Low back pain is one of the most common musculoskeletal disorders. It’s commonly referred to as mechanical low back pain, which simply means that it is likely from muscular and joint tightness. Low back pain is now becoming a leading cause of disability worldwide.
But how does low back pain occur?
Aside from stress from our everyday lives, it can happen due to improper posture, soreness after doing a workout, improper lifting techniques, or weakness from being sedentary. All of this can be a reason for having low back pain.
But with professional guidance, such as treatment provided by a physiotherapist, people can obtain 100% relief from it.
Here are some treatments for low back pain that you can encounter when you visit your physiotherapist:
1. Clinical Exercises
After an initial assessment, your physiotherapist will examine your signs of symptoms, mechanism of injury, functional capacity, flexibility, and strength of your back and other joints that may add up to the pain you’re experiencing. Through examination, it will be easier to make an exercise program that will be accurate for such conditions. Having a personalized plan from a physiotherapist will be more beneficial in recovering faster, focusing more on the whole body, not just the area of injury but also anything that can be a factor contributing to the pain. Some of the basic exercises will include core strengthening, lumbar stabilization, and stretching techniques.
Nowadays, Pilates is also being used as a clinical exercise to improve flexibility and increase strength. Pilates also helps with postural awareness, which is one of the factors in having low back pain if our posture is not properly aligned.
2. Manual Therapy
Another treatment that a physiotherapist can perform is joint mobilization. It’s a form of hands-on technique with a therapeutic effect. Mobilization techniques use a gentle approach in moving a specific joint in a painless direction. Although there are some cases where joint mobilization is not appropriate, such as if joints are hypermobile, osteoporotic, or pregnant. So as a patient, it is recommended to inform your physiotherapist if you have any history to prevent further injury.
Joint mobilization can increase the range of motion and re-establish accessory motion in the lumbar segments. A specific grade of oscillation depends on the level of limitation on the area. Once oscillation is performed, it activates sensory receptors to respond to the external stimuli. Grade 1 is the lightest and usually at the beginning of the range of motion, while Grade 5 is the strongest, but further training will be required to be able to execute safely.
3. Dry needling
One of the additional treatments nowadays for low back pain is using dry needling. It is a safe approach that aims to stimulate specific reactions in the body tissue. A sterile, solid filament needle is used to target a tender point of a muscle, which can give a release of tightness. Blood flow circulation increases, which will help to relieve the pain.
Some contraindications though on dry needling are needle phobia, patients with thrombocytopenia or under anticoagulant therapy, lymphedema, or medical emergencies.
4. Extracorporeal Shockwave Therapy
One of the advanced technologies that was developed in physical medicine and rehabilitation is shockwave therapy. Shockwave delivers focused waves or through radial pressure waves, which break up soft tissue calcification and increase collagen formation. This leads to the body’s healing process to improve pain. It accelerates blood circulation, which can help overuse tendon, ligaments, and muscle.
The good thing with shockwave therapy as well is that it helps prevent further invasive treatment such as steroid injections or low back surgeries.
Among those also to take precaution in undergoing shockwave therapy are patients with pacemakers, pregnant women, and those under anticoagulant. If there are tumors, infections, or skin abrasions in the area, and if you have already undergone a steroid injection within 6 weeks.
5. Spinal Decompression Bed
Another advanced technology that is being used today is the decompression bed. This modality helps to stretch the spine depending on the specific spinal level. It is usually used for conditions such as herniated bulge disc, degenerating disc, Grade 1 and 2 Spondylolisthesis, and sciatica. The spinal decompression bed gives space within the disc to increase fluid on it, wherein it can promote nutrients to increase, therefore healing itself more quickly and allowing the spine to move into place.
Also, another advantage of a decompression bed is that it has a kind of sensor that detects muscle guarding against the stretch; hence, tension from the pull will be released, ensuring the maximum decompression is reached.
The pull of the decompression bed will depend on the weight of the patient, so your physiotherapist will do a thorough examination first before it can be administered. Some of the contraindications with this modality are osteoporosis, spinal tumors, spinal infections, metastasized cancer, spinal fusion/implants, fractured vertebrae, ankylosing spondylitis, Cauda Equina syndrome, and cord signs (red flags). A health history is a must before treatment.
To summarize, low back pain management under research is still ongoing, but it’s very clear that physiotherapy treatment leads to success of relief and prevents any major invasive surgeries, especially if early intervention is done. If symptoms last less than two weeks, it is better to visit your physiotherapist to prevent any further pain and limitation of motion. Usually, if low back pain symptoms are acute within less than 2 weeks, there will be significant relief from it in just 3 to 4 physiotherapy sessions.