JUST BECAUSE BACK PAIN IS COMMON
DOESN'T MEAN YOU HAVE TO LIVE WITH IT FOREVER
Can you just magically make back pain disappear? Clearly not, but don't give up hope. Whether you have an acute injury or chronic pain, there are safe ways to target those issues. Will it be a quick fix? Likely, it will not resolve overnight, but with the proper diagnosis and a personalized plan, you can not only decrease the discomfort, but you can also reclaim your life! Let's help you to recreate this childhood memory 😁
THE LOW BACK:
ALSO KNOWN AS THE LUMBAR REGION
The lumbar region of our body comprises five vertebrae (numbered L1-L5) that provide a significant source of stability for our trunk and upper body. Between the vertebrae are intervertebral discs that allow the spine to move and serve as shock absorbers and cushions throughout our entire spine. We have five lumbar nerves that branch off our spinal cord and exit below their corresponding vertebrae. The vertebrae are also supported by many different ligaments that provide stability and tendons that attach muscles to the spinal column. The vertebrae in the lumbar region are the largest of the spine as they are responsible for supporting more of our body mass than segments in our mid to upper back. The intervertebral discs in this region are also larger, allowing for more movement to occur in this region. The primary motions that occur in the lumbar spine are forward bending (flexion), backward bending (extension), and lateral bending (right or left side bending); minimal rotation occurs in the lumbar spine.
Many muscles make up the lumbar region. A group of these muscles named together as the erector spine (iliocostalis, longissimus, spinalis) run along each side of the entire spine. These muscles are the primary extensors of the back when they work together. However, if one side works alone, they assist in side bending. Sitting deep to the erector spinae is another group of muscles known as the transversosponales (semispinalis, multifidus, and rotatores). These muscles are smaller, attach to the vertebra, and play a supportive role while assisting with extension and rotational movements. The transverses abdominus, one of our main core muscles, originates in this area and is an excellent source of trunk stability and control. Other muscles in the lumbar region are the quadratus lumborum and attachments of the psoas and iliacus, which are often associated with our hips.
As we mentioned last week, low back pain is the most prevalent reason our clients seek care with us. Though some causes of low back pain can be serious, this typically only accounts for 1-2% of people suffering from low back pain. Certain causes of low back pain are highly specific and are associated with neurological deficits; however, these also only make up about 5-10 % of all low back pain causes. We can rule out serious and neurological-related back pain with a detailed assessment during an initial evaluation. If any findings suggest a more involved reason for the low back pain, we will refer to the appropriate provider for further assessment.
However, most people presenting (90% or more) with low back pain fall into non-specific/mechanical/simple low back pain. In PT, we assist in identifying the impairments that have contributed to the pain. Factors that can contribute to pain in the lumbar region can be biological (weakness, loss of mobility/stiffness, etc.) as well as psychological (depression, fear of movement, etc.) or social (poor work environment, overtraining, etc.). During our evaluation, we will observe many measurements to identify the cause of the pain. Some examples of the tests we will perform are:
a demonstration of painful movements
a squat test
a lumbar movement assessment
core strength testing
testing of the muscles in the legs
testing of lumbar nerves
testing of reflexes
palpation of painful areas
assessing areas above and below the painful region
We compile information gained from our assessment to identify the cause of the pain. Our clinic's most common causes of low back pain are usually related to weakness in the core or supporting muscles such as the glutes. Weakness can lead to instability in the low back, which can cause pain and problems during motion. Other causes are limited mobility, lack of activity (prolonged sitting), lumbar muscular strain, or traumatic injury (fall, athletic injury, motor vehicle accident, etc.). Treatment for low back pain is based explicitly on the cause. However, most treatment includes drills to improve mobility, exercises to improve strength and stability, and manual therapy to manage symptoms and promote improved mobility. Physical therapy has an excellent success rate in alleviating the cause of non-specific/mechanical/simple low back pain; typically, over 90% of our clients with this sort of back pain note improvement or resolution of symptoms within 3-4 months (some even sooner!) The duration of symptom resolution is often associated with the duration of symptoms; the sooner an assessment can be performed to identify the cause of the problem, the sooner interventions to help fix the problem, and the sooner the pain will be resolved!
We hope this introduction to the lumbar region serves as a brief lesson into relevant anatomy and how PT can be used to assist in the treatment of low back pain. Similarly, we hope to reassure those suffering from low back pain that most cases are from benign causes and respond very well to guided mobility and strength training. If you suffer from low back pain, know you are not alone. According to Physiopedia, "Low back pain (LBP) is the fifth most common reason for physician visits, which affects nearly 60-80% of people throughout their lifetime"
WORKOUT OF THE WEEK
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LOCAL OPPORTUNITIES
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FROM THE BEND HEALTH FAIR:
"Join us at the Riverhouse for a day of fun while meeting local practitioners, coaches, therapists, counselors, makers, and health related organizations & businesses! We are hosting 40,000 square feet of local exhibitors with free classes and demonstrations! We will be raffling prizes to support Family Access Network! Bend Health Fair is a fun family community event. We will host a children’s section, pet section, and a makers section with art, foods, crafts, etc.Your $5 entry supports Family Access Network; to help families receive critical basic need services in Central Oregon."
WE'VE GOT YOUR BACK
Literally! Chronic low back pain can truly alter every aspect of your life. Our back plays a central role in our daily life and the many activities we enjoy. Unfortunately, without targeted intervention and a solid plan many people will avoid movement which can make the situation more complex. We would be honored to work with you and would love to play a role in helping you reach your goals and alleviate your pain.
We are here when you are ready,
Nicole and the OMPT team Want workouts specific to your activity? Reach out for a customized plan. Is there a particular sport or activity you'd like us to highlight? If so, please click here to give us your ideas!