Low Back Pain
It is well known that the lifetime incidence of back pain is extraordinarily high, affecting over 80% of the population. Low back injuries heal and the majority of people (50-80%) recover within 6 to 8 weeks. Others go on to develop recurrent and chronic low back pain. Long-term healing is difficult to achieve; without the correct treatment, 4 out of 5 people will suffer a recurrence within one year.
The right treatment can be the difference between healing completely OR developing recurrent episodic low back pain that becomes chronic, leading to long term dependency on pain medications and even surgery.
Low back pain can come from many different sources, but most commonly is referred from the lumbar disc, facet joint, sacroiliac joint, ligaments, muscles, and nerves. To identify the source of your pain, your physician and physical therapist will first listen to your story. Your history and symptoms are important to your diagnosis. MRIs and X-rays are often taken to look for herniated discs, arthritis, narrowing of the canal around the nerve (stenosis), and nerve root compression.
Your physician and physical therapist will then work together to determine the appropriate treatment.
Your physician will prescribe pain medications, do trigger point injections or epidurals to decrease pain and nerve sensitivity. If the pain persists, they may do radio frequency denervation (heating of the small nerves that innervate the joint), or surgery (micro-discectomy, laminectomy, disc replacement or spinal fusion). Although many people get relief from these procedures, others continue to experience pain.
The Physical Therapy Evaluation: At KIMA, after listening to you and your problem, we will perform a thorough physical examination to help identify the source of your pain. These evaluative tests may involve specific palpation and movements that bring on and take away your symptoms. We then look for an underlying cause of the symptoms.
- Does your posture influence your pain?
- Is there a joint moving too much or too little, increasing strain on the pain source?
- Is there weakness in a specific muscle or group of muscles?
- Do you have a classic movement fault like lumbar flexion, extension, or rotation?
- When we control that movement, does it take away your pain?
This system of testing and retesting is part of a clinical reasoning model. We use this clinical reasoning model to identify a movement diagnosis and prescribe a specific treatment.
Treatment: Once the therapist has identified what is causing your lower back pain, you will be given specific strategies to eliminate it. Some of these strategies may involve changing your posture or movement behavior, others may involve specific relaxation techniques (massage, breathing) or strengthening and motor control exercises.
KIMA therapists utilize Real Time Ultrasound Imaging for biofeedback of the deep muscle system such as transversus abdominus, pelvic floor and multifidus. Research has shown that in the presence of pain, these muscles have poor recruitment and delayed timing. Restoring this recruitment and timing using RTUI will optimize stability and prevent recurrence of pain.