Back Pain Prevention

Chronic low back painIf you suffer from lower back pain you are not alone. As someone who has suffered three episodes of intense LBP within the past ten years, I am among the millions of people who suffer from this condition. It is the number one reason to visit your doctor or miss work, and if you have never experienced LBP you are a in a significant minority. Back pain can range from a dull, constant ache to a sudden, sharp pain that makes it difficult to move. It can start quickly if you fall or lift something too heavy, or it can get worse slowly. Discs that sit between the vertebrae of the spine can rupture or break down. Muscles can strain or tear.

We use our back all day, throughout the day, and it can suffer extraordinary forces through our frequent bad habits while lifting, carrying heavy things, or even during sitting. Even if we think we are using the best posture and mechanics, we still can be setting ourselves up literally for a rude awakening.

So here are the best 8 ways to prevent LBP:

  1. Always warm up before exercise or other strenuous physical activity, including work activities that involve lifting or bending.
  2. Don’t slouch or lean forward when standing or sitting. Your back supports your weight the best when it is in its natural alignment.
  3. At home or work, sit in a chair with good lumbar support and proper position and height for the task.
  4. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support while sitting at your desk or even for long commutes. (Tip: Roll up a medium sized towel and wrap plastic wrap around it several times to hold it together. It will last longer and can work just as good as a $50 lumbar roll! I have one in my car!)
  5. Wear comfortable, low-heeled shoes if you need to be on your feet for extended periods.
  6. Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach strain2a-BBmuscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting. And ask for help when transferring heavy or odd shaped items.
  7. Limit excessive body weight around the abdomen. Maintain a diet with sufficient daily intake of calcium, phosphorus, and vitamin D, which will help to promote new bone growth.
  8. And last but definitely not least, if you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate at a faster rate.

Recurring back pain is often preventable and can often times become worse if we do not take care of our backs once an initial injury has occurred. If you have suffered a lower back injury, you need to take immediate actions to correct the reason you developed LBP in the first place and take proactive measures to eliminate these factors from occurring in the future.

Your best bet of preventing LBP from becoming chronic or recurring is to visit a physical therapist. Physical therapists are highly trained professionals who are experts in the musculoskeletal system. They can show you things such as weakness in your core muscles you didn’t think you had, faults in your lifting mechanics or posture, and even how the way you run or exercise can cause trips to the ER and years of pain.

Even if you do not have current LBP, I think you would agree that taking the time out of your day now is better than experiencing the symptoms in the future.

Remember:

“An ounce of prevention is worth a pound of cure.”  – Benjamin Franklin

Michael Phillip, PT

Physical Therapists – South Office

 

Herniated Discs (Part 2): Symptoms and Treatment

This blog is the second part of a two-part blog on herniated discs. In the first post we covered the anatomy of your spinal discs and the common injuries to these discs. You can visit that post by clicking this link. Today we will discuss the symptoms and treatment of a herniated disc and what you should expect when you see a physical therapist.

SYMPTOMS OF A DISC

Just as no two people are the same, neither are our injuries. So this is a list of all possible symptoms but even just having one or two could indicate a disc injury, or you could even have a herniated disc without any symptoms. But on the flip side you could have two or more and actually not have a disc injury. (Are you thoroughly confused yet?) An evaluation from a physical therapist or medical doctor would be required to properly diagnose or rule out a herniated disc.  These are the most common symptoms of a disc injury:

  • Forward flexed posture
  • Increased pain in the morning or late at night
  • You don’t love sitting (standing might also not be that great due to more pressure on the disc)
  • Symptoms radiating down your leg or arm such as numbness, tingling, and/or pain
  • Weakness in arms or leg
  • Muscle cramping or tightness in your neck or back

HOW CAN PHYSICAL THERAPY HELP?

Physical therapists can design treatment programs that help the discs heal and address any other associated issues the back and lower body have from compensating. The back will try to protect itself as you still try to function and it can result in muscle tightness and guarding, sacroiliac joint dysfunction, tension in the nervous system, core weakness, and injury to other structures in the spine (ligaments, joints, nerves) as the disc fails to do its job. Treatment of these related issues can help your pain and provide good stimulus for the disc to heal.  Additionally we can design exercise programs so you don’t risk re-injury.  You don’t have to become completely immobile while waiting to heal. For example walking 15-30 min can help pump nutrients to the disc to allow itself to repair.

Therapy can also involve “passive modalities” like traction, ultrasound, electric stimulation, heat and ice. These can help you feel better and promote healing, but you aren’t the type of person who lives your life laying down on a table. You need to lift, reach upwards, pick things off the ground, hike up 14,000ft while carrying a 20 lbs backpack.

Therapy will also include exercises to re-activate the small stabilizers (called the multifidus) of the vertebrae that “shut off” with low back pain. When these don’t work, the large muscles of the back to take over which leads to fatigue and spasm (aka more back pain and tightness). There is a large variety of simple to advanced exercises to work the muscles you need to and these aren’t your weight lifter grandma’s intense sit ups.

You might also be put through exercises to restore motion of the spine, improve the hydration of the disc and to improve flexibility of the lower limbs.  These help combat the stiff and “stuck” feeling of your low back.

Finally, PTs can teach you positions to ease your pain. Remember how I said sitting tends to be a painful position? Try a rolled up towel placed in the low back to maintain the natural curve. Don’t rely on the “lumbar support” from your desk chair or automobile seat. Don’t rely on a “one size fits all” for your specific back anatomy.

Low back bothering you through the day or at home? Try lying on the floor on your back with your hips and knees flexed to 90 degrees such as when you lay on the floor with your legs up on the sofa or a chair.

CONCLUSION

If after reading this you have further questions or suspect you may be suffering from a herniated disc, feel free to call us or stop by one of our offices to schedule an appointment with me or another therapist. One of the keys to a quick recover is to not only beginning to receive treatment right away, but also knowing what to do and what not to do. This is where we take each patient as an individual and create a specific program that matches your symptoms and abilities. So don’t waste any more time, come by and see us to get your back in shape and allow us to help you recover quickly and effectively.

Kacie Rognlie, PT

Clinic Manager – South Office

Synergy Manual Physical Therapy

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112

Herniated Discs (Part 1 of 2): Anatomy and Injury

For many people, injury to one of the discs in the lumbar spine (lower back) evokes thoughts of costly MRIs, large needles for injections, and stories of friends who have had bad backs their whole life. An injury to the low back doesn’t have to be a career or recreation ending injury and can be safely treated with conservative measures, so before you start thinking surgery I want to do some educating on discs and disc injuries to ease any fears of the unknown.

Anatomy of your Disc

The discs of the low back are like other structures in the body (bones, skin, tendons, muscles, etc) that can heal. To give you a better understanding, let’s start with some basic anatomy

  • A healthy, normal disc sits between 2 of the bones (vertebrae) in the spine to cushion shock forces, control movement of those 2 bones, and give us some extra height to tower over the competition. (well, for some)
  • The disc consists of outer and inner fibrous layers oriented like the skin of an onion. These are attached to the vertebrae above and below, which helps control the motion of the bones from moving too much on one another. Due to this connection, you can’t technically “slip” your disc out. I’m telling you this so you sound smarter when talking to medical professionals. (on a related  note , don’t tell your therapist you “twerked” your back. That is definitely not the term you think it is. You might have “tweaked” your back, which can happen, but I don’t want to know if you were trying a Miley Cyrus dance move)
  • Inside of the fibrous layers of the disc is an inner nucleus that is more gelatinous. Think about a jelly donut (you know you want one now!). This nucleus gives you the cushion of the spine.  Overall the nucleus and fibrous layers work together with your muscles and joints to provide the stability that allows you to do what you need to with your back.

Disc Injuries

A disc can become weakened due to the normal degenerative process of aging, prior injury from the glory days of high school sports, current or past overuse that is often due to lifting during work or sports, or a multitude of other injuries from falls or accidents. These past injuries often predispose the disc to future injury and limit its normal functions of support and cushion. The disc is most prone to injury with combined flexion and twisting motions. Throw on a weighted load such as during shoveling snow or yard work and you are setting yourself up back pain.

Injury can happen to inner or outer layers of the disc, the internal nucleus or a combination of those, which can cause a herniated (bulging) disc.  In some cases a bulging disc can impinge on a spinal nerve and cause pain, numbness, and/or tingling down the leg. However, depending on the extent of the bulge and where the injury is, the back may or may not even hurt and there are not always symptoms down the leg. For this reason, we can’t say that all discs herniations benefit from traction (aka “decompression therapy”), injections or surgery. This is where detailed evaluation from a skilled physical therapist can help you. Put us on your list of things to try if you think you might have injured your back at some point.

Conclusion

This post has covered the basics of the anatomy and what happens during an injury. In our next post we will go into more details of the symptoms of a herniated disc and what treatment approaches physical therapists can use to eliminate your symptoms and get you back to a normal life without surgery. If you have any questions, please give us a call or comment on this post. If you know you do have, or suspect you have, a herniated disc, give us a call to set up an initial consultation. We can often have you feeling better in just a few treatments.

Make sure to look out for Part 2 of this post, “Herniated Discs: Treatment“.

– Kacie Rognlie, DPT

Clinic Manager

Synergy Manual Physical Therapy

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112