Lumbar Spine (Low Back) Pain
Low back pain can come from a number of structures including the facet joints (which are the bony connection between the vertebrae), the discs (in between the vertebrae) as well as surrounding musculature.
Lumbar facet joint pain
Facet pain is usually unilateral (1 side of the body). Lumbar facet joint injuries will refer from your back into the top of the back of the hip, however has the ability to refer further around the side of the hip or into your leg. Pain is often reproduced with leaning backwards. Physiotherapy aims to reduce the inflammation and muscular spasm surrounding the area, as well as joint stiffness due to injury. As a result of this injury exercise is prescribed to restore normal muscle function which may be altered due to your pain levels.
Osteoarthritis is when the joint cartilage degenerates. The inflammation from the process can be painful and often leads to the joint and surrounding structures stiffening up.
Physiotherapy will work with hands on techniques to reduce the stiffness in these joints and show you exercises to keep the joints moving and the surrounding muscles strong.
Lumbar disc injuries
Disc injuries can cause pain or pins and needles in your back and can even refer down your leg to your toes. Discs do not slip and never will due to their structural attachments and functional anatomy. However they can be injured and with more severe injuries, the internal jelly substance can protrude from the disc causing lots of pain.
Disc symptoms can be aggravated from sitting, bending, lifting or even coughing. Discs can heal within a 3 month period if stressors are avoided and the muscles around the disc are strong. Your Physiotherapist will work with you to figure out what things you should avoid doing and to provide strengthening exercises.
Pars Defect and Spondylolisthesis
This condition can result due to a degeneration of the joints (arthritis) or due to stress fractures within the vertebrae. Spondylolisthesis is a forward movement of one vertebrae on top of another. Due to this manual hand on movement of joints is contraindicated and exercise is your primary method of improvement. Most of the time spondylolisthesis is found incidentally on an x-ray and often causes us no concern, however can cause low back pain. If the condition is as a result of stress fractures, immediate removal from stressing activities is utilised to reduce ongoing risk of injury. Common sports that cause stress fractures in the lower back include cricket, gymnastics and football. Treatment is aimed at reducing stressors of the area and improving the control and strength of the muscles surrounding the low back. If it is from a stress fracture, return to sport or activities can be very slow (up to 12 months).
Pregnancy related low back pain
Pregnancy alters the load through the lumbar spine. This change in position can add extra pressure on the structures in your lower back, causing pain. Physiotherapy can work to reduce tight muscles and joints and to provide exercises to relief the pain at home. Taping and bracing can also assist to reduce your symptoms.