Back pain is a condition that has challenged healers for thousands of years, there are Egyptian texts showing hands on treatment for back pain. This issue butts right up against our present day. The way we managed back pain in the 20th century did not work out, that’s putting it mildly.
The international medical trend to move away from any form of physical therapy; and instead emphasise pain killers, x Rays & bed rest, created what experts have called ‘a modern healthcare disaster’. It has been clearly stated by top gun medical researchers that this style of treatment created an ‘epidemic’ of people suffering with severe disability from their back pain. Thankfully we are slowly moving beyond this model of care into far deeper understandings, and far better outcomes for sufferers of back pain.
There are many different structures and tissues in the back that can be the source of pain. Bones, tendons, ligaments, fascia, discs, nerves can all be potential sources of back pain if they are not in a healthy, un-injured state. Deep muscle, fascia and weight bearing joints are by far the most common sources of back pain. These tissues are usually the first target of effective treatment in most cases of normal back pain, normal meaning, there is no major injury of disease process in the spine. When it is done in the right way, working with the soft tissues & joints can bring meaningful improvements in back pain episodes, and even in stubborn cases of back pain.
In general, effective treatment for back pain starts with accurate diagnosis and then finds ways to successfully target the specific painful tissues. In an ideal world ‘pain relief’ is merely a stepping stone to ‘rehabilitation’, pain relief is usually temporary, rehabilitation is more lasting
Step 1 – Get A Correct Diagnosis For Your Back Pain.
When you have back pain it is obviously important to know if you have joint pain, muscle pain, nerve pain, connective tissue pain, disc pain or something entirely more serious. A deeper level of understanding still, is knowing why these issues have arisen. Healthy discs don’t tear as a rule, and only a small percentage of us get muscle pain in our back while we perform ‘normal’ activities. These facts point to a deeper level of possible insight into your back pain. Questions like ‘Why would your disc tear just lifting a few boxes?’.. are the types of enquiry that open the door to a deeper level of investigation into back pain.
Ultimately most back pains boil down to faulty movement patterns and patterns of weakness, these are the causes of back pain and back injury. Identifying not only painful tissues but ALSO the patterns of weakness & imbalance that cause them, is the longer term path to successful management of back pain.
*Emotional stress and past trauma are major factors in many cases of back pain, dealing with these can be an essential part of treatment & diagnostics for a percentage of you. Here we are deliberately focusing on the biomechanical aspects of treatment. Even if you have stress related pain this is still important knowledge. If your tissues are in a healthy strong state it is very hard for them to generate ‘stress related pain’. If you have trauma and stress as part of your back pain the mind must heal, but so must the body.
Step 2 – Hands On Treatment For Your Back Pain
In most cases of back pain it’s necessary to work with someone who is willing to try a range of hand on methods to ease your pain. There are many exceptions to this rule, but if you have a healthy, normal body you probably need fairly vigorous exercise to stay fit, and you probably need firm hands on treatment in order to heal. At our clinic treatment examples include…
Acupuncture – acupuncture needles as a treatment for back pain are designed to reduce pain signals, reduce muscle spasm and increase blood flow.
Mobilisation – manual mobilisation of the spine can be very helpful, and is similar to the stretching you do yourself but can often achieve far greater range of movement.
Stretching – using hands on ways of stretching the back muscles with a trained practitioner can help free things up a lot when you are working to relieve back pain.
Manipulation – manual joint manipulation as a well established treatment for back pain, it is designed to increase movement and reduce pain signals.
Cryotherapy – the use of icepacks for managing back pain can bring a lot of relief. Ice reduces inflammation and interrupts pain signals.
Vibration Massage – deep percussive massage with the use of a mechanical massage machine can be extremely effective at reducing muscle spasm in the back.
Deep Tissue Release – releasing acupressure points that are found in the soft tissue of back pain patients can often make a big difference to your pain levels when you have back pain.
Suction Cups – using suction cups for the treatment for hip pain increases blood flow in the area, stretches the fascia and leaves funny marks that your friends and family will assume are bruises.
Scar Tissue Release – if you have had problems with back pain for a long time it’s quite likely you have some degree of built up microscopic scar tissue in the tissues of your back . There are stretching and scraping techniques that can break this kind of scar tissue up, this generally feels really good to have done.
If you have fairly minor back issues 1 or 2 treatments might do the trick. If you have a history with back pain you may find that you need a determined, flexible and open minded practitioner who is willing to ‘throw the kitchen sink’ at your pain to find out what works for you. People who have had back pain for a long time often find that they need a list of different treatments to manage and progress their back pain. If you need multiple treatments for your back pain it is often better to try and get them all done in an integrated way ‘under one roof’.
Step 3 – Rehabilitation Of Your Back Pain
If you suffer with stubborn back pain that you want to get rid of permanently it is likely that you will need to address the underlying weaknesses and imbalances uncovered in Step 1. This ‘rehabilitation’ step is important for those who want to attempt to resolve their back pain in the longer term.
The key to effective strengthening exercises for chronic back pain is learning to isolate your core muscles. The key to effective strength training for back pain is not planking and sit-ups. Planks and sit-ups are strength based exercises for the superficial layers of the trunk and the hip flexors, they do not target the deeper layers of the core. The muscles that have been shown to have an impact on back pain are the very deepest layer of stabiliser muscles.
At our clinic we take great care to teach people how to isolate and control their deepest core muscles. This can be a little tricky at first, but once you ‘get it’ it becomes a very rewarding process to deliberately create a feeling of inner strength in your back. Most people who do this work diligently, find that their back becomes dramatically less unpredictable and/or less achy within a matter of months.
A percentage of people with stubborn back pain also benefit greatly from insoles in their shoes, usually those people with either very high or very low arches. We spend our entire lives on very hard, flat and unnatural surfaces like concrete, this puts untold strain on delicate spinal tissues. Orthotics are a way of protecting the hip joint from these unnatural stresses in the longer term which can be extremely helpful when managing hip pain.
So here’s the thing .. try to resist getting swallowed up by solo attempts to treat stubborn back pain yourself. If you try a practitioner and it doesn’t work, try another one.
If you need root canal work there is no use thinking you are going to floss your way out of it. In the same sense, there is often no point in thinking you can personally stretch or plank your way out of stubborn low back pain. This is where healthcare professionals come in, we provide the health care (our job) that paves the way for rehabilitation (your job). Working on the strength and rehab side of things is your job. In the longer term and the right practitioner will point you in the direction of the the correct exercises for you. Then it is appropriate to go it alone.
Regardless of which treatments and exercises your particular case of back pain responds to the truth is these are all just the details. At the deepest level what we are talking about is the freedom to live a normal active life without being limited by unnecessary back pain. That’s worth whatever effort we need to make !!!!!