by Matthew Churchill – Head Physiotherapist, Friendlies Physiotherapy Service

Did you know that up to 80% of people will suffer from back pain at least once in their lifetime? That’s a lot of us! Most researchers say the actual figure is even higher.

If you have ever suffered from acute or chronic back pain, you’ll know it can be debilitating. However, many people don’t see a Physiotherapist until back pain starts to limit their lifestyle in some way. It may stop you from participating in sport or leisure activities, affect your ability to work or keep you awake at night.

Whatever the cause of back pain, a qualified Physiotherapist can help. Physiotherapists are trained to assess how people move and why movement patterns are related to pain. We look at range of movement, quality/control and restrictions to movement.

We then explore why this movement is abnormal. Is it a joint problem or a muscle problem? Could it be poor control or weakness? We use this knowledge of biomechanics to retrain and improve your movement and prevent back pain recurrence.

Common causes of back pain

Back pain, especially lower back pain, is rarely the result of a single cause. Our bodies are highly adaptable and compensate well when injured or tight.

So, if a joint in your spine gets stiff from a constant work posture, your body will adapt by utilising other areas, like the pelvis or hips. Initially, this works well. But continued imbalance leads to poor movement habits. That’s when pain can set in.

Our understanding of biomechanics and how different body areas interact has come a long way in the past decade, allowing us to identify and explain symptoms better than we could previously.

Causes of back pain can include but are not limited to:
· Weakness.
· Stiffness.
· Muscle or ligament strain^[1].
· Hypomobility (reduced range of motion) or hypermobility (increased flexibility).
· Joint dysfunction.
· Poor core stability.
· Disc disease.
· Age-related factors like development in adolescents and osteoporosis in the elderly.

Physiotherapy for back pain

Generally, anything related to muscles and joints is manageable by a Physiotherapist. Many muscle and joint issues can cause back pain that Physios can manage, including spasms, sprains, tears and weakness.

It’s essential to dig deeper to find the cause or causes. Physiotherapists can assess and determine the contributing factors and provide individualised treatment. We do this by thoroughly assessing movement patterns, looking for any imbalances or differences to normal. We also take a complete history of the development of your pain. Sometimes a change of routine, different work duties, new sporting activity or hobby can place loads on structures that cannot cope. We use a hands-on approach, feeling the movement of individual joints, palpating muscles and other soft tissues and analysing this information to determine a likely cause.

If you’ve ever had treatment for back pain, you may have noticed that it involved areas other than the site of the pain. Quite often, back pain can result from poor movement in other areas of your body. For example, poor hip range of motion can increase loads on your lower back, while poor pelvic movement or alignment can increase joint loads in the lumbar spine. Foot and knee biomechanics can load the back unevenly, resulting in pain.

Physiotherapy techniques for back pain

Physiotherapy for back pain relief may utilise many different interventions, including:
· Mobilisation and manipulation of joints.
· Deep tissue massage and trigger point therapy.
· Dry needling for muscle spasms and tightness/pain control.
· Movement retraining muscle strengthening and stretches/range of motion exercises.
· Bracing and taping for support for loose joints.

Our initial focus is to achieve correct and balanced movement of the spine. Once correct movement is achieved, we can develop maintenance strategies to prevent a recurrence.

For more complex issues, treatment may require several hands-on sessions as well as strengthening and stretching exercises at home. Our most important goal is prevention!

Acute versus chronic back pain

Pain can be acute (lasting less than four weeks) or chronic (lasting longer than 4-6 weeks). Acute pain is typically related to factors that haven’t created postural changes or compensations and is often less complicated to treat.

Chronic pain usually has many contributing factors and is always more challenging to treat than acute pain. Often people don’t make a Physio appointment until they’ve had back pain for several months. Pain is inconvenient. But pain that continues for months can be more severe and harder to treat because it has become chronic.

So how soon should you see a Physiotherapist after experiencing back pain or lower back pain? No pain is good pain when it comes to back pain, so we recommend visiting your Physiotherapist in the early stages.

If there is unrelenting pain that doesn’t improve with rest or medication, seek professional guidance. Neurological symptoms such as weakness, numbness or pain radiating down your legs can indicate severe spinal pathology, which should be assessed by a well-trained Physiotherapist or doctor.

Many people feel significant improvement with a single Physiotherapy session. Complex issues and chronic pain may require several treatments. We then focus on maintenance and prevention with home-based programs.

Get moving for back pain relief

Common factors contributing to back pain include weight gain and high-intensity loadbearing exercises like running and lifting heavy weights. Low impact exercise like walking, cycling, and swimming provide health benefits without the associated stress on your spine.

A good Physiotherapist can develop a fun program to enable you to achieve optimal health and fitness without contributing to spinal injury or deterioration.

The most significant factor that contributes to back pain is poor posture. Sitting for long periods or working in awkward positions is sometimes unavoidable. Moving well while completing tasks and changing position regularly when seated are essential for preventing lower back pain.

It’s all about learning to move in a way that doesn’t negatively impact your body. Getting a Physiotherapy assessment of how you move can provide valuable information to help you work and play efficiently.

Rest or exercise: what is the best strategy for back pain?

Many people are unsure whether to keep going or rest when they experience pain. It depends on the cause and severity.

Rest can settle the symptoms during acute episodes and allow a quicker return to normal function.

With chronic pain, rest is not productive and won’t achieve a good outcome. Chronic pain needs to be evaluated and treated differently for each individual. Rest rarely provides any long-term improvement.

Walking is an excellent exercise for your overall health and can help with back pain. However if, walking is contributing to the pain, taking a rest from that activity can relieve the symptoms.

Prevention is the key to managing back pain

Most of us will experience back pain during our lives. Ultimately, Physiotherapists aim to prevent minor acute episodes from becoming chronic. It’s like servicing your car. If you regularly keep on top of minor problems, you are far less likely to have a huge issue. Sometimes, regular spaced-out appointments can prevent severe pain and dysfunction.

The keys to managing lower back pain are early intervention, comprehensive assessment of your biomechanics and a good program of exercises and stretches to improve and maintain biomechanics to prevent reoccurrence.

If you’re one of the lucky ones who has never had back pain, we want to keep it that way! Studies show that exercise can effectively reduce the risk of developing lower back pain by 33%.^[2] If you are unsure about what exercise is right for you, a Friendlies Physiotherapist can create a suitable home exercise program for your needs.

Friendlies Physiotherapy Service can help

Is it time to get treatment for your back pain? The team at Friendlies Physiotherapy Service is here to help. Book a consultation today on 4331 1888.
Find out more about our Physiotherapy services.

For reference (used in the article):
^[1] Mayo Clinic, Back Pain, accessed 3 December 2021.
^[2] Shipton, E.A. Physical Therapy Approaches in the Treatment of Low Back Pain. Pain and Therapy 7, 127–137 (2018).