To better understand the possible causes of LBP, let’s first get to know the structure of the spine. The adult spine consists of twenty-four stacked vertebrae atop the sacrum of the pelvis and the coccyx or tailbone. The lower back, also known as the lumbar spine, consists of five vertebrae and comprises the space between the lower ribcage and the top of the pelvis and sacrum. The spinal cord runs through a canal created by these vertebrae. Through small holes in the vertebrae, spinal nerves that control motor and sensory function of the lower body and bowel and bladder systems, exit the spinal canal.

Intervertebral discs sit between each vertebrae providing cushion, shock absorption and support. Finally, there are many muscles that compose the back. Some muscles are more superficial--closer to the skin--and often help in moving or positioning the arms. Intermediate layers of muscles act on the ribcage to help with respiratory function and finally there is the deep layer of muscles which lie close to and help move the spine. Any of these anatomical structures may be involved in back pain or injury and your physical therapist will perform a series of tests and measures to help them localize the cause.

Intervertebral discs are made up of a gelatinous center called the nucleus pulposus surrounded by a strong, fibrous outer layer called the annulus fibrosus. When excess pressure or strain is applied to the spine the annulus fibrosus can tear which allows the central nucleus pulposus to extrude out the opening. This is called a disc herniation. The bulging disc can then place pressure on the delicate nerves. Disc herniations sometimes occur acutely as a result of a sudden force applied to the spine such as lifting something heavy with poor body mechanics. It can also occur as a result of slow degeneration or tearing of the annulus over time such as can happen after years of standing or sitting with poor posture.

WHAT SYMPTOMS OF LOW BACK PAIN CAN IMPROVE WITH PHYSICAL THERAPY?

• Aching, burning, sharp or dull pain in the lower back.
• Aching, burning, sharp or dull pain that radiates into the buttocks, thighs, lower legs or feet.
• Numbness or tingling in the legs, back or groin area.
• Muscle weakness in the legs.
• Changes in bowel and bladder function.

WHAT ARE THE CAUSES OF LOW BACK PAIN?

• Degenerative disc disease.
• Disc herniation.
• Fracture.
• Muscle strain.
• Postural dysfunctions.
• Spinal stenosis.
• Sciatica .
• Lumbar radiculopathy or pinched nerves.
• Spinal tumor.
• Osteoarthritis.
• Bone spurs.

The goal of physical therapy treatment for LBP is to relieve symptoms while addressing any underlying or contributing factors that may predispose you to recurrence or progression of your pain. As mentioned above, my team and I will create an individualized treatment plan based on your unique presentation and the findings of our exam but here are some treatments commonly used to manage LBP:

Reduce pain, inflammation and irritation:While completely eliminating your symptoms may take time, making you more comfortable in the meantime is an important first step in your rehabilitation. Applying ice or heat, ultrasound or electrical stimulation to the affected area can often give you some relief. Soft tissue mobilization or gentle joint mobilization may also be employed by your physical therapist to reduce tissue irritation.

Improve flexibility: When a joint lacks the flexibility needed to perform a movement optimally, extra stress and strain may occur in the spine. Your back PT program may include stretching, myofascial release techniques, joint mobilization and mobility exercises to improve flexibility in the back itself but also in other areas of the body such as the ankles, hips, and shoulders.

Build up your strength: Just as lack of flexibility around joints of the arms and legs can lead to pain or tightness in the back, lack of strength and stability can too. You will learn exercises to help strengthen the muscles around the back and abdomen to properly stabilize the spine and also in the arms and legs to minimize excess strain transfer to the back.

Optimize your movement: Learning proper biomechanics and enhancing the neuromuscular control of joints and muscles is an essential component of healing and preventing back injuries. Physical therapists are movement experts and through analyzing your movements, can guide you in improving how you move and train your muscles to perform those movements in the safest and most effective way possible.

If you are dealing with low back pain and ready to find a long-lasting solution to your symptoms call us today to learn more about our services and schedule an evaluation: