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Back Ache and Physiotherapy

67% of adults suffer from back aches and pains every year...and of these 70%, more than half of them develops long term back pain (chronic back pain).

Back pain can be cause by a variety of problems, because it's so complex. It can be due to the disc, or the joints, or the back muscles, or the ligaments attached to the back.

As clinicians, we note that most of the patients we've seen in our experience who suffer from back aches and pains develop them more likely due to postural and repetitive strains over time.

In some cases of back injuries and pains, it can cause sciatica, where the disc in the spine dislocates to one side, and this compresses onto the nerves there.

This is turn causes a nerve-type pain where one may experience pain, tingling, crawling, numbness, cold or stabbing pain that travels (also termed as radiating) down one side of their buttocks, thighs and back of calves.

Some patients also claim to experience pins and needles.

These sciatica-related sensations can last from days to months, depending on severity.

Symptoms of back ache may include:

1. Muscle pains and ache
   
2. Intense pain that seems sharp, shooting or stabbing-like in nature
   
3. Pain and discomfort that travels down buttocks, thighs and calves
   
4. You may find that your back and posture has become "stiffer and harder" than before
   
5. You may find that you have difficulties in standing upright due to pain
   

Our senior physiotherapists would need to assess and perform differential diagnosis to find out the main cause of your back aches and pains, and this is very important because if we don't treat the main cause of the problem (and just treat the symptoms ie pain), then you will just keep coming back to us - and that's not good.

We actually want you to be able to move without pain, and engage in activities, play and work that is important and meaningful.

Pulled Lower Back /Lumbar Muscle Strains

In some cases of patients, their back aches happen because of soft tissues injuries such as ligaments and muscles that are pulled due to overly taxing the soft tissues, or awkward positions/movement (eg "waking up with neck pain").

If the back pain is lower part of the back, they are termed as "low back pain" (LBP) and can be caused by nerve inflammation or radiculopathy or other structures in the lower back.

Sciatica

Sciatica pain is a very specific nerve type of discomfort and pain because of HOW it happens. Sciatica happens when the disc of a back joint slips out to the side and compresses onto the nerve there (the sciatic nerves runs on both sides of the spinal column at our hips).

When a back injury happens, this disc at the hip level may be dislocated, slipping out and pressing onto the nerves, which can cause mild to severe pain, weaknesses, discomfort and more.

Ruptured Spinal Disc

Sometimes the spinal disc inside the spine can be inflamed and swollen, leading to muscle spasms in the back, leading to very tight back muscles.

This is a commonly experience situation for patients who experience ruptured spinal discs.

Physiotherapy for back and neck pains

Physiotherapy for a person with back aches and pains really depends on the nature of the injury (medical history), amount of pain presented (and tolerance).

We will always start with pain relief modalities such as cold therapy to decrease the spasms and inflammation, ultrasound therapy to accelerate soft tissue healing, gentle mobs to glide the joints and tissues.

Once the pain levels are lesser/tolerable, we will start to increase the mobilizations of the joints, muscles and soft tissue, to increase range and decrease pain experienced.

Then we will move onto strengthening and return back to functional movements.

Physiotherapy for back aches and pains are generally between 6-12 sessions, some needs less, some need more sessions, depending on the severity of the condition and pains.

Patients may also receive the following physiotherapy treatment modalities:

• cold therapy
  
• moist heat paraffin wax therapy
• radio-frequency Indiba physiotherapy to accelerate soft tissue healing
• joint mobilization
• stretching exercises
• strengthening exercises
• scar management
• hands on manipulation and mobilization (manual therapy)
• computerized spinal decompression traction
  
• soft tissue management
• heat therapy and heat treatment and heat pack to relief tight muscles and joints
• ultrasound therapy to accelerate soft tissue healing
• exercise therapy
• acupuncture and/or dry needling
• deep tissue release
• and more