All Posts tagged back pain physical therapy

Does Spinal Decompression Help Low Back Pain?

Does Spinal Decompression Help Low Back Pain?
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Spinal decompression may help treat low back pain, but this popular treatment isn’t a sure thing. Advertising for spinal decompression targets people with degenerative disc disease, bulging discs, herniated discs, or spinal stenosis.

What is spinal decompression?

Spinal decompression is a form of mechanical spinal traction, which refers to the separation of the bones, joints, and discs of the back.

It is theorized that this separation relieves pressure on the nerves in the back and helps decrease pain, and thus, improve function.

Many spinal decompression systems are operated by the use of a computer, allowing the health care provider to adjust the amount of traction force, the angle of traction provided, or the amount of time the traction force is applied. Common trade names of spinal decompression devices are the VAX-D System, the Spinal Aid System, and the DRX-9000 System, among others.

Some spinal decompression units require that you lie on your stomach while treatment is rendered; others have you lie on your back.

Are there risks associated with spinal decompression?

A review of the published data for the use of spinal decompression reveals very little risk associated with treatment. One study reported on a patient who developed severe pain while on the unit. A follow-up MRI of the spine revealed that this patient’s lumbar herniated disc had increased in size.

The patient subsequently had a lumbar surgery and it was reported that the patient recovered fully. Other studies report some increase in pain for a few participants.

Does spinal decompression help low back pain?

The main theory behind spinal decompression is that providing traction to the compressed structures in the spine helps relieve pressure and pain.

So traction must help low back pain, right? Well…

A study published in the 2001 issue of Physical Therapy Journal (PTJ) evaluated various forms of treatment for acute (symptoms for less than 4 weeks), sub-acute (4-12 weeks) and chronic (more than 12 weeks) low back pain. The published evidence available for the use of traction for low back pain received a grade of “C” (no benefit demonstrated).

Claims have also been made that spinal decompression creates negative pressure in the discs of the spine, which helps to pull bulging discs back into place. A published study reporting on three patients concludes that spinal decompression did lower the pressure in the discs while using decompression. This is a small study, however, and no cause and effect conclusion about spinal decompression and low back pain can be made.

However, more studies have been conducted since the ones mentioned above. More observational studies using larger trial groups are finding the spinal decompression may help with some of the symptoms of low back pain, specifically the radicular leg pain.

And, there are still smaller studies finding positive outcomes.

Simply put, there is limited scientific evidence that spinal decompression can help your low back pain. Does that mean that it does not work? Not entirely. It just means that the current level of research is not sufficient to draw positive cause/effect conclusions for the use of spinal decompression. There may be other more affordable options for you to consider when faced with treating your low back pain.

What does help low back pain?

While many treatments are available for your low back pain, the scientific data indicates that maintaining normal activity is a good treatment (grade of “A” — benefit demonstrated — in the 2001 PTJ review) for acute low back pain. Exercises for your low back also received a grade of “A” for sub-acute and chronic low back pain.

The great thing about exercise is that it is a low-cost, easily implemented treatment. Your physical therapist can teach you how to improve your posture and implement the right exercise program for your specific condition to treat your low back pain.

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Back Pain and Sciatica Method

Back Pain and Sciatica Method
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Anybody who gets back pain and sciatica kind of pain will have common questions what should i do, what i should not?  Who should I see and can I fix pain by myself?  Should I do flexibility exercises or strengthening exercise?

In most cases patient with severe sciatica kind of pain end up in first med or emergency room.  They might do x-ray and most likely give them pain killers and would advise patient to see either orthopedic or physical therapist depends on their condition.

In any case, you might end up with physical therapy.  Physical therapist role is to centralize your pain, help you to maintain correct posture and do back stabilization exercises. Physical therapist may also use pain modalities to control your pain.

Physical therapists who is trained in McKenzie methods are specialist while treating sciatica kind of pain.  Therapist should be able to do thorough assessment of your problem and see whether you are right candidate for McKenzie technique.

With McKenzie technique therapist will try to centralize radicular pain and then help you to reduce or eliminate pain from back completely.  Mackenzie exercises are done in progression.  Once patient is comfortable with first step of exercise then move to next.

How Do I Know If the Exercise is the Correct One for Me?

If you are experiencing pain on one side of your back or leg, then try the first exercise and monitor symptoms as you exercise. Watch for centralization, which is a decrease in leg or thigh pain and an increase in low back pain.  Centralization that occurs while you are performing an exercise is a good sign and indicates that the particular exercise is the correct one for you to be doing.

If your symptoms worsen, fail to centralize, or only centralize partially, move on to the next exercise in the list. Attempt the exercise, and monitor any changes in your symptoms.  Remember pain that moves closer to your spine is a good sign.  Any sign of more radicular pain or worsening symptoms patient should stop those exercises immediately and speak to their physical therapist.

Also before starting any exercise for your back in severe cases, it is a good idea to check in with your doctor to be sure that exercise is safe for you to do.

  • Prone Lying, Prone Props, and Press Ups

In the case of sudden onset of acute low back pain, you should try the emergency back pain exercises first.  Lie on your stomach for a few minutes, if that is comfortable then prop onto your elbows for a minute or two.  Monitor your symptoms for centralization.  If it centralize continue and you can slowly go on elbows.

If symptoms are improving then and then only, try a few press ups.  Try to keep your hips and back relaxed as you use your arms to press your upper body up.  Try to press up as far as possible to restore the normal forward curve in your low back.  Perform 10 repetitions and monitor your symptoms.

If your pain does not fully centralize with the press up exercise, you may need to see doctor or physical therapist.

Above mentioned exercises first step in McKenzie exercises.  If that has not resolved your problem you need attention for your problem.

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Understanding Back Pain

Understanding  Back  Pain
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People who suffer from lower back pain are encouraged to help themselves with exercises and being active and getting skilled physical therapy.  Lot of times patients are not explained in detail what is causing their pain and how to manage them so they can get better faster.

As back pain is very common and most of us experience in our lifetime.  Best way to avoid surgery or get better faster is to perform skilled exercises with help of physical therapist who can tailor exercises depends on type of back pain patient has.

Understanding back pain

There are several structures in the back that can cause and/or contribute to low back pain.

  • Intervertebral Discs

Although the intervertebral disc is a remarkably versatile and strong structure, essentially acting as a shock absorber during everyday activities, sometimes the disc fails when there is a sudden, unexpected force (such as a fall, lifting, or other trauma), or due to ordinary wear and tear over time. And when the disc does get injured it repair itself with fibrous tissue which can also cause pain and patient could hae recurrent back pain.

Activity is also needed to maintain the exchange of fluids in spinal structures and reduce swelling that naturally occurs in the tissues surrounding an injured disc. This swelling can further irritate nerves that are already affected by herniated disc material.  It can be achieved by particular exercises and physical therapy modalities.

These patients are normally complain of radiating, numbness, heaviness kind of pain and also complains of weakness in some leg muscles at times.

  • Spinal Muscles, Ligaments, and Tendons

The collective soft tissues around the spine – the muscles, ligaments and tendons – are also very important in maintaining proper spinal balance and strength. With decreased activity, the connective fibers of ligaments and tendons can begin to adhere to each other and lose resilience and may tear when sudden overload occurs. Unlike discs or connective tissue, however, when soft tissues are injured, they can quickly repair themselves.

Since muscles are in constant communication with the central nervous system, anger or anxiety can tense the muscles and cause muscle spasms. Ongoing tension inhibits normal muscle function and leads to muscle wasting and further stability problems, which in turn can lead to chronic lower back pain.

In this cases normally patient is complain of localized pain.

  • Spinal Nerves

When nerves are cut, pinched, or otherwise irritated, the muscles that the nerves control cannot work or reduce function of muscles. For example, when a herniated or bulging disc presses on the L4-L5 nerve root, it may inhibit the nerve’s ability to make the muscles it controls in the ankle and foot work properly, causing what is known as foot drop – the ability to raise the foot or stand on one’s tiptoes.

Most of these patients are complain of radiation, numbness, burning pain along with weakness in muscles or unable to move muscle.

Above mentioned are few reasons person can have lower back pain or leg pain with or without back pain.  In any case, Patient should consult orthopedic or neurologist if pain is really worst. In other circumstances patient can have consult with physical therapist and see if they can help them.

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