Back Pain & Spinal Rehab
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A personal approach in Edinburgh
Why do I have back pain?
Back pain is one of the most common conditions that is seen by Healthcare professionals and will impact around 80% of the population at some time in their lifetime. Even though the prevalence is high it does not always have a long term impact, and many will recover quickly and return to normal function. In fact, around 65% will recover within 6 weeks but psychological and social factors may influence how well an individual copes with and recovers from an episode.
The spine is individually unique and is made up of many intervertebral discs, small facet joints, muscles, tendons and ligaments that all can be a source of pain. Age-related changes occur naturally in our back as we get older which typically affects the discs first and the facet joints later. The discs become smaller and dehydrated and the facet joints get normal arthritic changes. Generally, these changes do not cause symptoms, however, back pain can occur with or without a specific event or trigger. Most back pain is what's known as "non-specific" (there's no obvious cause) or "mechanical" (the pain originates from the joints, bones or soft tissues in and around the spine).
Is my back pain serious?
It is very unlikely that your back pain is caused by a ‘serious spinal problem‘. However, when back pain is accompanied by feeling unwell, weight loss, night pain, sweats, neurological symptoms affecting both arms or legs, bladder or bowel disturbance, recent history of cancer, you should see your GP or contact NHS 111. You may also be refered to an Orthopeadic spinal consultant
Why do I get the pain down my leg, is this Sciatica?
The nerves that pass from your back travel down your legs and if a nerve gets pinched in the back this can cause pain, pin and needles, and numbness, radiating down the buttocks, legs and feet. Sciatica is when it occurs at the back of the leg. It is most commonly caused by a ‘slipped (prolapsed) disc’ or arthritic spinal joints pressing on a nerve. Other conditions such as Spondylolisthesis (slipped vertebrae) can also cause this as well as stiffness and pain If symptoms persist after six weeks of conservative management as described above then see a spinal surgeon,
What can I do to help my back pain?
If you have had a recent episode of back pain good quality management can settle most episodes. For example, discuss with your Pharmacist or GP regarding medication if required and seek out your Physiotherapist. In the meantime try and keep moving, avoiding prolonged periods of sitting at the desk or lying and avoiding specific activities that provoke your symptoms. A course of Physiotherapy may incorporate manual therapy, mobility and flexibility work combined with strengthening. We may also use modalities such as Electrotherapy and Acupuncture to aid in pain reduction. Our goals at Stuart Mailer Physiotherapy are to help get you back to normal strength, function, lifestyle and reduce any reoccurrence through our core stability/spinal rehab plan and back to fitness programmes.
We will first discuss your history and your discomfort and then perform a detailed clinical examination of your back and associated areas. From this, we can then help diagnose your back pain and also give you reasons why it has occurred. This allows us together to formulate a treatment plan and rehabilitation plan. If we think we won't get you better we will refer you to an Orthopaedic consultant and help you get the right treatment required.
If you require physiotherapy, treatment may initially be manual therapy such as spinal mobilisation, soft tissue work or other interventions like Acupuncture or Compex and then we will use exercise therapy. Our goal is to help you return to the lifestyle you desire even if it is playing a sport, back to work or walking. Whatever it is, we will treat you and your back individually and bespoke giving you the best possible outcomes.
Back Pain Treatment
Back pain treatment can encompass a range of interventions. We may undergo manual therapy and joint/spinal mobilisations and soft tissue massage to help improve your movement and reduce pain. If pain is high we can use modalities such as Acupuncture to help reduce this and also reduce muscle spasms or muscle tone.
Electrotherapy such as the Compex can help increase your movement and muscle activation which can help start your rehabilitation. We will start your rehab straight away and this may be mobility, stretching or strength work. It is common to undergo a range of core stability training and other functional movements to help get you back to normal as quickly as possible.
Our Back to Life, Back to Fitness protocol includes mobility, strength and Core stability if required. This is basically a format to get you moving easier and get stronger to cope with your daily tasks or activities.
Core Stability Training
A Personal Approach in Edinburgh
Core Stability Training
Core stability training is a format of exercises designed to improve our abdominal, pelvis and lower back strength. This can also be seen as Spinal Rehab, Through a series of exercises, we can improve the muscular endurance and strength of these muscle groups that help provide support to our spine. Exercises are designed for the individual and are bespoke to their requirements and presenting factors. No core training class is the same as each person has different presenting factors. This may involve exercises that are seen in Pilates, Yoga or others and the use of equipment can be used such as gym balls, Bands, and Weights to all help facilitate increased strength, endurance and stability or our trunk. Many articles have demonstrated that core strength training strategies assist in the alleviation of chronic low back pain, especially if focusing on training the deep trunk muscles. As Stuart Mailer is a Physiotherapist, Sports Therapist and Pilates Rehabilitation Teacher, he has vast experience in spinal rehab.
Back to Fitness
Back to Life
Back to Fitness Back to life
The exercises that are performed in the Back to Fitness, Back to Life are a continuation of the Core stability and Spinal Rehab Training. These will incorporate more lifestyle movements, general strength, endurance and mobility exercises and of course specific exercises for your related to your back pain. The goal of this is to take you back to the normal lifestyle you have, and the task you enjoy. If you are a runner we may have you doing running-related drills with a weight or band. If you like to go hill walking we will aid in giving you the strength in the right areas to help reduce the load on your spine. It may be that you are struggling with your work, but whatever the task is, we will tailor your plan to your goals.
Because we like objective measures we will not only assess you and take you through your progressive fitness plan but you will have your own objective measure called the pain provocation test exercise. This is the one thing you find hardest to complete or undertake and we will target this to help get that back to normal.