My back hurts! What should I do?
Everyone experiences back pain at least once in their lifetime. It is the leading cause of years lived with disability in both developed and developing countries.
There could be several reasons why the back could start hurting in the first place. The triggers could be e.g. lifting awkwardly, repetitive bending, a fall, or being fatigued or tired. However, about a third of patients with an acute episode cannot recall a trigger.
Whatever the reasons be, the main concerns of every individual suffering from back pain especially when it is of moderate to severe intensity causing interference in daily activities; is the risk of persistence and the need to seek a diagnosis, treatment and cure as well as reassurance of the absence of any serious pathology.
As time passes by with the persistence of pain, concerns start to grow regarding the ability to regain previous levels of fitness, emotional stability, and engaging in meaningful activities.
How Can Physiotherapy Help You With Low Back Pain?
– unexplained weight loss
– vertebral compression fracture due to a fall or underlying osteoporosis
– fever/chills in addition to pain with rest or at night (spinal infection)
– sudden loss of bowel and bladder function
– numbness & weakness in the lower limbs
– history of inflammatory arthritis
– back pain with leg pain (in sciatica or lumbar canal stenosis).
Once we are confident that there is nothing sinister going on, we look for the plausible causes of pain that could be from tissues like intervertebral discs, facet joints, back muscles, sacroiliac joints etc.
Sure, we check your movements – bending forwards/backwards/sideways/rotations. Look for any mechanical aggravators.
We will try to address the sensitivity of that movement by doing some hands-on therapy including soft tissue massage and joint mobilizations, taping, dry needling, pain relieving exercises, addressing the back stiffness with mobility exercises, global strengthening required to manage the overall load management etc. that will desensitize the symptoms. Awesome, yeah?
BUT let’s also focus on other areas that may be influencing, contributing, driving, predisposing the pain besides movement and mechanical loads. For example:
- You must be sensitive to bending forwards
- The onset was associated with repeated bending
You must be:
- having elevated anxiety and had bouts of depression prior to the onset of pain
- having anxiety specifically related to pain and worry about damage
- avoiding engaging in meaningful activities
- still looking for a structural diagnosis such as pain related to degenerative facet joint changes or disc prolapse found on MRI (even though the changes are age-appropriate)
- stressed with work
- having financial stress
- going through relationship crisis with your partner
Does Recognizing The Multifactorial Nature Of Back Pain Allow You To Be More Specific?
All or most of these factors may certainly be contributing to your pain in the hindsight.
We recognize that pain is complex and after listening to your narrative and doing a thorough assessment, we realise that low back pain has a number of contributors. It allows us to address ALL these factors and tailor the treatment to an individual than follow a recipe.
What’s in your cup of sensitivity?
Do you want to reduce the stressors that are overflowing from your cup?
Or build a bigger cup?
We use Greg Lehman’s cup analogy (greglehman.ca) to explain that pain occurs when all of the stressors/loads in our lives exceed the space in our cup.