Did you know 80% of the world’s population will experience low back pain at some stage in their lives? Luckily most low back pain resolves but it it still very disabling when it is present. At Active Physiotherapy Newtown & CBD, treating and managing low back pain effectively is one of our specialties, and we do it really well! So let’s answer a few really common questions (FAQs) that arise:
How do you prevent low back pain?
Generally by staying active. Moving and doing any form of exercise makes a huge difference. And it doesn’t matter what that exercise is, it can be Tai Chi, soccer, cycling, running, swimming, walking or indoor mountain climbing. Just get moving!
What causes low back pain?
There can be many varied reasons why people can get low back pain. Uncommon but super important reasons like a fracture or cancer are important for your doctor or physio to check for – and we can do that when we see you. But let’s remember 99.9% of people who come and see us don’t have these serious issues.
So what other things can cause low back pain?
Well, disc related pain is common, facet joint pain is also reasonably common. Sacro-iliac joint / pelvis pain is also very common. Our comprehensive assessment of you when you come and see us is designed to take the time to really look at your body, how it moves well, where it’s not moving so well and, from this assessment, we can make a judgement call on what’s driving your low back pain.
We also see patients who have a mixed presentation. What this means is they have an issue in their low back, let’s say an irritated disc – but they’ll also show signs of a poorly moving foot, or hip. This other region can be causing increased pressure or tension on the lumbar disc and either causing or keeping the symptoms going. This type of situation can occur when a patient is trying to stay active and recover from back pain but not necessarily moving efficiently or optimally. Of course, we will assess this with you when you come and see us.
What is sciatica?
Sciatica is nerve pain in the leg and can be extremely painful and debilitating. We commonly have patients come in with referred pain into their leg, telling us they have sciatica. However, in the absence of nerve signs, they will generally only be describing lumbar referred pain into their leg. Sciatica responds very well to physiotherapy and usually resolves in 6-8 weeks. If you are correctly diagnosed with sciatica, in addition to physiotherapy, there are also effective pain medications that you can take. Your GP will help you with this.
How long does low back pain last?
Well this is tricky one! It all depends on how serious it is, how long standing the problem has been there for, and how strong and active you have been prior to getting injured. We have some patients who have been very fit and strong and describe a mild sacro-iliac joint getting “jammed”. In this case, these patients can be pain free in one session. However, we have other patients who are deconditioned, possibly due to other medical issues, and these patients can take 6-12 weeks to rehabilitate. When your physio sees you, they will give you a rough time frame of long you might take to recover.
I’m pregnant and my back is really sore. Is there anything physio can do?
Yes! In fact, as physio doesn’t involve any medications or surgical interventions, it’s 100% safe for both mum and baby. Generally, changes in how the female pelvis moves during the different stages of pregnancy make some pain in this area very common. Usually, the pelvis joints don’t move very much and have super stiff ligaments. However, during pregnancy, hormonal changes cause the pelvis to become more mobile in preparation for childbirth. These hormonal changes are normal and can cause the joints of the pelvis to become more mobile, and this increased movement can be painful. Pregnancy related pelvic pain responds very well to the specialised physiotherapy that we offer.
Do I need to get scans of my low back?
Most likely no. Scans are expensive and cost up to $400. In general, after 20 years of research into this area, we believe it’s not that important to get X-Rays or scans of your low back. So we recommend saving time and money. 99% of our patients will resolve their pain without the need for a scan. If your physio thinks you need scan, they will discuss how best to do this with you.
I feel like my core isn’t very good – what can be done for this?
In our Newtown clinic, we have an ultrasound machine which can look inside your tummy to where your layer of core muscles live. Using this technology, we can watch in real time, how well your brain is able to activate your important core muscles. If your brain cannot perform this task optimally, we’ll give you the training in order for this to improve. If your brain is able to perform this task well, we will give you that feedback as well. Once we have your core muscles firing optimally, we will look to integrate this into your tasks for everyday life and into your sporting endeavours.
What should I expect when I come to see the physio? What is low back pain treatment like?
We usually like to see new patients for 1 hour for their initial consultation. This allows us to fully assess how well your joints, muscles and nerves are moving. Once we have an understanding of what’s driving your pain or movement dysfunction, we will talk to you about what we’ve found, and we plan to do about it. Most of our patients are feeling much better within 2 weeks of their treatment starting – but there are some caveats to this statement (see next paragraph).
Your low back pain treatment will be hands on and will look to get your joints, muscles and nerves moving normally – during this time we will also start to educate you on how to move optimally again. This might involve manual therapy to your joints, massage, stretches or acupuncture/dry needling. We will also coach you into moving with more efficiency and less pain.
After your initial appointment, we will most likely need to see you again for some follow up appointments so we can keep the improvements coming. These will usually be 30 minutes long appointments.
Our philosophy is to aim to treat you as little as possible and to try to empower to move better and feel better sooner. We want all of our patients out there, living their lives, pain free and happy!
Will I have to do exercises?
Yes! And this is where our caveat from the last paragraph comes in. Please read our blog article on why exercises are so important here:
https://activephysiotherapy.net.au/services/exercise-therapy/
and here https://activephysiotherapy.net.au/why-do-we-give-you-exercises-when-you-come-and-see-us/
Because we move differently when we have pain and don’t even realise it, it’s super critical to get you moving optimally again and all the medical evidence we have for this is to do exercise. So, as a patient, we need to work with you to teach you how to do the right exercises for you – all you have to do is do them.
So here’s hoping we’ve answered some of your burning questions around low back pain. If there’s anything else you need, just call our clinic on 9519 4913 and we will do our best to help you. Alternatively, you can always book online here:
https://activephysiotherapy.net.au/online-bookings/
Until next time,
Dr John.