Education

Dealing with back pain

Back pain is one of the most common health problems that causes physical disabilities. However, if you are experiencing back pain, you don’t have to just grin and bear it.

Physiotherapy is a widely recommended form as the treatment for back pain, and can help prevent disability in a number of cases. This approach may be used alone or in combination with additional methods such as hot/cold compression, massage, short wave diathermy, ultrasound, or traction. The back is a highly complex structure consisting of discs, vertebrae, ligaments, muscles, and facet joints, and physiotherapists are well-trained in all aspects of pain education, movement, and functional recovery. Furthermore, research shows that early access to physiotherapy, even in the emergency department for non-traumatic back pain, is associated with reduced pain and disability levels.

Physiotherapy encourages specific, guided movements from early on as this has been shown to improve recovery and mobility, while reducing the occurrence of disability.

One study even suggests that psychosocial therapy directed at addressing fear of movement following injury provided by physiotherapists can help improve rehabilitation outcomes. More specifically, when psychosocial intervention is delivered by physiotherapists, individuals with back pain displayed less fear of movement and less depression. They also had a lower risk of chronic pain and disability in comparison to back pain sufferers who only received physiotherapy.

Physiotherapy also focuses on manipulative techniques that precisely target the source of the pain, and mobilization methods that help ensure that the muscles and ligaments in the back do not become stiff. This also involves correcting potential postural problems in order to prevent the back pain from becoming worse.

In particular, there are two types of therapies that are typically performed for back pain: passive and active.

Passive therapy may involve the use of modalities such as:

  • Hot/cold compression – helps reduce inflammation and back muscle spasms
  • Ultrasound – provides pain relief through the use of sound waves that produce heat deep in the soft tissue of the back
  • Iontophoresis – treatment approach that uses an electrical current to deliver medication through the skin
  • TENS units – transcutaneous electrical nerve stimulator that also involves the use of electrical stimulation to help reduce back pain and muscle spasm
  • Mechanical traction - to increase blood flow to the injured area and reduce the feeling of compression in the back

These passive modalities are best only for the first few days after an acute injury to reduce excessive swelling and muscle spasm, and for early pain relief to allow safe movement of the injured area.

Other passive therapy may include soft tissue massage, spinal mobilization or manipulation, or acupuncture. Again, all these approaches are designed to reduce your pain, improve your mobility, and reduce your fear of movement so you get active and healthy again.

Active therapy is especially important for the rehabilitation of the spine and it entails exercises that include:

  • Stretching exercises (e.g., back extension exercise, knee-to-chest stretch, hip stretch, gluteus/piriformis stretch)
  • Strengthening exercises such as dynamic lumbar stabilization and movement re-education
  • Low impact aerobic exercise
  • Activity-specific exercises that help you get back to YOUR favorite sports or recreational pursuits.

Overall, physiotherapists understand the importance of a multi-modal approach for the rehabilitation of clients with back pain. The physiotherapists at North Hill Physiotherapy are especially well-trained and equipped to assess the nature of your back pain in order to develop a therapeutic plan that is specific to your needs.

Experiencing a painful back problem may cause a loss of mobility or even lead to a fear of normal movement.
However, receiving physiotherapy can help you safely regain your full range of motion. The experts at North Hill Physiotherapy can also show you how to maintain the proper posture that can help to prevent further back problems.

Call North Hill Physiotherapy today to speak with a trained professional who can assist you.

References
1. Magalhães MO, Comachio J, Ferreira PH, Pappas E, Marques AP. Effectiveness of graded activity versus physiotherapy in patients with chronic nonspecific low back pain: midterm follow up results of a randomized controlled trial. Braz J Phys Ther. 2017; pii: S1413-3555(17)30281-2.
2. Sohil P, Hao PY, Mark L. Potential impact of early physiotherapy in the emergency department for non-traumatic neck and back pain. World J Emerg Med. 2017; 8(2):110-115.
3. Sullivan MJ, Adams H. Psychosocial treatment techniques to augment the impact of physiotherapy interventions for low back pain. Physiother Can. 2010; 62(3):180-9.
4. Timm KE. A randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy. J Orthop Sports Phys Ther. 1994; 20(6):276-86.
5. Tousignant-Laflamme Y Pt PhD, Laroche C Pt, Beaulieu C Pt, Bouchard AJ Pt, Boucher S Pt, Michaud-Létourneau M Pt. A randomized trial to determine the duration of analgesia following a 15- and a 30-minute application of acupuncture-like TENS on patients with chronic low back pain. Physiother Theory Pract. 2017; 33(5):361-369.


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