It has been an incredible journey to be a physiotherapist over the past 24 years. When I started practicing, a physiotherapist still required a referral from a physician in some places and we relied on heat and physiotherapy type machines for temporary pain relief. We still discussed things like rest and bracing for back pain (now replaced with advice for early activity). Now we can confidently assess and treat low back pain and have a number of proven strategies to help people.
Back pain is complex. It can arise from a trauma or for no apparent reason at all. It can involve a number of structures in the back from joints, ligaments, muscles, discs, nerves and more often than not, most of the above at the same time. Back pain can be aggravated by certain activities and postures, previous injuries, deconditioning (such as weakness, or stiffness), fear of movement and stress or anxiety. Imaging such as x-ray or MRI can be helpful in confirming a diagnosis but is not the whole picture. MRI findings do not always point to the source of your pain. The assessment in clinic is key in assessing the source of your pain, your function and possible causes for ongoing low back pain.
While back pain can be complex, the treatment and management of back pain doesn’t have to be. The main goal is to have a healthy back which means minimal pain, good mobility, strong and flexible muscles and able to do activities without fear. This is achieved in physiotherapy through a combination of therapeutic exercise, manual therapy, occasionally IMS/dry-needling and for more stubborn back pain, consultation with a physician for possible interventional procedures.
If you’re having back pain you probably know that keeping active is important and exercise can be helpful. However it’s hard to know what to do when you are in pain. This is where seeing your physiotherapist early is really important. You’ll get a diagnosis and prognosis for your back injury or condition. You’ll learn what types of activities you can do and how much. You’ll learn specific exercises to reduce pain and get your back healthy again. You may also get help through in clinic treatment such as manual therapy or IMS to regain mobility and reduce pain you cannot get on your own. The earlier we see people with their back pain, the easier their recovery.
Rob Holmes, PT, BScPT, MClSc, FCAMPT, cGIMS, is a Physiotherapist at Evidence Sport and Spine North.