If you have low back pain (LBP), you are not alone. Everyone at some point has back pain that interferes with work, routine daily activities, or recreation. Low back pain is the most common cause of job-related disability and a leading contributor to missed days at work.
What causes LBP:
As you age, bone strength and muscle elasticity tend to decrease. The discs begin to lose fluid and flexibility, which decreases their ability to cushion the vertebrae (bone).
Pain can occur when lifting something too heavy or overstretching, causing a sprain, strain, or spasm in one of the muscles or ligaments in the back. If the spine becomes overly strained or compressed, a disc may rupture or bulge outward and put pressure on the nerves. When these nerves become compressed or irritated, back pain results.
Most LBP may be due to trauma or injury, but pain may also be caused by degenerative conditions such as arthritis or disc disease, osteoporosis or other bone diseases, irritation to joints and discs, or congenital (birth) abnormalities in the spine. Obesity, weight gain during pregnancy, stress, poor physical condition, bad posture, and poor sleeping position also may contribute to low back pain. Symptoms may be exacerbated by coughing or sneezing.
People with diabetes may have severe back pain or pain radiating down the leg related to neuropathy. People with these symptoms should contact a doctor immediately to help prevent permanent damage. (NIH LBP)
Conditions associated with LBP:
Bulging disc (also called protruding, herniated). The intervertebral discs are under constant pressure. When discs degenerate and weaken, cartilage can bulge or be pushed into the space containing the spinal cord or a nerve root, causing pain.
Sciatica can occur for example if a muscle, herniated or ruptured disc presses on the sciatic nerve. This compression causes shock-like or burning low back pain combined with pain through the buttocks and down one leg to below the knee, occasionally reaching the foot. In the most extreme cases, when the nerve is pinched between the disc and an adjacent bone, the symptoms involve numbness and some loss of muscle function along the leg. The condition may also be caused by a tumor, cyst, metastatic disease, or degeneration of the sciatic nerve root.
Spinal degeneration from disc wear and tear can lead to a narrowing of the spinal canal. A person with spinal degeneration may experience stiffness in the back upon awakening or may feel pain after walking or standing for a long time.
Spinal stenosis related to congenital narrowing of the bony canal increases the likelihood that an individual may have pain related to disc disease.
Osteoporosis is a bone disease marked by progressive decrease in bone thickness and strength, resulting in fractures of brittle, porous bones in the spine and hips. Women are four times more likely than men to develop osteoporosis.
Skeletal irregularities produce strain on the vertebrae and supporting muscles, tendons, ligaments, and tissues supported by spinal column. These irregularities include scoliosis, a curving of the spine to the side; kyphosis, in which the normal curve of the upper back is severely rounded; lordosis, an abnormally increased arch in the lower back.
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple points of tenderness, particularly in the neck, spine, shoulders, and hips.
A new review article published in the Journal of the American Academy of Orthopaedic Surgeons indicates that patients with LBP should consider physical therapy as a first line of treatment for their condition, according to the American Physical Therapy Association (APTA). The review recommends that in most cases of symptomatic lumbar degenerative disc disease, the most effective treatment is physical therapy combined with anti-inflammatory medications. (NSAIDs). Most patients have resolution of symptoms without the need for surgery.
Exercise and manual therapy including spinal mobilizations, have been shown to be beneficial. In addition, patients should be educated regarding daily activities and the use of appropriate body mechanics. Physical therapists are trained to identify which of these treatment strategies will be most effective for an individual patient, which further improves the effectiveness of your care.
Receiving care from a licensed physical therapist can further improve the odds that you can maintain your quality of life and avoid surgery. Your Physical therapists can help you develop a safe and effective exercise program that is personalized to your specific needs and goals. Surgery should be the last option, but too often patients think of surgery as a cure all and are ready to go under the knife.
Call Dr. Richardson for more information, or to make an appointment contact:
Hughes Medical Centre
Lower South Hill
Anguilla
Tel # (264) 497- 3053
Atlantic Star Center of Medical Excellence
South Hill
Anguilla
Tel # (264) 497- 0765
Family Health Center
Fairplay Complex
The Valley
Anguilla
Tel# (264) 584-3030
Via email:ginarichardson DPT@gmail.com
There will be other monthly articles to follow regarding Physical Therapy.
