Got Back Pain? You May Need to See a Physical Therapist in Brooklyn

Got Back Pain? You May Need to See a PT

Back pain is a major health problem worldwide, and it is one of the leading causes of disability among older adults. It can affect a wide range of age groups, and frequently affects daily life, sleep patterns, work performance, and a decrease in overall general well-being.

Common Causes of Back Pain

While back pain is easily felt, unfortunately, the main cause is not easily diagnosed and identified. This is why medications are not enough to drive away back pain, and why physical therapy is important. A physical therapist may help to identify the main cause of the problem. According to research, the single most common cause of back pain is mechanical stress or soft tissue injuries. 

1. Mechanical Issues - this refers to a muscle strain or a ligament sprain. A strain happens when your muscle is stretched and pulled to a capacity it can’t accommodate. This commonly happens due to overuse, fatigue, poor alignment and improper use of a muscle. For example, we can strain our back muscles if we perform a deadlift incorrectly. Another mechanical issue, a sprain occurs when a ligament (the structure that holds our bones together) is stretched and pulled. When this happens, it is then a muscle’s responsibility to hold the joints together, ultimately resulting in fatigue and pain. If this is the cause of your back pain, rest, stretching, and strengthening exercises are usually implemented during therapy. 

2. A herniated disc & degenerative disc disease - a disc is found in between our vertebral spine. It’s a jelly-like structure that functions as a shock absorber. Sometimes, a disc slips and wedges out in between where it’s supposed to be, and compresses the nerve roots found behind the spine. This then causes pain that corresponds to the nerve it is impinging on. With this type of back pain, one can also expect pain to be present in parts of the lower extremities. Intervertebral discs also go through the usual wear and tear we experience as we age, so they lose water and their jelly like consistency lessens which affects their shock absorbing function. Since they cannot resist forces well, the ultimate result is also back pain. 

3. Sacroiliac joint dysfunction - another condition that causes back pain is an issue with the joint that joins your sacrum at the bottom of your spine to your pelvis. Dysfunctions happen when there is too much or too little movement in this area. There is too little movement when we are very tight around the hips and pelvis, and there is too much movement when we are very flexible around the joint. Both of these circumstances lead to instability. A physical therapist can spot a sacroiliac joint dysfunction through special tests. 

4. Facet Joint Dysfunction - Facet joints are like the pillars of your spine. They connect vertebrae to one and another. Facets can be inflamed when there are degenerative changes. This can cause pain when you turn your back a certain way or if you try to bend forward or backward. When facets undergo degenerative changes, they can also affect the discs, thus causing even more pain to an individual.   

5. Trauma - Fractures and dislocation of spinal segments and parts can also occur, especially in contact sports. These can also result from a very bad fall, or a vehicular accident. Trauma to the spine not only causes back pain, but it can also put a person at risk of paralysis. 

There are also more serious underlying causes of back pain like cancer and osteoarthritis. The goal of physical therapy is not just to eliminate the pain, as medications do, but also define and eliminate the source of the pain itself.

You May Need to See a PT

If you’re in a lot of pain, you would most likely choose to lie down and rest, to let it go away by itself. However, studies suggest that resting will only make your back pain worse! This is because your muscles grow weaker with tightness and fatigue when there is pain and bed rest promotes even more weakness. 

So what should you expect from a typical physical therapy appointment? A PT will help you decrease the pain you are feeling by using physical agents like hot and cold compresses, electrical stimulation, and ultrasound therapies. Physical therapists may also try to do manual therapy in which they use soft and deep tissue massage to loosen your muscles, and joint mobilization techniques to loosen up tendons or ligaments. Lastly, they will teach you exercises that will help stretch and strengthen structures around your spine.

Williams and McKenzie Exercises

These two are almost always incorporated during exercise in a physical therapy program. Williams exercises are all about flexion of the spine, while McKenzie exercises are all about extension. They both consist of about five to six exercises or positions that you have to hold and perform, that stretch and strengthen your spine at a certain level. While they both try to address your pain, it is extremely important to know what is causing your back pain before performing any type of exercises. Williams and McKenzies are only meant for certain types of diagnosis. For example, if you have spinal stenosis, structures in your spine are crammed together when you extend your back. In this scenario, your PT will teach you William’s Flexion Exercises. In cases where a disc is bulging, your PT will likely teach you McKenzie’s Extension to help decrease the backward displacement of your disc. 

Think of your spine as the mast of a ship. It’s a tall pole that’s placed in the center of a ship, with lots of attachments but only a few supports. Your spine is surrounded by internal organs, ligaments and muscles. Your muscles are one of the main supports of your spine, so it’s important to keep them strong and healthy. If they tighten up or weaken, they cause back pain. Don’t forget to ask your PT for a home exercise program, and make sure to follow it!

Preventing Lower Back Pain From Returning

There is always a risk for back pain to return. So here are tips to prevent it from recurring:

1- Remain active. Live a healthier lifestyle!

This includes having a balanced diet. You should try to avoid being overweight since it increases the load on your spine. There is still much work to be done after Physical Therapy for back pain, so it is best if you can find a fitness regimen that will fit your schedule and lifestyle to prevent your muscles from being atrophied and stiff. It can be as simple as a low-aerobic activity like brisk walking in the morning, a 10 to 15 minute full body stretch before going to work, or swimming for an hour every weekend. Some patients feel comfortable with enrolling in yoga and pilates classes, since these types of exercise incorporate both stretching and strengthening in their poses. Exercise is very important as a lot of patients return to PT because their muscles went back to their original state, causing a recurrence of back issues.

2- Work on proper posture, and learn proper body mechanics

It’s quite hard even for the most fit individual to maintain proper posture at all times. One way to help yourself to keep a good posture is exercise, and another is learning proper body mechanics. Body mechanics is a term used to describe how to move around efficiently and without hurting yourself. There is a right way to lift that heavy box of paperwork, and there’s a proper way to move furniture. 

3- Reduce stress and quit smoking!

While back pain is as real as can be, one big factor that can affect it is stress. Having back problems while sitting in front of a desk at work? It will probably worsen if you are stressed and anxious about a deadline. Even worse, what started as just lower back pain can extend up until the upper back, or radiate down the legs- i.e.- Sciatica. Don’t forget to get some “me” time, meditate, and relax. Also, stop smoking. It’s not yet entirely clear how smoking specifically affects back pain, but it does narrow your blood vessels, which can result in decreased nutrients delivered to the spine and back area. 

Suffering from back pain? Give Evolve Physical Therapy in Brooklyn a call today! 1-718-258-3300

NYC's Premier Holistic Physical Therapy Clinics-

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

After Pregnancy Physical Therapy

Postpartum Physical Therapy Services

Exercising during and after pregnancy is exceptionally important, and every pregnant woman should invest her time doing so when under the supervision of her physical therapist and personal trainer.  Movement is the very essence of health and is beneficial to everyone. Just as a professional athlete needs to stay on top of his game year-round, future moms have to take extra care of their health status in order to be able to endure one of the most demanding and beautiful periods of their life.

Running through the basics - what can I expect during pregnancy?

Carrying a baby causes loads of changes, and a lot occurs due to physiological hormonal fluctuations in your body. In the beginning, everything is gradual, then it speeds up dramatically. In the final trimester, you can tell every difference from week to week.

All of this means changes in all tissues, but most important for us as physical therapists, connective and muscle tissue becomes more soft and flexible, so it can adapt to extra weight and distension happening in your abdominal area. It all sounds quite normal, and it absolutely is. However, things involving pain in the back and joints tend to happen as well,  and are often also categorized as "physiological" and transitory. Pain is not something you should tolerate, especially during and after pregnancy while stress is out of the question. My team here at Evolve physical therapy in Brooklyn can assure you that there is much that can be done to make your pregnancy as painless as possible.  

Physiotherapy for Back Pain

The lower back and joint system are where the pain is most likely to occur while carrying a baby. This usually happens around the 5th month, followed by an increase in body weight. Some of the other contributing  factors would be:

• Sitting a lot, or sleeping in a non-physiological position

• Laxity of ligaments in pregnancy

• Increased pressure on lower extremity nerves caused by the enlargement of the uterus

• Distension of the deep abdominal wall

Of course, not all of these problems happen to every single pregnant woman. But still, the main rule I always follow in this particular case is that exercise is our best friend in ensuring a more comfortable postpartum period. In that case, I suggest we get down to working out!

Relieving postpartum back pain is one of our main goals here at Evolve. You can expect one of our therapists to lead you through an individual postpartum workout plan consisting of carefully selected exercises to cover every critical region.

Strengthening your core is something your body will be most grateful for because weakness in the abdomen automatically means weakness of the spine stabilizing system. With nothing to hold your vertebrae, lower back pain is imminent. However, that is something we can and will change.

Our next stop will be mending the abdominal separation, also known as diastasis recti abdominis. During pregnancy as your abdomen distends, and connective tissue or linea alba that connects left and right side of the rectus abdominis muscle becomes stretched and become thinner. This allows the abdominal muscles to stretch as well and make room for the baby. Sometimes this separation in your abdomen spontaneously retreats after giving birth, but there are cases that demand physical therapy treatment. This is where we jump in, offering you the opportunity to try out our postpartum rehab program at Evolve!

Manual therapy as a Healing Approach

Manual therapy consists of applying specific techniques and skills such as joint manipulation and mobilization, as well as methods by which a physical therapist evaluates and treats soft tissues and bone structures. The primary goal of manual therapy is to reduce pain, increase mobility and eliminate inflammatory changes. This will, of course, result in better blood circulation in that region as well, ensuring much quicker convalescence in your postpartum period!

Manual therapy techniques can be used as a multi-modal approach, and we should always strive to combine them with other kinesitherapy and proprioceptive techniques. Many elements of this healing method require certain expertise, and that is why you should consider consulting one of our team members here at Evolve physical therapy.

How can strength training help me in the postpartum period?

Just when you think you're out of the woods you realize that there are loads of things waiting for you on the other side, and it's not going to be easy getting them back like they used to be. Like I said in the beginning, exercising at this point may feel over overwhelming after all you've been through, but it is your one-way ticket to feeling and looking healthy and functional once again. It will benefit you greatly, and help you to do the following:

Reestablish normal breathing patterns: In the postpartum period, paradoxical breathing can occur and gentle, steady breathing exercises and kinesitherapy is just what you need to get back on track.

Strengthen your deep pelvic floor: In order to prevent unpleasant incontinence episodes, muscles of the pelvic floor should always remain on top of their function and serve as a steady foundation for your urogenital tract and pelvic organs. To ensure all of this, we offer you to join us at Evolve and follow a workout plan devised by one of our team members that will help you in cases like this.

Improve stability of your lower back: We already talked about the importance of spine stability through pregnancy and it is equally important for it to stay stable and healthy after your postnatal rehabilitation. Again you can consult one of our therapists, and enroll in our postpartum rehab program that can be designed according to your needs!

Work with the Evolve Team for Physical Therapy After Pregnancy

There is absolutely no need for you to feel additionally exhausted and in pain because of a few bumps on the road. With the right amount of attention and work, everything can become the way it used to be. So come and join us so that we make sure you fully enjoy your newest phase of life. Oh and, congratulations!

How Can Physical Therapy Help My Sciatica?

By Nick Mazzone, PT, DPT, CSCS

What is Sciatica?

Sciatica is one of the most common symptoms associated with lower back pain. It refers to the sensation of burning pain that tends to radiate from the buttock down the leg. The distance the pain travels is typically correlated to the extent of the irritation effecting the nerves. The name “sciatica” comes from the sciatic nerve, which is one of the largest nerves in the body. The spinal nerves that become irritated are typically those that eventually come together to form the sciatic nerve (from spinal level L4 to S3). Sciatica is not a permanent condition and does not typically require surgical intervention.

What causes sciatica?

 These symptoms are typically caused by excess pressure on a nerve after it exits the lumbar spine (lower spine). This pressure can come from a herniated disc, arthritis in the lumbar region, and other conditions in which the space that the spinal nerve travels becomes compressed or shrinks.

How can physical therapy help improve this condition?

 This condition is relieved by decompressing the region in which these spinal nerves travel. This can be achieved through a specific mobility and strengthening program that includes postural education and awareness training. These specific exercises will depend on the location at which the nerve is being irritated. Generally speaking, in order to decrease pressure in the lumbar region of the spine, you must be mobile in not only the lumbar spine but the thoracic region (mid back) and hips. This will help take pressure off the low back by allowing a more even distribution of movement. Think about it this way: If you are lacking proper mobility in your thoracic spine, your lumbar spine will have to make up for this lack of mobility. This can lead to increased stress and strain in this area. The same idea works for the hips.

Postural training is important in helping to decrease pain and inflammation in the low back. The pelvis and lower spine are anatomically connected (the lower spine actually sits in the pelvis), and therefore movement between the two will be interrelated. The position of the pelvis will dictate the posture in our lumbar spine during all activities (including at rest!). Depending on where the nerve irritation is occurring, this positioning of the pelvis will either increase or decrease pressure on the nerve. If the irritation is occurring at the point where the nerve exits the spinal canal (at the nerve root), extension of the lumbar spine should help alleviate the pressure by “opening” the region where the spinal nerves exit, while flexion of the lumbar spine may increase pressure due to “closing” of the region. Refer to the picture above for a visual of this phenomenon. “Lordosis” is known as lumbar spine extension, while “flat” spine refers to a flexed spine. The picture below demonstrates these movements.

 Click here to find out more information about physical therapy for sciatica or call 1-718-258-3300

Check out this video that demonstrates a simple mobility exercise for the sciatic nerve to help alleviate your symptoms of sciatica:

Nick Mazzone received his Doctorate in Physical Therapy from Stony Brook University. He has a strong background in strength and conditioning and aims to bridge the gap between strength training and physical therapy. Nick believes that a lifestyle centered around physical fitness and mental well-being are vital to one’s successes and happiness. For this reason, he educates his patients on pain science and helps empower them and motivate them to reach their goals every day. You can find him at Evolve Physical Therapy in Mill Basin, Brooklyn, NY. To view some of his other content, visit drnickmazzonedpt.wordpress.com.

Resources:

 Main photo of sciatica pain in leg retrieved from https://www.magnilife.com/blog/5-effective-ways-for-dealing-with-sciatica-pain/

Photo of irritated nerve retrieved from http://arizonapaintreatmentcenters.com/from-dr-craig-peterson-mva-sciatica

Photo of lumbar flexion and extension retrieved from https://b-reddy.org/making-pull-ups-and-burpees-more-shoulder-and-lower-back-friendly/

Photo of pelvis position and lumbar spine retrieved from https://body-motion.co.uk/injuries/postural-pain/improve-your-sitting-posture/