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Lower Back pain - Part 2

29/4/2014

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Treatment for lower back pain is often pain medication is the first option people think about when treating back pain to get quick relief. This may be fine for short term, however until the cause is addressed and treated, the symptoms will continue to appear.

There are many different options for treating back pain, and depending on the cause, a combination of different therapies may be required. Since everybody is different, what works for one person may not work for the next, so it is important to find what works for you.

Trigger Points in Lower Back
Myotherapy is extremely helpful in reducing pain and tension through the body, as when muscles are tight, they can affect posture, and therefore tension throughout the whole body. Tightness through the psoas, quads, rectus abdominus, gluts and diaphragm tend to be muscles that are neglected in treating lower back pain. Working through these soft tissues with your myotherapy can bring about great results, even after one session.
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Lower torso trigger points
Your myotherapist treats soft tissues, bringing the musculo-skeletal system back to a state of balance. A Myotherapist may use techniques such as; muscle manipulation, dry needling, trigger point therapy, cupping and will provide the client with advice regarding self-treatment, corrective exercises and stretches.

Another form of treatment that is very beneficial is floatation therapy. By lying in a quiet, dark floatation tank that is filled with 350kg of Epsom Salts (magnesium sulphate), a client can get relief from lower back pain through calming the nervous system, removing gravity creating a feeling of weightlessness, and also by offering natural pain relief through endorphin-release.
Risk Factors for Developing Lower Back Pain
There are certain factors that can increase your risk of developing back pain, or aggravate it once you have it, including:

  • Being stressed or anxious
  • Poor posture
  • Standing, sitting or bending down for long periods
  • Lifting, carrying, pushing or pulling loads that are too heavy, or going about these tasks in the wrong way
  • Having a trip or a fall
  • Being overweight
  • Weak core muscles
  • Wearing incorrect shoes
  • Sleeping on a mattress that is not suitable for you body
  • Using the incorrect pillow - you should consider a pillow and sleep consultation at the clinic

Self Care for Lower Back Pain  
If you are suffering lower back pain, these are some of the things that your myotherapist can recommend to you to help, it if you can’t see a health professional straight away.

  • Cool or Heat Therapy - Ice is best in the first 24 to 48 hours after an injury because it reduces inflammation. After 48 hours, you can switch to heat which will help to relax the muscles, as well as providing some pain relief. Whether you use heat or ice — take it off after about 20 minutes to give your skin a rest. If pain persists, talk with your myotherapist.

  • Natural Pain Relieving Gels -  Sombra is a fast acting natural pain relieving gel that brings temporary relief to lower back pain and other forms of pain.

  • Keep moving - As much as you may not feel like it, it is important to keep moving – keep doing your daily activities where possible. Moving will stop muscles and joints from stiffening up, which will only make the pain or discomfort worse. Only do what you can, don’t overdo it. Gentle movement such as walking and swimming are great ways to keep mobile. As you get better, increase your activity levels and your myotherapist will recommend exercises to help strengthen the muscles around your spine, pelvis and core muscles, as this will increase your back support.

  • Stretch - Gentle stretching can really help your muscles to stay flexible and can help to reduce tightness. If you are sitting a lot, getting up to stretch your legs is important as inactivity (especially sitting for long periods) will only make your back pain worse. Or you can also try sitting on a firm chair instead if your soft couch.

  • Watch your posture - Slumping makes it harder for your back to support your weight. Be especially careful of your posture when lifting heavy objects. Never bend over from the waist. Instead, bend and straighten from the knees.

Call Your Doctor If:
  • You have weakness or numbness in your legs, or you have trouble standing or walking.
  • You lose control over your bowels or bladder.
  • Your low back pain is severe, doesn’t go away after a few days, or it hurts even when you’re at rest or lying down.
These could be signs of a nerve problem or other medical condition.

Preventing Lower Back Pain

It is good to take note of what you have been doing (or not doing!) that affects your back pain. Some ways to prevent lower back pain include:
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Preventing lower back pain
  • Exercise - Go for walks, go for a swim, increase core strength training
  • Stretch - Especially any neglected muscles that may contribute to lower back pain such as psoas, gluteals, quads and abdominals.
  • Drink water - Hydration is vital to disc health. Dehydration can weaken and shrivel your discs, and combined with inactivity, this can lead to disc problems.
  • Diet - Eat nutritious foods, especially vegetables and foods rich in omega 3 fatty acids such as salmon, coconut oil, avocado and olive oil.
  • Sleep - Sleeping on your side with a good mattress and good pillow, making sure to alternate sides.
  • Posture - Good posture is vital to minimising back problems.
  • Shoes - Avoid wearing high heels, wear comfortable and supportive shoes to help maintain good posture.
  • Get bodywork - Myotherapy is a great way to keep your musculoskeletal system in balance, which can prevent you getting back problems. Your myotherapist will give you specific strengthening and stretching exercises to bring balance back to your body.
  • Think ergonomically - Design your workspace so you don’t have to hunch forward to see your computer monitor or reach way out for your mouse. Use a desk chair that supports your lower back and allows you to keep your feet on the floor.
  • Stop smoking - Smoking can increase your risk for osteoporosis of the spine and other bone problems. Osteoporosis can in turn lead to compression fractures of the spine.
  • Watch your weight - Use diet and exercise to keep your weight within a healthy range for your height. Being overweight puts excess stress on your spine.
  • Wallets - Removing your wallet from your back pocket can alleviate some stress on the back.
  • Nutritional supplements - Fish oil and magnesium tablets can help with back pain.
Lower back pain does not have to take over your life. In many cases, there are ways to get the help and support you need, if you choose to find it. If you are suffering from lower back pain, why not try myotherapy and see for yourself how it can help you. You can make a booking online or you can call us on 9440 9453.

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Lower Back pain - Part 1

27/3/2014

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Lower back pain
If you are experiencing lower back pain, you are not alone…

Did you know that 80% of people over the age of 35 experience lower back pain at some point in their lives? And 1 in 4 people will be suffering from it right now…

PictureLower Back Pain
About Back Pain
Back pain is one of the most prevalent health conditions affecting at least one in ten Australians at any time. According to the Medical Journal of Australia, “up to eighty per cent of Australians will experience back pain at some point in their lives and 10% will experience significant disability as a result. Lifetime prevalence of low back pain is reported to be as high as 79.2% in Australian adults and 84% in adolescents”. One in four adults with back pain are reported to have fair to poor physical health, compared with one in nine of the general population. Back pain has been reported to double or even triple feelings such as sadness, worthlessness, hopelessness, as well as feeling like everything is an effort.

There is also a link between chronic pain and depression, and they commonly occur together. Depression is often associated with decreased function due to chronic pain, as people are unable to do the many things they would normally have been able to do without pain.

Back pain can refer to both upper and lower back pain. Upper back pain affects the mechanics of the lower back, so sometimes they will co-exist. This blog will focus on lower back pain.
What is Lower Back Pain?
Acute Back Pain vs Chronic Back Pain

Lower back pain can be experienced as pain or tension around the lower back area (lumbar spine) and can affect the spine, joints, ligaments and muscles as well as nerves.
The causes of lower back pain are varied, from either irritation to a nerve or muscle, to tightening of the myofascia (connective tissue covering a muscle) to physical damage or dysfunction of the spine… it can be either an acute or chronic condition, with different types of pain of varied intensities.

Generally acute back pain is considered pain lasting a few days up to 6 weeks, sub-acute back pain lasts 6 weeks to 3 months, and chronic back pain lasts longer than three months.

Anatomy of Lower Back
Lower Back Pain – Lumbar Facet Joint

Your back (spine) provides you with support, mobility and protects the spinal cord. The vertebrae articulate with each other via the facet joints along the spine, and are also separated from each other by a “shock absorber” known as an intervertebral disc.

The vertebrae are held together by ligaments, and create the site of attachment of the back muscles. Spinal nerves exit at the side of each vertebrae, which send messages to the muscles, organs and the brain.

The lower back refers to the lumbar spine area. It is a complex structure composed of the vertebrae (the bones of the spine), muscles, nerves, ligaments, and other soft tissues. Lower back pain can result from either injury and damage to any of these structures, or can also be caused by the spine and body being in mis-alignment due to tension in some muscles as well as the connective tissue (myofascial tissue / fascia).
Sometimes, it is actually not just muscular tightness, but fascial tightness that is the problem. Fascia is a web of connective tissue throughout our body that literally connects everything. It covers muscles, creates tendons and ligaments, covers organs and connects muscle to bone. It is a highly adaptable tissue, with elastic properties. Deep fascia can contract and is affected by the stress response. Fascia tightens, which creates tension. After the period of stress has passed, the fascia and muscles may remain in a state of tension, which can lead to damage, trigger points, adhesions and even create scar tissue over time.
 Commonly, the muscles that are responsible for creating pain in the lower back area, include:
  • Psoas
  • Quads – particularly Rectus Femoris
  • Quadratus Lumborum
  • Latissimus Dorsi
  • Adductors
  • Rectus Abdominus
  • Gluteals
Thoracolumbar Fascia Can Contribute To Lower Back Pain
PictureThoracolumbar Fascia
Fascia connects via Myofascial Lines or “Fascial Trains”, whereby muscle fibres that run the same direction connect via the fascia. Looking at the picture of the Superficial Back Line (one of 12 different Myofascial Lines”), you can see that fascia connects your head to your toes – literally! Fascial line tightness can contract not only the fascia covering the muscle, but can contract a whole line of fascia, creating overall tightness throughout the body, which creates musculoskeletal imbalances.

The thoracolumbar fascia is a diamond shape of connective tissue that is located directly over the lumbar spine area. It forms the attachment of the Latissimus Dorsi Gluteal muscles, and the Transverse abdominus muscle (core). This area can also become tight and contract, creating postural imbalances.

Causes
It’s sometimes hard to know exactly what causes back pain. It’s usually thought to be related to a muscle strain or mechanical dysfunction in one of the structures in your back, rather than just a nerve problem.

For many people with back pain, there isn’t any one specific underlying problem or condition that can be identified as the cause of the pain. Lower back pain can have many causes including:
  • Weakness of core muscles can mean that more load is taken through the back, putting pressure on the lumbar spine
  • Fascial tightness – increased tension in connective tissue, making it prone to injuries such as tears or strains
  • Back muscle strain or sprain
  • Disc injury or degeneration such as slipped disc, bulging disc, herniated disc
  • Scoliosis
  • Nerve-root pressure / nerve irritation / nerve impingement
  • Spinal stenosis (a narrowing of the spinal canal through which the spinal cord passes)
  • Inflammation in the surrounding areas which is where turmeric may help relieve pain
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Examples of Disc Problems
  • Degenerative disease such as osteoarthritis or osteoporosis
  • Rheumatoid arthritis
  • Back or spinal injury
  • Spondylolisthesis (vertebrae slips forward and out of position)
  • Repetitive Movements
  • Postural stress
  • Abnormal bone structure e.g. short leg or asymmetrical pelvis
 
Back pain may also be caused by an infection or cancer, but these two causes are very rare. The most common causes are either injury or strained/sprained/tight muscles.

Symptoms of Lower Back Pain
Symptoms of lower back pain can depend on the cause. Some common symptoms include:

  • Muscle spasm and tightness
  • Muscle cramps
  • Stiffness
  • Pain around the back and buttock areas
  • Numbness
  • Tingling
  • Aches
  • Muscle Spasm
  • Locking joints creating a limited range of movement (ROM)
  • Weakness

If you are experiencing these symptoms, book online now to see our Myotherapist today who can start treating you for your lower back pain.

In “Part 2″ our next blog will cover treatment options, self care and prevention of lower back pain, so stay tuned!


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    Lena Yammine is the author of the Inner Outer Health Blog.

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