Most people will suffer from back pain at some point in their lives. Back pain is common among athletes who strain their back muscles or it may be the result of spinal injuries such as fractures or sprains. Accidents, falls and direct blows to the back can also cause back pain. However, many people report back pain with no specific incident, rather it is the result of poor sustained postures or weak core muscles that over time have resulted in pain.
A direct blow to the back may result in a contusion. Symptoms include pain, swelling or bruising over the area.
Muscle tears are graded according to the degree of the tear. With a grade 1 tear, you will feel tightness in the back, but may be able to walk properly and not have much swelling. Problems with walking and sudden twinges during activity may be symptoms of a grade 2 tear. There will also be some swelling and pain. With a grade 3 tear, pain is more severe and swelling appears immediately. Walking is difficult. Muscle strains can occur from over stretching the back either from sporting activities (e.g. tennis) or from reaching too far such as in pruning the garden or from lifting something that is too heavy.
Sprained facet joints and disc protrusions can also cause significant back pain. Sprained facet joints between the vertebrae can be caused by the same factors that cause muscle tears while protrusions of the intervertebral discs can also be caused by these factors or by simple acts like sneezing or coughing or getting out of bed where there is a history of weakened core muscles or poor postural habits. Symptoms of joint sprains and disc protrusions include pain with sitting or standing, pain moving in and out of positions and limited range of movement, If the disc protrusion has caused a nerve impingement, there may be referred pain, tingling, numbness or weakness in the lower limbs.
A physical therapy evaluation for back pain includes a subjective history of the type of injury, symptoms and prior level of function. We may also ask questions about your sleeping posture and behavior of the symptoms during ADLs (activities of daily living) and other activities. An objective assessment follows, which includes an examination of your posture, gait, active range of motion of the spine, strength, reflexes and muscle flexibility.
A treatment plan may involve
- Using modalities to reduce pain, such as ice packs, heat and ultrasound.
- Soft tissue massage, trigger point therapy and acupuncture to reduce spasm, relieve pain and reduce inflammation.
- Taping the back for comfort and stability.
- Showing you the best positions for relief of pain and muscle spasm.
- Spinal mobilization to improve mobility of specific intervertebral joints.
- Training in posture, body mechanics, strengthening and conditioning. This is a vital part of your recovery. We will give you a graded exercise program to ensure you have the correct posture and to strengthen your core muscles to prevent further injury and stabilize the back.
It is important that each injury be assessed by a physical therapist for an accurate diagnosis and appropriate treatment plan. Our goal is to provide symptom relief, restore joint and soft tissue mobility, prevent re-injury and to help you make a successful return to your activities.
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