Back Pain Treatment 2

Ultrasound Physiotherapy May Help:

Lower Back Pain

Ultrasound retraining of your Core Stability Muscles has fantastic benefits for low back pain sufferers. 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%. It's 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, due to trauma or just extra mobility, the SIJ has too much-uncontrolled motion. This new motion allows the joint to adopt an unusual position which may result in pain. The transversus abdominis (TA) and oblique abdominals through their attachments to the iliac bones help the pelvis's closure and improve the position, control and stability of the sacroiliac joints. 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 muscle 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. The trauma of birth 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. Along with this, a hormone called "relaxin" is released through your body during the months before and post-delivery. Relaxin makes the pelvic ligaments soften to enable the pelvis joints to stretch for the delivery. This elasticity means that the transversus muscle has to 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 used by your Obstetrician for routine pregnancy scans. Caesarian births have additional complications due to the cutting of 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, the 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's 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 the incorrect timing of muscle recruitment. 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 the prevention or resolution of 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 seem to 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!

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 core stability level. We can then determine, and at what level it fails to cope with your body's demands. 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 can test further when your core stability muscles lose control of your spine and 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 the 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.

Exercise Ball for Lower Back Pain

Is an Exercise Ball Good for Lower Back Pain?

Back pain is often the result of having weak stabilising muscles supporting your joints. Without strong support, your joints 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 lower back pain sufferers 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.

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

So, doe the use of an exercise ball help lower back pain? In most cases, YES. But, in some cases, it can aggravate your lower back pain.  Please consult your trusted back pain physiotherapist, for an individualised assessment and back care program.

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

Your physiotherapist has special training in the reactivation techniques of these stabilising muscles. For more advice, please contact your physiotherapist.

Heat Packs

There is no doubt about it, applying a heat pack to an aching body part provides almost instant relief from pain and stiffness.

microwave heat packs

How Does Heat Ease Your Pain?

For centuries, applying heat is a simple yet effective way to manage your pain and joint or muscular stiffness. Deep and penetrating heat not only relieves your pain but also enhances your recovery process. By applying a heat pack to your painful joints and muscles, the heat stimulates your sensory receptors to block the transmission of pain signals to the brain, resulting in an instant and effective pain relief. Even if you are a chronic pain sufferer, heat packs can help relieve your discomfort - NOW and for many years ahead! If you've been suffering from either stiffness or pain that feels better when you apply heat, have a warm relaxing bath or a hot shower. Alternatively, a microwave heat pack could be the best investment you'll make this year.

How Does Heat Help You?

  • By increasing tissue elasticity, heat reduces your resting muscle tension and helps to relax those nasty painful knots.
  • Your pain quickly eases via the sedation and soothing of any pain-irritated nerve endings.
  • The profound heating increases your blood flow to the painful area, bringing more nutrients to the injured area while flushing out the damaged debris. This flush-out helps to quicken your healing rate.
  • The deep heat also promotes a speedier healing rate by stimulating your natural metabolic rate. In other words, there is more energy available to fix the injury quicker.

What's the Advantage of Wheat Heat Packs?

Can be heated in a microwave with a turntable in about two minutes. The durable but soft fabric allows for comfortable use and an ability to mould to your body shape, which is great for those super curvy areas such as your neck, knees and shoulders. You can even pop it in bed with you during those cold winter nights!
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