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Chronic Back Pain Physiotherapy
Low back pain (LBP) is the fifth most common reason for physician
visits (this means that 20%, or 1 in 5 visits to doctors are because of
low back pain). To make matters worse, low back pain affects nearly
60-80% of people throughout their lifetime.
Low back pain that has been present for longer than three months is
considered chronic (long term), although there is still no consensus about the
definition of chronic low back pain (CLBP).
Right now, specific causes of LBP are uncommon, and in
approximately 90% of patients a specific generator cannot be identified
More than 80% of all health care costs can be attributed to chronic
LBP. Nearly a third of people seeking treatment for low back pain will
have persistent moderate pain for one year after an acute episode. It is
estimated that seven million adults in the United States have activity
limitations as a result of chronic low back pain.
Clinically Relevant Anatomy
The lumbar region is situated under the thoracic region of the spine.
The lower back consists of five vertebrae (L1- L5) and has a slight
inward curve known as lordosis. The fifth lumbar vertebrae is connected
with the top of the sacrum. The vertebrae of the lumbar spine are
connected in the back by facet joints, which allow for forward and
backward extension, as well as twisting movements.
The two lowest
segments in the lumbar spine, L5-S1 and L4-L5, carry the most weight and
have the most movement, and this is what that makes the area prone to injury.
vertebrae are spinal discs, and they provide shock-absorbing functions to support. Discs in the lumbar
region of the spine are most likely to herniate (slipped disc) or degenerate (degenerative disc disease), which can
cause pain in the lower back, or radiating pain to the legs and feet.
The spinal cord travels from the base of the skull to the joint at
T12-L1, where the thoracic spine meets the lumbar spine. At this
segment, nerve roots branch out from the spinal cord, forming the cauda
Some lower back conditions may compress these nerve roots,
resulting in pain that radiates to the lower extremities, known as
The lower back region also contains large muscles that
support the back and allow for movement in the trunk of the body. These
muscles can spasm or become strained, which is a common cause of lower
5-10% of all low back pain patients will develop into chronic low back pain (ie long term).
From research, CLBP
prevalence rates are lower in individuals aged 20-30 years, increasing
from the third decade of life, and reaching the highest prevalence
between 50-60 years.
That being said, the prevalence rates stabilizes in the
seventh decade of life. There’s no difference in CLBP prevalence at
different periods of the year or in different places.
There is higher CLBP prevalence in
- people of lower
- people with less schooling
indication that prevalence has doubled over time too, which may be due to
important changes in lifestyle (obesity) and in the work industry.
Factors as a
- family history of disabling back pain
- radiating pain
- advice to rest upon back pain consultation
- occupational LBP or
caused by traffic injury
are all associated with chronic disabling back
pain over lifetime. Job satisfaction and psychosocial factors also play a role in the development of CLBP.
In patients with low back pain (LBP), alterations in fiber typing
in multifidus muscle and erector spinae are assumed to be possible factors in
the etiology and/or recurrence of pain symptoms as it negatively affects
muscle strength and endurance.
Most patients who suffer from chronic low back pain experience pain in the lower area
of the back (lumbar and sacroiliac regions) and mobility impairment.
Pain can also radiate (travel) in the lower extremities, or generalized pain can
be present. Patients with CLBP may also experience movement and
coordination impairments. This could affect the control of voluntary
movements of the patient.
It can be challenging for the patient to maintain the neutral
position, malalignment of the body can occur. It can also be found
difficult to maintain a standing, sitting or a lying position,
especially in case of radiating pain to the lower extremities.
things in the arms, or bending can also provoke complaints. Daily
activities, such as cleaning, sports and other recreational occupations
can become a big task for people with CLBP.
The complaints are recurring and occur longer than three months.
It is possible that CLBP passes in episodes. Some episodes are more
severe than others, but overall the patient is affected by the
impairments. Eventually, social contact and work environment will suffer
from this great impact on the patient's health and wellbeing.
Research has shown that the patient history and biopsychosocial
evaluation are crucial to establish chronic LBP. Patient history and
self-report forms help rule out serious pathologies such as
There are also clinical tests that could be used to sort patients
with a higher risk for CLBP from patients with (sub)acute low back
pain. The best predictor is the lumbar spine flexion test.
differences might be seen in
- functional tests
- sensation in the feet and
- in the different pain provocation tests
what our senior physiotherapists can do for your chronic low back pain
Patients with chronic low back pain generally don't need corrective spinal surgery and tends to respond well to spinal physiotherapy.
Some of the spinal physiotherapy treatments our senior physios may provide includes:
We may also recommend:
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(or check your pains / injuries)
Phoenix Rehab Physio Services
Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.
PHYSIOTHERAPY & PHYSICAL THERAPY
See all the conditions our principal physiotherapists treat.
HAND THERAPY & CUSTOMIZED SPLINTING
Patients who sustained injuries to their elbows, forearms, hands, wrists
(sprains and fractures) and fingers, usually will benefit / require Hand Therapy to
- manage and decrease hand pains
- improve range of motion, strength and dexterity
- increase the function of their hand
following injuries or post-operations
Commonly treated hand pain injuries includes
REFORMER CLINICAL PILATES & WELLNESS PILATES
Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.
It is a system of safe and effective exercises, which
meet specific individual needs, to treat a wide range of injuries
You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.
TRADITIONAL CHINESE MEDICINE (TCM)
- Cupping TCM
- Auricular Therapy TCM
- Herbal TCM Medicine & Supplementation
DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY
Sports and deep tissue release massage helps to increase nutrient-rich blood
flow to tired, tight and tense muscles to accelerate recovery and shorten downtime / recovery period required.
It also prevents
muscles from scar tissue micro-tears (and potential ruptures), and increases muscle
performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.
Read the benefits of regular deep tissue release therapy here.
All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).
See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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book an appointment today
(or check your pains / injuries)
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