muscle injuries and core stability deficiency in causing pain.
5. Back Pain Prevention: Essential Tips From A Physiotherapist: Focuses on the role of exercise combined with education in reducing the risk of low back pain episodes, showcasing PhysioWorks' approach to tailored exercise programs for flexibility, strengthening, and postural control.
6. Pulled Back Muscle: Offers details on the terminology used to describe muscle and ligament injuries in the back, including diagnostic tools and treatment options.

Real-Time Ultrasound Physiotherapy

What conditions may be assisted by real-time ultrasound physiotherapy?

• Lower Back Pain - Transversus Abdominus & Multifidus
• Sciatica
• SIJ Pain / Pelvic Instability
• Pregnancy Back Pain
• Hip Pain - Gluteal tendinopathy
• Shoulder Pain - Rotator Cuff
• Knee Pain - VMO activation
• Foot Exercises - Flat Feet
• Core Exercises
• Pelvic Floor
• Pilates
• Dry Needling

Lower Back Pain

Ultrasound retraining your Core Stability Muscles has fantastic benefits for sufferers of low back pain. Researchers have investigated the benefits of ultrasound retraining since the 1990s. They have discovered that your chances of not experiencing another bout of low back pain (LBP) within 12 months are 4.4 times better if you have undertaken an ultrasound-guided exercise program: 70% vs 16%.

Its effectiveness also lasts. After three years, you still have a 2 in 3 chance of not experiencing LBP if you did the exercises. Hides et al. (2001).

More info: Lower Back Pain

Sciatica

Ultrasound retraining of your Core Stability Muscles has fantastic benefits for sciatica sufferers. Since the vast majority of sciatica is caused by sciatic nerve pinching in the low lumbar spine, a treatment that helps your back will almost always alleviate sciatica.

More info: Sciatica

SIJ Dysfunction

The Sacroiliac Joint (SIJ) should be a reasonably stiff or rigid link between the pelvic bones. In some people, the SIJ has too much uncontrolled motion due to trauma or just extra mobility. This new motion allows the joint to adopt an unusual position, which may result in pain.

Through their attachments to the iliac bones, the transversus abdominis (TA) and oblique abdominals help the pelvis's closure and improve the sacroiliac joints' position, control, and stability.

Researchers have discovered that the contraction of the TA muscle significantly stiffens and supports the sacroiliac joint. This improvement is more significant than that caused by an abdominal bracing action using all the lateral abdominal muscles. (Richardson et al. 2002)

More info: SIJ Pain

Pelvic Floor Retraining

Strong pelvic floor muscles are essential for men and women. Women have been encouraged to exercise their pelvic floor muscles for decades, but now we understand that it is just as vital for men. Research has found that a durable pelvic floor improves:

• Incontinence (urine dribbling)
• post-childbirth (women)
• post-prostatectomy (men)
• erectile dysfunction (Uni of Bristol study, 2004)
• sexual sensations and enjoyment (Impotence Association, UK)

More info: Pelvic floor

Pelvis Instability

Some people are born a little more flexible than the rest of us. Usually, these people have poor muscle tone in their deep, stabilising muscles. The transversus abdominis is the most important muscle that holds the two halves of the pelvis together. Core stability retraining will improve your deep core muscle control, which dynamically stabilises your pelvis, SIJ and lumbar spine.

More info: Pelvic Instability

Pregnancy or Post-Childbirth Back Pain

Carrying a child is a physically demanding task. The baby's weight places continual pressure on the pelvic floor muscles and stretches the lower abdominal muscles.

Birth trauma involves further stretching of the pelvic floor muscles and sometimes tearing. Hence, the pelvic floor muscles and the transversus abdominis become weak, stretched and inhibited. A hormone called "relaxin" is released through your body during the months before and post-delivery. Relaxin softens the pelvic ligaments, enabling the pelvis joints to stretch for delivery. This elasticity means the transversus muscle must work even harder to stabilise the pelvis and lumbar spine.

The good news is that Ultrasound Retraining is very safe for the unborn child. The ultrasound equipment is the same as that your Obstetrician uses for routine pregnancy scans.

Caesarian births have additional complications due to cutting muscle layers and, in some cases, nerves. We highly recommend US retraining following a Caesarian delivery.

More info: Pregnancy Back Pain

Post Abdominal Surgery

Abdominal and pelvic surgery involves cutting through the muscle layers. Along with post-operative pain, muscle trauma changes the core stability muscles' ability to work efficiently. As with other muscle cuts, your Transversus Abdominis, in particular, needs to be strengthened post-operatively. Otherwise, it will almost certainly remain permanently weak.

The lower part of the transversus muscle fibres is separated (such as in appendix removal or caesarean births). Because of this, you need to retrain the muscle to learn how to use it again correctly.

Pre-Pilates, Yoga, Gym & Exercise Programs

Exercise programs that aim to develop your core strength can often do just the opposite. The most common reason for injury and back pain is incorrect muscle recruitment timing. Pilates, Yoga, gym strengthening, and other exercise forms place high demands on your core stability system. Suppose the core muscle recruitment order is abnormal. Your chance of injury increases in proportion with the exercise difficulty.

Research has identified that the order of core muscle recruitment is the most critical factor in preventing or resolving pain.

Remember, if you build a skyscraper on a weak foundation, it will eventually topple. The same goes for your core stability muscles. Recruit the deeper muscles before your superficial layers, just like adding floors to a sturdy skyscraper and your back will be healthy and pain-free forever.

More info: Pilates

"Pot Belly" Syndrome

"Pot Belly" - or whatever you wish to call it, is a cosmetic problem related to your lower stomach muscles.

Some people have lax lower stomach muscles. No matter how hard you pull in your tummy, the lower part doesn't pull in. Ultrasound retraining is a valid alternative to cosmetic surgery.

The problem is that the transversus abdominis muscle has stopped working effectively, and the upper abdominal muscles dominate. Hence as you attempt to pull in your stomach muscles, the upper stomach muscles suck in, but the lower part doesn't. The result is a "Pot Belly"."Pot Belly" is a common problem post-pregnancy.

With Ultrasound Retraining, you can learn to draw in your lower tummy muscles and solve your "Pot Belly" forever!

Real-Time Ultrasound Clinics

• Ashgrove PhysioWorks
• Sandgate PhysioWorks

Real-Time Ultrasound Physiotherapy FAQs

• Real-Time Ultrasound Physiotherapy
• What Conditions Are Assisted By Real-Time Ultrasound Physiotherapy?
• Is Ultrasound Physiotherapy The Whole Solution For Lower Back Pain?
• Real-Time Ultrasound Physiotherapy: What To Expect?
• Real-Time Ultrasound Physiotherapy Clinics - Brisbane
• Lower Back Pain

Ultrasound Physiotherapy

A Potential New Hope for Lower Back Pain Sufferers

Introduction

Are you battling with persistent lower back pain? Ultrasound physiotherapy might be the solution you've been looking for. With research studies showing a 70% success rate in preventing the recurrence of lower back pain, this innovative approach is changing lives.

The Power of Ultrasound Physiotherapy

Ultrasound physiotherapy stands out for its effectiveness in not only treating but also preventing lower back pain. One study revealed that patients who underwent ultrasound physiotherapy had a 4.4 times higher chance of avoiding repeat back pain within a year compared to those who didn’t. What's more, 65% of these patients didn’t experience another bout of pain in the following three years.

What is Ultrasound Physiotherapy?

Ultrasound physiotherapy uses sound waves to provide a real-time view of your muscles and joints. This technique enables physiotherapists to diagnose and treat lower back pain more accurately. It's a non-invasive, pain-free method that can significantly improve your recovery process.

Is Ultrasound the Complete Solution?

While ultrasound physiotherapy is highly effective, it's part of a broader treatment plan. Your physiotherapist will combine it with other techniques like manual therapy, exercises, and education about back care to ensure a holistic recovery.

What to Expect During Treatment

During an ultrasound physiotherapy session, you'll experience a detailed examination of your lower back. The physiotherapist will use a handheld device to glide over your skin, providing a clear image of the underlying muscles and tissues. This process helps in identifying the exact cause of your pain and tailoring a precise treatment plan.

Consulting a Physiotherapist

If you're considering ultrasound physiotherapy, consult a qualified physiotherapist with real-time ultrasound available in their clinic. They can assess whether this treatment is suitable for your specific condition.

PhysioWorks Real Time Ultrasound Clinics

• Ashgrove PhysioWorks
• Sandgate PhysioWorks

Conclusion

Ultrasound physiotherapy offers a promising path to relief for those suffering from lower back pain. Its non-invasive nature and high success rate make it a preferred choice for many.

What to Do?

If you're experiencing lower back pain, don't wait. Book an appointment with a physiotherapist trained in real-time ultrasound therapy. Early intervention can prevent chronic issues and help you get back to your pain-free life faster.

Related Articles

• Understanding Lower Back Pain: Causes and Solutions
• Effective Exercises for Lower Back Pain Relief
• Your Guide to Managing Chronic Back Pain

Real-Time Ultrasound Physiotherapy FAQs

• Real-Time Ultrasound Physiotherapy
• What Conditions Are Assisted By Real-Time Ultrasound Physiotherapy?
• Is Ultrasound Physiotherapy The Whole Solution For Lower Back Pain?
• Real-Time Ultrasound Physiotherapy: What To Expect?
• Real-Time Ultrasound Physiotherapy Clinics - Brisbane

Back Pain Info

• Common Causes of Back Pain
• Back Pain Products & FAQs