66% of low back pain will resolve on its own in just a few days to two weeks. But almost one-third go on to become chronic and live in fear of flare-ups in which severe pain stops them from doing anything. Physical Therapy for back pain can relieve symptoms and prevent reoccurance.
If this is you, We can HELP Prevent your Back from Going Out!
Instead of suffering and being fearful, our virtual physical therapist will guide and empower you to be in control. We will outline a physical therapy treatment plan so that you:
- Understand what causes your back to give out
- Recognize the warning signs
- Prevent future incidences
- Empower you with the knowledge to stop reoccurrences
- Eliminate your fear of pain and reinjury
Causes of Mechanical Low Back Pain.
Mechanical low back pain occurs because of a physical problem in your low back. Non-mechanical causes can be inflammatory or referred and account for less than 3%. A mechanical assessment will differentiate mechanical from non-mechanical because mechanical pain is affected by movement and positions. Inflammatory and referred pain are not.
A mechanical problem is like a cut on your knuckle, moving in one direction – bending will “open the cut” and cause further bleeding. The opposite direction – straightening your finger and applying overpressure will stop the bleeding and allow healing. If one direction aggravates your symptoms, the opposite direction will releave. Mechanical back pain reacts similarly: one direction exacerbates the problem while the opposite removes the joint’s stress.
Understand how to prevent your back from going out.
- What movements or activities are you afraid will cause your back to go out or aggravate your symptoms?
- What movements relieve your symptoms?
These questions will help to establish the direction that “opens the cut” or causes the mechanical problem in your back. With this information your virtual physical therapy provider with deveope a physical therapy treatment program for your back pain. The movement that usually brings relief will be the corrective exercise or a “Directional Preference.”
The Specific Cause of Injury help to establish your Physical Therapy Treatment for Low Back Pain.
The number one cause of low back pain is prolonged poor sitting or “C” curved posture. This position places posterior stress on the spine. The position is not the culprit; the length of time in this position is the offender. Sustained posterior pressure on the spine from sitting at work all day, driving to and from work, relaxing, watching tv at night – all place the same stress on the spine. Many also sleep in the fetal position, putting the spine in a flexed “C” curve position. Adding insult to injury, those with low back pain often receive instruction to sleep with something under their knees. Lying on your back with your knees bent puts your lumbar spine in the same flexed posture of slouched posture. Instead of taking the posterior stress off your back, everything you do to relax only adds more of the same posterior stress.
Continued posterior pressure pushes the disc’s nucleus backward, causing it to bulge and eventually herniate. Instead of adding more posterior stress, relief will come from moving into the opposite position, eliminating the strain or cause.
Bending combined with twisting is the number two cause of injury to the low back. The weakest part of your spine is the posterior-lateral. Bending with a twist places stress in the vulnerable posterior-lateral spine. This pressure can cause trauma to the disc causing the nucleus to tear through.
Repetitive bending, heavy lifting, and trauma are the 3rd, 4th and 5th cause of a spinal injury—poor sitting and repetitive bending place the same posterior stress on the low back. Our bodies are designed to move and thrive in an environment that features mobility. Like sustained slouched posture, repetitive pressure in one direction without going the opposite direction causes stress and tissue breakdown.
Heavy lifting and trauma from a fall or car accident are acute injuries. The healthier the spine, the more it can withstand. If the spine is tight, weakened, and already has degenerative changes, acute stress can cause more significant damage.
Recognizing the Warning Signs – Education is an important part of Physical Therapy Treatment:
Stiffness, tightness, and loss of mobility are all warning signs that the mechanics of your back are not in a healthy state. If the problem is not addressed, then a simple sneeze or picking up a piece of paper can throw out your back.
The loss of mobility indicates a mechanical problem within the joint. The joint is not moving as it should. It is similar to putting a tiny pencil into the door jam of a large door. The pencil will stop the door from fully opening and closing. Removing the pencil will allow the door to open and close again fully. When the soft tissue in your back is displaced too far in one direction, it causes stiffness and eventually loss of movement. Correcting the soft tissue obstruction will return the joint to its proper state and improve your mobility.
What causes low back pain to become chronic?
Low back pain is the leading cause of disability in the US and worldwide. Treatments for back pain have escalated to the most expensive medical problem.
Why do some experience back pain for just a few days while others develop chronic symptoms and even disability?
A recently published research article investigated this very question. Researchers found that 32% of those with low back pain have lingering or chronic symptoms. This large prospective study then outlined the contributing factors that lead to prolonged symptoms. The risk of transition to chronicity was associated with early care not aligned with current practice guidelines.
Prevent Recurrences – Physical Therapy for Back Pain.
To prevent your back from ‘going out’ again, you must first understand why it is going out. Is it your sustained sitting posture all day without moving in the opposite direction?
Evidence-based practice guidelines for the treatment of low back pain include the following:
- Early access to proper care that includes:
- Mechanical Assessment to determine directional preference.
- Care that focuses on patient education, empowerment, and functional activity.
- Advice to stay active and at work as much as you are able.
- Address fear and social issues
- Screen for red flags or non-mechanical factors and provide an appropriate referral for further testing.
Virtual Physical Therapy providers are ideal enabling early access to high level care and can deliver physical therapy for back pain that inclues all of these elements.
Video of a Lumbar Mechnanical Assessment.
Non-Guideline Care that increases the risk of low back pain becoming a chronic condition:
- Pain medications, including opioids
- Passive care (Medication, bed rest, massage, manipulations, surgery)
- Referral to a specialist
- Radiographs (x-ray, MRI, CT Scans) – unless indicated to rule-out red-flags / pathologies.
The data found that 48% of those with LBP received at least one “non-guideline” treatment within three weeks of their initial visit or care.
Specifically:
- 30% received prescriptions for non-recommended medications (65% opioids)
- 24% received radiography (MRI/CT scan)
- 6% referred to a specialist
Example #1:
Charlie has a 20-year history of back problems, starting when he played football in college. He is now a builder and suffers from his back going out a couple of times a year, leaving him bed-ridden for a few days.
Charlie saw a VPT virtual physical therapy provider and answered these questions as follows:
What movements aggravate your symptoms?
Driving in the car, especially going over bumps
Lifting
Bending
Prolonged sitting
Coughing/sneezing
What movements relieve your symptoms?
Walking
Lying flat on my back
We can build a picture of how bending or flexion aggravates Charlie’s back while Extension relieves.
Worse with Flexion: Bending, lifting, sitting
Better with Extension: walking
Learn more about Back Pain, Herniations and How You Can Self-Treat by downloading our Ebook:
If you would like to schedule with a virtual physical therapy provider to prevent your back from going out – schedule with one of our experets: https://VirtualPhysicalTherapists.com
