KIM’S KORNER
[dropcap]A[/dropcap]t some point in our lives we all know somebody who has experienced low back pain. It may be a one-off episode or something that occurs at random and sometimes for no apparent reason. Quite often you hear people describing their symptoms as sciatica but not all back pain is sciatica, so what exactly is causing your pain? Firstly, it’s important to understand the structure and function of the spine. The spine is divided into three different sections: the neck (cervical spine), the thorax (thoracic spine) and the lower back (lumbar spine), and has three main functions:
• To protect the spinal cord (the home to the network of nerves, stemming from the brain to muscles and organs)
• To provide support and balance, enabling us to maintain an upright position
• To allow flexibility and movement.
The lumbar spine is made up of 5 vertebrae (L1-L5) and is responsible for the movements of flexion and extension and protecting the nerves that supply the lower limbs.
It is often the site of injury and although the symptoms may be similar the causes can be from different structures. The most common types of low back pain are:
• Mechanical Pain
(non-specific back pain) Often described as soreness and/or stiffness but whose origin has not been identified but may be caused by muscles, ligaments, tendons, joints and sometimes discs. Symptoms can be acute—lasting less than six weeks; sub-chronic—lasting between 6-12 weeks, or chronic—lasting more than six weeks. It is usual for symptoms in this category to resolve spontaneously but it may be necessary to seek advice from your doctor or a physiotherapist.
• Referred Pain
This is often described as dull and achey and tends to move around and vary in intensity. Pain is often felt in the buttock area, groin, hip and upper thigh but rarely radiates below the knee. It is often confused with sciatica. Once nerve pain has been ruled out and the cause determined, your physiotherapist can work with you to develop a treatment plan and rehabilitation programme including strengthening and stretching exercises.
• Radicular Pain
This pain radiates into the leg along a nerve root. It is often referred to as sciatica but the sciatic nerve is not the only nerve that can be affected. It is usually caused by pressure on a nerve, inflammation or direct injury to the nerve. The most common causes of nerve compression are a herniated disc and stenosis of the spinal column.
Back pain can be severe and stop you in your tracks. The first thing we normally do is reach for the pain killers, but did you know that ice is a great pain analgesic? Using ice regularly for 20 minutes a few times a day can help reduce pain and get you moving again. The best advice is to exercise, but quite often we do not know what is safe and end up doing nothing. This is where physiotherapy can help. Physiotherapists are healthcare professionals who specialise in normal movement, function and pain relief through natural methods without the use of medication. Of course, if your pain is severe and you experience any loss of sensation or movement in your limbs then you should visit your doctor first. So exactly what will your physiotherapist do for you?
• Assess posture, muscle strength, flexibility and movement patterns. Poor posture can put a strain on muscles, ligaments and joints, which can cause pain and stiffness. Our daily activities can also cause muscle imbalances, where some muscles are tight and others overstretched; whilst others are strong and their opposite partners weak; stretching tight weak muscles can add to your pain and dysfunction. Your physiotherapist is skilled in identifying how efficient your muscles are.
• Determine the aggravating factors. By listening to you on the positions and movements that affect your pain, your physiotherapist will advise on suitable resting positions and how to move correctly, especially when sitting or lifting heavy objects.
• Develop a unique rehabilitation programme based on your needs. An elite athlete would not have the same programme as somebody sitting at a desk all day.
So the next time you experience back pain, before reaching for medication or taking complete rest. consult your doctor or your physiotherapist.
Kim Jackson is a UK-trained physiotherapist with over 20 years’ experience. She specializes in musculoskeletal pain and dysfunction, including back pain and sciatica, stroke and other neuro conditions plus sports physiotherapy, having worked with local, regional and international athletes and teams treating injuries and analyzing biomechanics to improve function and performance. She is registered with the Allied Health Council and is a member of PASL. She currently works at Bayside Therapy Services in Rodney Bay,
