Ross discussing Low Back Pain on KFM:
Back Pain Specialist:
- I have been treating back pain since 2002 & have extensive experience working in some of the top pain clinics in Ireland.
- My passion & lifetime commitment to helping others who are suffering with back pain is based on personal experience. I suffered with chronic low back pain & underwent significant frustration in seeking help from several different practitioners.
- My educational background has facilitated a considerable research focus on chronic low back pain management & rehabilitation.
Call Naas Physio Clinic Naas on:
(045) 874 682
Causes of Low Back Pain
Low back pain affects about 80% of people at some point in their lives. Low back pain may be classified by duration as acute (pain lasting less than 6 weeks), or chronic (more than 12 weeks).
Most episodes of low back pain, with and without symptoms spreading into the buttock and tops of the legs are not serious and the symptoms will reduce over time. If you experience leg pain that moves into the calf and it is associated with numbness and/or weakness then you should have this investigated further immediately.
Is it a Disc Herniation?
A disc herniation will be diagnosed based upon specific tests carried out by the physiotherapist or chiropractor. An examination will involve tests of skin sensation along certain parts of the lower limb that are supplied from the nerves that exit the spine between the joints of the lower back. Your practitioner will also test that reflexes & muscle tone is intact. If any of these tests are positive then this is an indicator of a definite disc bulge. However, negative test results does not rule out a disc bulge but suspicion will be based on clinical findings and reported symptoms & aggravating movements.
If you suffer with pins & needles, numbness or sensory changes in the legs or feet then you should inform the physio of this on your initial consultation. In severe cases weakness of the foot may manifest as a drop foot where the front of the foot drops towards the floor when the foot is raised.
None of these symptoms are grounds for panic & most can be managed conservatively by your physiotherapist or chiropractor without needing to resort to invasive surgery.
Low Back Pain Treatment:
The best advice is remain as active as possible and avoid long periods of rest. It is important to keep moving & avoid prolonged periods of rest. If the symptoms persist consult a physiotherapist. Symptoms can re-occur with back pain and by consulting one of our physiotherapists or chiropractors they will fully assess your back and show you how to prevent future episodes. This will involve a combination of treatment and a home exercise programme that will correct your spinal weakness.
Physio Treatment of Disc Bulge
Research suggests that appropriate physiotherapy & chiropractor treatment that incorporates graduated loading can help bring about changes in the disc itself that will facilitate healing & prevent re-occurrence. To find out more about getting treatment visit our physiotherapy clinic in Naas.
This reference from Adams et al. (2010) describes the type of disc lesions that give rise to pain:
‘Biochemical ageing mostly affects the aneural nucleus and inner anulus (Antoniou et al., 1996a) and gives rise to a “dark disc” on MRI. Age-related changes occur from the inside out (Haefeli et al., 2006), progress over many years (Hassett et al., 2003) and are difficult to modify because central regions of the disc have an extremely low cell density. Pain on the other hand is associated with discrete structural changes in the peripheral anulus (Moneta et al., 1994; Videman and Nurminen, 2004; Freemont et al., 1997; Peng et al., 2009a) and vertebral endplate (Freemont et al., 2002; Peng et al., 2009b), and the consequent reduction in disc height (Cheung et al., 2009; de Schepper et al., 2010). Peripheral regions of the disc are innervated (Fagan et al., 2003), have a relatively high cell density (Hastreiter et al., 2001) and nutrient supply (Ferguson et al., 2004), and can heal effectively from the outside-in (Osti et al., 1990), at least in young animals.’
In other words, the parts of the disc that give rise to pain are responsive to adequate load & can be rehabilitated & strengthened to prevent reoccurrence.
How do I Prevent of Low Back Pain?
Exercise is effective in preventing recurrence of low back pain in those with pain that has lasted more than six weeks. There is little evidence that back belts are any more helpful in preventing low back pain than education about proper lifting techniques. Maintaining an active lifestyle that involves regular exercise & back strengthening is an important component of back pain prevention.
Exercise has been shown to improve the nutrient transport & disc health in both human & animal studies. Nutrient transport in dog discs is enhanced by long-term exercise (Holm and Nachemson, 1983) and hindered by fusion (Holm and Nachemson, 1982). In back pain patients, a single session of lumbar joint mobilisation has been shown to increase water diffusion within a degenerated nucleus pulposus (Beattie et al., 2009). Running has been shown to stimulate disc cell metabolism & prevent disc narrowing in rats (Wei et al., 2009).
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(045) 874 682
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