Low back pain is the most common disease in the United States. While most low back pain is caused by muscle spasms and can be treated with a few weeks of rest and over the counter anti-inflammatory medications, some people have more persistent symptoms. This can become debilitating to the point that it limits the quality of life and ability to function.
The initial treatment of a degenerative spine is still rest and anti-inflammatories (NSAIDs). The goal is to return to a reasonable level of activity as soon as possible, limiting immobility to 2 days or less. However, if these home remedies do not work, therapy and injections can be useful.
Which Therapy is Right for You?
A skilled therapist can identify the probable cause of back pain and provide techniques to improve the motion of the spine, decrease the impact of degeneration in the joints and improve the quality of life. Most people think they already know how to stretch and lift and therefore do not need therapy. Others believe that after one to two sessions of therapy they’ve “learned everything” and more therapy is useless. Therapy is much more than stretching, which is why it is too complex to master after a few sessions. Some of these techniques include:
Manual therapy is a term that describes any “hands-on” treatment performed with the intent to improve the joint and tissue mobility and thereby improve pain.
Massage: Muscle relaxation through direct manipulation of the muscle relieves pain.
Traction: Traction can slightly pull apart the vertebra and take pressure off the discs and facet joints which may be causing pain. Traction also can open the spaces where the nerves exit the spine to improve extremity pain.
Range of Motion: Active and passive range of motion exercises can stretch deconditioned lumbar muscles and decrease pain.
Myofascial Release Therapy: The fascia is a layer of tissue over the muscles. When it is tight, it makes the muscle less pliable and essentially tightens the muscle. Myofascial release loosens this tissue relieving the muscle pain.
Back pain could be caused by weak abdominal and lower back muscles. If certain muscles are weak, then other structures supporting your spine have to work harder. Developing stronger core muscles avoids the extra stress.
A therapist will evaluate your condition and tailor an exercise routine to improve joint mobility, flexibility and strength. This will improve posture, stamina and protect the spine from progressive degeneration.
While hot and cold packs rarely actually heat or cool the deep tissues, they can improve pain. Hot packs can decrease muscle spasms and improve relaxation before stretching. Cold packs constrict superficial blood vessels and reduce swelling. Cold also potentially slows the painful nerve impulses.
Dry needling involves the insertion of a thin filament into a muscle or tendon to elicit a healing response. Tight and painful muscles often need a “reset” button to change how the muscle contracts. Dry needling has been proven to decrease muscle tension and pain.
Transcutaneous electrical stimulation uses electrodes to stimulate nerves on the skin that somehow blocks pain signals to the brain (Gate control theory). This may also stimulate the body to produce natural pain killers called endorphins.
Penetration of an anti-inflammatory medication to the local tissues may be improved by administering a low, direct current. The electric current itself may also block pain fibers going to the brain (Gate control theory- similar to TENs).
When a nerve, such as the sciatic nerve, is trapped by surrounding muscles and bones, it potentially becomes inflamed and stops moving smoothly. Nerve gliding exercises help pull the sciatic nerve through this tissue without the inflammation and pain.
Poor posture, weight distribution and asymmetric gait patterns add extra stress to the muscles and joints in the low back. Improving the coordination of asymmetric gait reduces pain.
Certain studies suggest that 3/4 of patients with chronic back pain have a leg length inequality of 5mm or more. The longer leg carries more weight and is subject to more stress from walking or running. Shoe lifts can diminish leg length discrepancy and reduce the extra stress on one leg thereby decreasing low back pain.
Have you been experiencing consistent pain with no relief? Contact us today at Rocky Mountain Brain & Spine Institute to learn if physical therapy is right for you.