I’ve said it a million times, so I guess I’ll say it one more time. Low back pain (Lower Back Pain, Lumbar Pain) is a global epidemic as 80% of adults will experience low back pain at some point in their life. Treatment options for low back pain can be overwhelming and result in frustration because generic treatments may not target the nuances of low back pain - potentially leading to chronic low back pain.
Additionally, the over utilization of unnecessary imaging studies, medications, and even surgeries have added to the prevalence of chronic and recurrent low back pain.
But first, let’s dive into a few stats on lower back pain:
As recently as 2020, an estimated 619 million people had experienced lower back pain, and we can only assume that number has risen since.
The odds of experiencing low back pain increase with age, and typically peaks at middle age. Additionally, gender differences indicate that women are more susceptible to experiencing or reporting low back pain.
Most importantly, low back pain is considered the leading cause of disability across the entire world.
Quick Anatomy review of the lower back.
The low back, much like many other regions of the body, consists of a variety of muscles, ligaments, fascia, bones/joints, discs, and nerves that can all be the source of your pain or injury.
Depending on the cause or mechanism of injury - ranging from lifting in the gym, repetitive twisting with housework, falling, a car accident, prolonged sitting occupation, or many many more causes - these actions will create different amounts of stress to different structures, resulting in a a wide assortment of injuries.
Each of these above structures can cause pain with tissue injury; however, each structure is treated significantly differently. Different structures will respond uniquely to movements and applied stress, making relief difficult when generic treatment is administered.
For example, sitting down/bending forward may feel good and recommended for ome joint related injuries at the lumbar spine - but this may cause further injury or even increase pain to a disc-related or muscular injury to the low back.
Common Injuries Called Low Back Pain
As you may know, “low back pain” is an umbrella term that encompasses a variety of injuries.
A few examples of a some diagnoses colloquially called low back pain include:
Herniated discs
Muscle strains (pulled muscle)
Facet Joint Injury
Arthritis
SI Joint pain
Double crush injury
Thoracolumbar fascia Injury
Each of the above injuries can have overlapping symptoms and be referred to as lower back pain. However, as alluded to above, each of these structures needs to be addressed in a unique manner
This is the primary reason that a thorough Osteopractic Physical Therapy Evaluation with accurate Differential Diagnosis is performed on the first visit of Physical Therapy.
Conservative Treatment Options for Low Back Pain
When your Physical Therapist has the ability to spend 60 minutes of uninterrupted time to listen to you and perform a thorough assessment, then the root cause can be uncovered by utilizing a systematic approach of ruling out or ruling in sources of pain.
As a result of performing this detail oriented assessment, the proper treatment interventions can be selected based on your presentation. These interventions can be a mix of Dry Needling, Spinal Manipulations (Adjustments), Joint Mobilizations, Stretching, Cupping, Scraping, and Corrective Exercises/Strengthening Exercises.
Each of these interventions will have different rationale and there is not a one size fits all treatment strategy for low back pain.
For example, the layman’s terms rationale of benefits and utilization of Dry Needling consists of:
Decreased pain at the target tissue
Improved blood flow
Decreased pain sensitivity with chronic pain conditions
Reduced stiffness
Improved range of motion and flexibility
Improved tissue healing
Subsequent decreased medication usage
Dry Needling may be appropriate for a patient with muscular tightness but maybe not appropriate for a patient with a fear of needles or has post-surgical lymphedema.
While the layman’s terms rationale of benefits and utilization of Spinal Manipulation (adjustments) consists of:
Improving Pain Pressure Threshold
Muscle Relaxation/Inhibition to associated vertebral levels
Nervous System reset
Spinal manipulation may be appropriate for the patient with lumbar hypomobility (stiffness) but not appropriate for a patient with comorbidity of long term steroid use or metabolic bone disorder or suspected cauda equina.
And of course, the correct strengthening exercises are a vital component of a treatment plan for low back pain.
The point of the previous examples is simply to illustrate that every patient presenting with low back pain is unique and should be assessed independently because not every intervention is appropriate for every patient - thus, there are no generic treatments.
Moral of the Story
Carefully selected, conservative treatment strategies consisting of a variety of treatments - including dry needling, manual therapy, and strengthening - for low back pain are very beneficial in the treatment and prevention of lower back pain.
And as your pain and symptoms resolve, then increased resistance training / loaded strengthening programs to the lumbar spine are added and can help prevent reinjury.
And if you are in the Acadiana region - Lafayette, Youngsville, Broussard - then you have an Osteopractic Physical Therapy clinic right in your backyard. At Flow Physical Therapy in Lafayette, Louisiana, we provide 60 minute, uninterrupted and personalized Osteopractic treatments to make quick work of your low back pain.
Click the button below to finally address the stubborn low back pain that just doesn’t seem to go away no matter what you try.
Dr. Patrick Thompson, PT, DPT, OCS, Dip. Osteopractic, FAAOMPT
Owner of Flow Physical Therapy and Wellness
337-366-1703
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