Back Pain Treatment 2

What is Physiotherapy Treatment?

Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques education and advice.  Physiotherapists maintain physical health, help patients to manage pain and prevent disease for people of all ages. Physiotherapists help to encourage pain-relief, injury recovery, enabling people to stay playing a sport, working or performing activities of daily living while assisting them to remain functionally independent.

There is a multitude of different physiotherapy treatment approaches.

Acute & Sub-Acute Injury Management

Hands-On Physiotherapy Techniques

physiotherapy treatment

Your physiotherapist's training includes hands-on physiotherapy techniques such as:

Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, just to name a few.

Physiotherapy Taping

Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.

Alternatively, your physiotherapist may recommend a supportive brace.

Acupuncture and Dry Needling

Many physiotherapists have acquired additional training in the field of acupuncture and dry needling to assist pain relief and muscle function.

Physiotherapy Exercises

Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly-skilled in the prescription of the "best exercises" for you and the most appropriate "exercise dose" for you depending on your rehabilitation status. Your physiotherapist will incorporate essential components of pilates, yoga and exercise physiology to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.

Biomechanical Analysis

Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.

Hydrotherapy

Aquatic water exercises are an effective method to provide low bodyweight exercises.

Sports Physiotherapy

Sports physio requires an extra level of knowledge and physiotherapy skill to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports Physiotherapist.

Vestibular Physiotherapy

Women's Health

Women's Health Physiotherapy is a particular interest group of therapies.

Workplace Physiotherapy

Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstation set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.

Electrotherapy

Plus Much More

Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your individual problem, please contact your PhysioWorks team.

What is Therapeutic Ultrasound?

Therapeutic ultrasound is an electrotherapy modality which has been used by physiotherapists since the 1940s. Via an ultrasound probe through a transmission coupling gel in direct contact with your skin, ultrasound waves are applied.ultrasound Therapeutic ultrasound may increase:
  • healing rates
  • tissue heating
  • local blood flow
  • tissue relaxation
  • scar tissue breakdown.

How Could Ultrasound Help?

Ultrasound increases local blood flow. This increase may help to reduce local swelling and promote soft tissue healing rates. A higher power density may soften scar tissue.

Specific Ultrasound Uses

Mastitis or blocked milk ducts successfully respond to therapeutic ultrasound. The effect is quite dramatic, with improvement within 24 to 72 hours.The most common conditions treated with ultrasound include soft tissue injuries such as muscle, ligament injuries or some tendinopathies.Phonophoresis uses ultrasound in a non-invasive way of administering medications to tissues below the skin. This method may assist patients who are uncomfortable with injections. With phonophoresis, the ultrasonic energy forces the drug through the skin.

What is an Ultrasound Dose?

A typical ultrasound treatment will take from 3-10 minutes. Where scar tissue breakdown is the goal, this treatment time could be much longer. During the procedure, the head of the ultrasound probe is in constant motion. If kept in continuous motion, the patient should feel no discomfort at all.Some conditions treated with ultrasound include soft tissues injuries such as muscles or ligament injuries, tendinopathy, non-acute joint swelling and muscle spasm.

How Does an Ultrasound Work?

A piezoelectric effect, caused by the vibration of crystals within the ultrasound head of the probe creates the sound waves. The ultrasound waves generated then pass through the skin cause a vibration of the local soft tissues. This repeated cavitation can cause a deep heating locally though usually no sensation of heat will be felt by the patient. In situations where a heating effect is not desirable, an athermal application occurs. Athermal doses are typical during acute fresh injury and the associated acute inflammation.

When Should Ultrasound be Avoided?

Contraindications of ultrasound include:
  • local malignancy,
  • over metal implants,
  • local acute infection,
  • vascular abnormalities,
  • active epiphyseal regions (growth plates) in children,
  • over the spinal cord in the area of a laminectomy,
  • over the eyes, skull, or testes
  • and, directly on the abdomen of pregnant women. Treatment ultrasound differs from diagnostic ultrasound!
Like all medical equipment, when used by highly trained professionals, such as your physiotherapist, therapeutic ultrasound is very unlikely to cause any adverse effects. Please consult your physiotherapist for their opinion on whether therapeutic ultrasound could assist your injury.Therapeutic Ultrasound differs from Real-Time Ultrasound Treatment.

Lower Back Pain Treatment Guidelines?

While lower back pain treatment will vary depending on your specific diagnosis, your physiotherapist will have the following aims.

PHASE I - Back Pain Relief & Protection

Managing your back pain is the main reason that you seek treatment for lower back pain. In truth, it was the final symptom that you developed and should be the first symptom to improve.Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include ice, electrotherapy, acupuncture, de-loading taping techniques, soft tissue massage. A course of non-steroidal anti-inflammatory drugs such as ibuprofen may also help in this phase.

PHASE II - Restoring Normal ROM and Strength. Early Back Exercises.

As your lower back pain and inflammation settles, your lower back pain may feel better. Still, you are more vulnerable to re-injury during this honeymoon period when you don't have pain, but your muscles and ligaments are weak. During this phase, your physiotherapist will turn their attention to restoring your normal lumbar spine motion. Plus they'll assess your muscle length and resting tension, muscle strength and endurance, proprioception, balance and gait (walking pattern).Your physiotherapist may commence you on a lower abdominal core stability program to facilitate your important muscles that dynamically control and stabilise your lower back and pelvis. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best back exercises for your specific needs.

PHASE III - Restoring Full Function

Depending on your chosen work, sport or activities, your physiotherapist will aim to restore your back's function to allow you to return to your desired activities safely. Everyone has different demands for their lower back that will determine what specific treatment goals you need to achieve. For some, it is merely to walk around the block. Others may wish to run a marathon or be a fast bowler. Your physiotherapist will tailor your back pain rehabilitation to help you achieve your own functional goals.

PHASE IV - Back Exercises - Preventing a Recurrence

Recurrence of lower back pain can occur. The main reason for a recurrence is due to insufficient rehabilitation. In particular, poor compliance with deep abdominal core muscle exercises. You should continue a version of these back exercises routinely a few times per week. Your physiotherapist will assist you in identifying the best activities for you to continue indefinitely.

Suffering Back Pain. What Should You Do?

While lower back pain is commonplace, the diagnosis of the cause of your back pain is specific to you, and therefore, the treatment or investigation pathway varies for each case.A spinal health care professional can assist you with a prompt diagnosis, early referral, acute and chronic back pain relief, plus long-term self-management or back pain prevention strategies specific to you. You should feel confident that your practitioner has screened you particular pathologies that require urgent medical attention. They should assess you for neurological deficits such as:
  • loss of bowel or bladder function,
  • leg muscle weakness,
  • loss of sensation,
  • diminished reflexes,
  • and, day-to-day function.
A thorough assessment will determine whether you have radiculopathy or stenosis. This diagnosis is essential since treatment usually differs from NSLBP or radicular pain.For specific recommendations, please consult a musculoskeletal physiotherapist or another spinal healthcare practitioner.You probably already know that back pain has a nasty habit of returning within a few months of the initial injury. Research has shown that you have an 80% chance of recurring back pain within 12 months of the first episode.  The good news is that you can reduce your chances significantly if you do the right thing early.

What Should You Do When You Suffer Back Pain?

Rest?

The latest research recommends that you only spend a day or two resting in bed. More extended periods cause muscle weakness which ultimately makes repeat back pain more likely.

Ice or Heat?

We recommend ice treatment for 20 minutes every 2 or 3 hours for the first 48 hours. The ice should help reduce your pain, swelling and back spasms. After a few days, you are safe to use heat packs. We usually recommend avoiding heat (and heat rubs) in the first 48 hours. Heat packs encourage bleeding, which could be detrimental if used too early.

Should You Use a Back Brace?

A back brace can help you to get back on your feet or allow you to return to work sooner. We don't encourage long-term use because research has shown that your stomach and back muscles will weaken as you become reliant on the brace.

What Medication Should You Use?

Your Doctor or Pharmacist may recommend pain relief in the form of paracetamol or an anti-inflammatory.  You are best seeking their advice as certain drugs can interfere with other health conditions.

When Should You Commence Physio?

In severe cases, when the slightest movement causes unbelievable pain or spasm, it may be best to wait a day or two to start treatment. This delay will allow the majority of swelling to settle.  Slight niggles or "my back feels out" sufferers can usually commence treatment (and maybe fixed) on the day of injury.  If you are not sure what to do, please call us for advice. We'll happily guide you in your time of need.

What About Core Stability Training?

The current trend in physiotherapy and fitness training is 'core stability training' (back and abdominal muscle control).

What If You Do Nothing?

Research tells us that symptoms lasting longer than three months become habitual and are much harder to solve. The sooner you get on top of your symptoms, the better your outcome and the quicker you'll get back to living your life."Back pain is something you could be suffering needlessly".

What Results Should You Expect from Physiotherapy?

Not only will your physio diagnose the cause of your pain and give you the "peace of mind" associated, but they'll also help you to:
  • Relieve your pain quicker
  • Cope better with your pain using proven strategies and tips
  • Get you back to work and play quicker through faster healing rates
  • Loosen and strengthen your back with individually prescribed exercises
  • Prevent future bouts of back pain via our holistic back pain management approach
Think about it. Back Pain is Something You Could be Suffering Needlessly.Please use our expert advice to guide you out of pain quicker and for a lot longer.If you have any questions regarding your back pain (or any other condition), please call us now to discuss your situation. You'll find our friendly staff happy to point you in the right direction.

Core Exercises

While all back exercises that strengthen the muscles that traverse your back are essential, back pain researchers have emphasised retraining your deep core muscles as a priority."Core Stability" is your body's ability to control and support your spine via specific muscles dynamically.Your spine is an inherently unstable area of your body. Your lower back has five vertebrae that allow twisting, bending and arching with no other bones to assist. They sit on top of a triangular bone called the sacrum, which wedges itself into the pelvis. Unfortunately, without strong support, all of these bones would fall in a heap on the ground.Your deep core muscles are the main structures that support, control and move your lower spine and pelvis. They are also the most energy-efficient and best-positioned muscles to do the job for 24 hours a day.However, when they turn off, your spine is not fully supported by its usual muscular corset. This lack of support makes it quite vulnerable to injury and chronic pain.Research has shown that our back pain causes your "deep core stability" muscles to STOP working in EVERY case.The first time you experience low back pain, your brain automatically inhibits the regular activity of the Transversus Abdominis (TA) muscle. This inhibition occurs in 100% of sufferers. Unfortunately, even once the back pain has eased the TA muscle does not automatically switch on again.Inhibition of the TA muscle exposes your spine to further trauma and hence "recurrent back pain". Each incident becomes a little more severe, and consequently, further wasting of the TA occurs.Other causes of muscle inhibition include previous abdominal surgery, pelvic pain and post-pregnancy.

What are the Benefits of Core Stability Training?

Researchers have shown that the correct use of your core stability muscles not only prevents pain but also alleviates pain if you're already suffering. Also, your body's strength, power, endurance and performance will improve. You'll be able to run faster, jump higher and even throw further when these muscles work correctly.For more information, please contact your physiotherapist.

Core Stability Muscles

The deep core stability muscles of the lower spine include:
  • Transversus Abdominis (TA)
  • Multifidus (MF)
  • Pelvic Floor (PF)

Transversus Abdominis

core.stability.muscles The Transversus Abdominis (TA) is the deepest abdominal muscle. It is the "corset muscle" of the spine and pelvis. In the typical situation, TA contracts in anticipation of body motion to guard the spinal joints, ligaments, discs and nerves.

Multifidus

Multifidus (MF) muscles are very short muscles running from the transverse processes (on the sides) of one vertebra up to the spinous process (the middle of the back) of the next vertebra upwards. Their primary function is back stability. They do not produce an extensive range of movement, but work to provide small, "fine-tuning" postural changes, all day long.

Pelvic Floor & Diaphragm

The TA and the MF work in conjunction with your pelvic floor and diaphragm to make a flexible but stable region around your lumbar spine. It is this ability to stabilise your lumbar spine in its many positions that enable you to overcome back problems and reduce your chances of a reoccurrence.

What Are The Ideal Core Exercises?

Your deep core stability muscles retraining uses specific low-level activation exercises. While a very skilled physiotherapist who has training in deep core activation can observe and palpate for the correct muscle contraction, the best way is to see them working on a real-time ultrasound scan.Real-Time Ultrasound Physiotherapy guidance allows you to see how your muscles are contracting in real-time. This visual feedback will enable you to correct your specific deep core muscles inside your stomach, lower back, and pelvic floor as you attempt to contract those muscles.

Beware of “Core Stability” Exercises!

The fitness industry is full of fitness instructors who profess to know how to activate your core stability muscles. Unfortunately, the wrong core exercises will do you harm. Most progress your core exercises far too quickly and bypass these critical muscles to strengthen your outer abdominal muscles further and leave your deep core muscles weak. Research evidence has found that this renders you vulnerable to lower back pain and injury.

How Good is Your Core Stability?

Research clearly shows that core stability retraining has short and long-term benefits for low back pain sufferers. The good news is that we also know that core stability training markedly reduces your chances of re-injury.Research on lower back pain sufferers has shown us that if you can re-activate your core stability muscles, your chance of recurring back pain reduces.Your chances of not experiencing another bout of low back pain (LBP) within twelve months are almost three times better if you have undertaken an ultrasound-guided exercise program84% vs 30%.After three years, you still have a two in three chance of not experiencing low back pain if you did the exercises. Adding even more research support, if you didn't do the exercises, you only have a one in four chance of being pain-free. You're still over twice as likely to not experience another episode of back pain. Hides et al. (2001).PhysioWorks physiotherapists have professional knowledge in the training of core stability muscles. The difficulty has always been how to quantify a patient's level of stability control. That is, until now.The solution has been to develop a useful and clinically practical method of assessing your level of core stability. We can then determine and at what level it fails to cope when the demands placed upon your body. That is, what is the individual client's functional Back Stability Score (BSS)?

How Do We Assess Your Core Stability?

Your PhysioWorks physiotherapist will assess you to determine your current symptoms, pathology and functional requirement. Then, they'll physically test you to decide on your back stability based your ability to activate your core control muscles (transversus abdominis, multifidus and gluteals).If you can isolate these muscles, we are then able to test further when your core stability muscles lose control of your spine, become inhibited or fatigue. This testing assists us in determining what tasks make you vulnerable to back pain or injury.

What Happens After Your Core Stability Score is Determined?

Based on your functional needs, your treatment directs towards your specific areas of weakness. The result is a much stronger, stable and pain-free back. If you would like to know your Back Stability Score, please contact PhysioWorks.

What are the Benefits of the Functional Back Stability Score?

For Patients

  • You have a quantitative guide to your functional goals
  • You have a current status score. Progress is measurable.
  • You can progress quickly through the BSS levels to maintain motivation and self-esteem
  • Individualised treatment. Different retraining options depending upon desired outcomes.
  • You can self manage in long-term
  • Your goals are functional (task-related) rather than merely a strength score.
  • Quantitative Feedback for You, Your Health Practitioners and Insurers.
  • Achieve stepped goals and sensible, steady exercise and treatment progressions.
  • We'll educate you on how to prevent future injuries.
  • You'll be introduced to ergonomics and understand the best postures for you
  • You will prevent future bouts or at least minimise their severity
  • It's a research-backed solution.
  • It's perfect for all ages and physical ability.
  • There is a clear path for progression.
  • You perform your exercises in the comfort of your own home without expensive gym equipment or membership
  • You'll have personalised professional guidance for assessment, reassessments and progressions.
  • You'll be pain-free ASAP

For Clinicians & Insurers

  • It's a precise measure of your functional capacity
  • It allows better judgments on patient directions, e.g. returns to work
  • It offers better-individualised advice and treatment
  • It reduces jargon through measurable standardisation
  • It's a practical measure that can be related to other outcome measures such as Oswestry Disability Score
  • There is a clinically relevant correlation between subjective and objective findings
  • It reduces malingering.

What Conditions Does the Back Stability Program Improve?

  • Spinal Pain
  • Spinal Posture
  • Pelvic floor function
  • Sciatica
  • Spondylolisthesis
  • Spondylosis
  • Degenerative Disc Disease
  • Poor Balance or Fall History
A British Medical Journal study found that pre-event stretching does not reduce the overall risk of injury. However, stretching does slightly reduce the risk of specific kinds of damage (injuries to muscles, ligaments and tendons). These soft tissue injuries are common in both elite and recreational sportspeople. It seems reasonable and common sense that stretching may not prevent you suffering a broken bone or a joint dislocation, but it could reduce your chance of a soft tissue injury.The other main finding was that stretching reduces the risk of experiencing soreness, which always makes exercising more enjoyable!While sustained stretches in isolation may not be the answer, other studies have shown that warming up does reduce your injury rate. While there is no "absolutely proven"method of warming up yet, the preferred options appear to be a graduated progression to prepare you for your sport. In simple terms, warm-up steadily from gentle exercises that increase in intensity and speed as you progress through your warm-up period.It makes common sense for you to warm things up slowly to start and then prepare with replicate skills, to what you will require shortly on the field, at the end of your warm-up.For more specific warm-up and injury prevention advice particular to your sport or work, please ask your physiotherapist to prescribe a warm-up and warm-down routine specific to you and your sport or physical activity.

What Causes Back Pain?

Back pain is often the result of having weak stabilising muscles supporting your joints. Without strong support, your joints simply collapse. Your bony skeletons don't stand up by themselves. The bones are held upright by efficient, supportive muscles that work across every joint in your body.

Research has shown us that pain causes these supportive muscles (known as your "stabilisers" or "inner core stability" muscles) to stop working. Research on sufferers of lower back pain has found that these muscles stop working every time you experience back pain.

Even worse, in most cases, these muscles don't automatically start working again when your pain goes. They need to be deliberately re-started by your brain.

How Can You Reactivate Your Core Stability Muscles?

There are several ways to reactivate your core stability muscles. One of the most effective is to use a Swiss Exercise Ball. Usually, some simple Exercise Ball exercises can often automatically 'kick start' these stabilising muscles.

Your physiotherapist is an expert at the reactivation techniques of these stabilising muscles. For more advice, please contact your physiotherapist. Alternatively, you can download or eBook on Back Pain Rehabilitation using a Swiss Exercise Ball.

How Does a Swiss Exercise Ball Eliminate Pain?

Your Exercise Ball is an unstable surface. When you sit or exercise upon one of these balls, your body will automatically recruit your natural balance reactions. One of the critical most components of your balance reaction system is the activation of your stabilising muscles. With repeated use over just a few days, your stabilising muscles will automatically start working again in most cases.

Researchers have discovered that by merely activating the inner core stability muscles, you have two to three times less likelihood of recurring lower back pain.

What Can You Do?

If you want to fix your back pain, you can do something. The Exercise Ball could be just the solution you need to avoid future bouts of lower back pain.

You've just added this product to the cart:

Do NOT follow this link or you will be banned from the site!