Back Pain Physio from Hogan and Mitchell

Back Pain

Back pain is very common and will affect approximately 80% of the population at some time in their adult life. It can be very painful and severely limit even simple day to day activities like sitting, bending/lifting and walking. Pain can be due to local muscles, disc or joint problems, and in some cases can spread down the leg. It is very rarely due to serious disease (less than 1% of all cases)

Sciatica is a term used to describe pain in the leg originating from the sciatic nerve. Other symptoms can include pins and needles, numbness and muscle weakness. More often than not this stems from a problem in the back where the nerve is irritated or trapped as it leaves the spine. Often these resolve on their own within 6-12 weeks but hands on treatment can help improve symptoms quicker.

The last 5 vertebral bones in your spine are what are referred to as your lower back (also called Lumbar spine). Between these vertebral bones are your discs. These are made up of a tough outer layer called the annulus, and a more gel like inner called the nucleus. You can get pain from any of the structures around your spine including ligaments, tendons and the joints and bones themselves.

The nerves that exit from this part of your back travel down your legs, and receptors in them supply your brain with information about sensation. These nerves also supply electrical signals from your brain to your muscles to make them work. Sciatica is an old-fashioned term for when the lower most nerve (the sciatic) can become irritated and give pain down the leg.

Why does it hurt?

Repetition of poor posture, an unhelpful/poor movement pattern, or a recent injury can bring on back pain.

Myths, misinformation or lost in translation?

We often come across people telling us they have ‘wear and tear’, ‘slipped discs’ or a ‘crumbling spine’ and occasionally someone who has been told they may end up in a wheelchair! Sometimes things get lost in translation so let’s try to explain what may actually be happening:

‘Wear and tear’ is a phrase associated with osteoarthritis. Just like on the outside we get a little more wrinkly and grey, on the inside we get older too. This varies a lot from person to person and it is a normal change to occur.
‘Slipped discs’
This a common misconception; the disc DOES NOT slip in and out, or move out of place. The medical term for a true ‘slipped disc’ is a bulge or herniation. This is where some of the contents of the disc push out towards or through a tear in the rear part of the disc, causing the disc to change shape slightly or some of the contents escape. The tear normally develops over time and often something very simple like a bend or twist is the straw that ‘breaks the camel’s back’. The majority of people who have this can recover with time and rehabilitation and only a small percentage of people actually require surgery. The posture or movement patterns need to be addressed to prevent recurrence.

‘Crumbling spine’
This is extremely rare and only ever affects the elderly population.

‘Twisted pelvis’
Evidence of this actually happening is extremely controversial and often very misunderstood by clinicians. Asymmetry is normal, we should not get hung up on it, but look for what we can change. Manipulation of the pelvis has been shown to make no difference to how the joints move, but effective rehabilitation and core stability have been shown to be extremely effective.

Hands on treatment can accelerate the recovery, combined with a simple change in habits and lifestyle and some rehab exercises.
‘Back pain need not cripple you unless you let it!’

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