Spinal Conditions
SPINAL PROBLEMS
Back pain is the most common complaint we see in the outpatient setting followed closely by neck problems. It is said 80% of the population will suffer low back pain at some point in their life. Some patients we see report a history of trauma or an event that has brought on their pain but the majority tend to have no explanation as to how their pain started. Like all injuries or aches and pains, early diagnosis, advice and treatment is important to try to avoid pain becoming chronic and to try to avoid recurrence of these problems.
LOW BACK PAIN
Low back pain has many presentations. From a low grade back ache, to unremitting leg pain/sciatic pain and many different scenarios in between. The majority of low back pain comes from non-bony structures (for example - ligaments, muscles, articular cartilage, joint capsule and the intervertebral disc). There are bony injuries that do occur. These typically (but not exclusively) present either in the athlete who performs extension/rotation sports (e.g. gymnastics, cricket fast bowling) or the older patient. They make up a very small percentage of the back problems we see.
Low back pain sufferers should aim to stay as mobile as possible and avoid sustained postures for any length of time (e.g. sitting). You also need specialist assessment to identify the underlying cause of your pain and this may open many ways to treat that problem. Treatment will be different for each individual, depending on their problem. We may use mobilisation or manipulation to increase range of motion and decrease pain. Exercises to encourage self mobilisation may be given. Massage to increase flexibility in the soft tissues and fascia. Exercises to retrain the muscles that stabilise the spine. Pilates rehabilitation.
Research has shown that people who suffer from low back pain do not use the muscles that stabilise the spine as they did before their first episode of back pain (or like people that have not suffered from back pain). It has also shown that retraining these muscles can significantly decrease the risk of recurrence. We specialise in the retraining of these important muscles. Lots of people talk about this as core stability - but it ideally needs to be broken down more than that to effectively manage individuals differing presentations.
NECK PAIN
Like back pain, neck pain can come in different forms. If you suffer from a nerve root irritation in the neck it will typically refer pain into the arm and shoulder blade. Whiplash injuries suffered in road traffic accidents or sports typically don't have immediate symptoms but instead steadily increase over a period of hours and days. Treatment techniques for neck pain are the same as those used for back pain but again, a treatment plan can only be decided on after a detailed examination has taken place.
Research for whiplash injuries strongly supports early mobilisation and trying to maintain normal day to day activities. People who stop moving generally take longer to recover and end up having more time off work. Research also shows that pain affects our ability to move and control our neck and that these muscles need re-educating.
POSTURAL PROBLEMS
Postural pain tends to start as an ache but can eventually lead on to "trapped nerve" type symptoms. In the neck the most common presentation is a poking chin and round shoulders. In the lower back we see sway backs, flat backs and increased lordosis (inward curve) presentations. The earlier you try to correct these problems, generally the easier it is for both the patient and the therapist. Again, detailed examination is required and a treatment program (as for back pain and neck pain) is put together.
