The most important thing regarding back pain treatment is to eliminate the primary pain cause (dysfunction), and to soothe the symptoms.

Spine Anatomy

The spine is a structure consisting of 33 to 34 vertebrae. Individual vertebrae consist of the vertebrae body and the vertebral arch. The vertebrae are joined with intervertebral discs, and facet joints. Bone elements of the spine and intervertebral discs are held together by ligaments. Under normal conditions the spine has natural curvatures: lumber and cervical lordosis (spinal curvature towards the front) and thoracic kyphosis (spinal curvature in the opposite direction). These curvatures work as an absorber, reducing axis forces and also have a crucial influence on spine endurance. With properly developed curvatures, the spine is 10 times more durable than a straight spinal column. Intervertebral discs are the joints between vertebrae and their bodies. Each intervertebral disc consists of the anulus fibrosus, nucleus pulposus and endplates.

Causes of back pain

Improper physiological construction of the body or spine, an inactive way of life, and injury or sickness may cause shrinking of intervertebral spaces. This may cause pressure on the nucleus pulposus of intervertebral discs, which is the most common reason for back pain. Accumulated risk factors: desk jobs and lack of movement cause the muscles and ligaments which are responsible for correct body posture and the reduction of burden on the spine to become limp and weaken. As a result of this a greater force is enacted upon the spine, leading us towards serious spine injuries and increases in pain.

physiotherapist

Types of back pain

In general, back pain is divided into two categories: specific pain (medical conditions include dyscopathy, compression fractures, degenerative changes, osteoporosis, tumors etc) and non-specific pain (patient suffers from pain but diagnosis does not show any illness of dysfunction – afflictions are caused by overextension resulting from lifestyle, or individual predisposition). Considering duration, we divide pain into three categories: sharp, sub acute, and chronic.

Diagnostics

First, you need to go to a specialist – a rehabilitant, orthopaedist, or neurologist who will examine you, check your medical history, conduct a physical examination, and order proper diagnostic tests (X-Ray, MRI, CAT Scan). This allows us to assess the patient’s condition, degree of dysfunction, and define proper treatment ensuring the required results. The main questions doctors will want to find the answers to are: Where is the source of the pain - muscles, joints or nerves? What causes the pain – injury, illness, overburden, or lifestyle? On this basis adequate treatment or physiotherapy is planned.

8 most effective physical therapies for back pain

Only a small percent of patients suffering from back pain undergo surgery. The majority of patients can simply undergo conservative treatment, which means that causes of pain are eliminated through the patients cooperation with a physiotherapist (manual therapy, kinetic therapy, physiotherapy) and patients independent therapy at home (kinetic therapy – healing with movement). The most important goal that both patient and therapist want to achieve is extinguishing the pain and preventing its reoccurrence, directly related to muscle-skeletal dysfunction prevention.

1) Manual therapy

Manual therapy is a physical therapy for back pain based on correcting the positioning of intervertebral joints to decrease the pressure on nerve structures in the spinal cord, and releasing patients from pain. The advantages of manual therapy include a shortening in the duration of treatment, a speedy and full recovery, and the avoidance of chronic pharmacological treatment and its side effects. When conducted by a competent therapist using the correct positions, it is a non-evasive and painless treatment. In manual therapy the patient-therapist relationship is crucial as the patient’s mood after treatment depends on their relationship. 3-4 days after treatment the primary aggravation (an intensification of the symptoms) might occur. The better the interaction with the therapist is, the weaker the aggravation will be. One therapeutical session consists of 3-5 treatments in 1 or 4 week intervals, depending on the patient’s condition. In order to prepare the patient for the treatment and maintain results, therapists will apply healing massages, post-isometric muscle relaxation, and exercises relaxing and strengthening all body muscles. Depending on requirements, in between sessions physical treatment may be applied to decrease muscle tension. After regaining primary functionality, treatments are repeated in order to maintain results – the frequency is defined individually, 2-3 times a year, on average.

2) Medical massage

Massage healing is focused on skin, muscle tissue, and the joint and ligament system, through speeding up biochemical processes. A consequence of this is the more effective removal of metabolism products and a quicker provision of nutrition. Massage facilitates the flow of vascular blood by decreasing pressure in arteries, which improves the functioning of the heart. Massage improves the functioning of the respiratory system, which causes an increase in the quantity of oxygenated blood, and better nourishment of muscles, bones, and joints.

3) Tensegrity massage

This physical therapy for back pain is based on working with whole groups of muscles, bones and ligaments joined together according to the tensegrity rules, rather than with singularly chosen muscles. Through normalization of muscle tension, we can achieve amazing results in pain relief. Tensegrity massage causes the doctor to treat the patient holistically, as it is based on the assumption that all body structures are connected. It is thought that pain in one part of the body may signify illness in other, supposedly unrelated, areas (pain in the sacral curve is often caused by tension transferred from scars after appendix removal).

4) Kinetic therapy

Kinetic therapy is a treatment involving different forms of movement. The intention of this physical therapy for back pain is to restore the painless mobility of the spine and limbs, improve the functioning of the whole body and muscle strength, and control weight loss. It also includes the promotion of correct movement habits. This method is also used in prevention, recreation, and rehabilitation.

5) PNF (Propriceptive Neuromuscular Facilitation)

The goal of this therapy is movement re-education and activities focused on removing individual problems, caused either by injury or illness. It is based on 3-D movements, movements everyone makes every day. This approach treats the complete muscle-skeletal system, enlivens the nervous system, and teaches the nervous system proper movement patterns. An increase in activity in weaker areas of the body is achieved by engaging complete muscle chains, engaging stronger muscles, and use of strong reflexes. The PNF method is highly effective because it is based on precise problem analysis and focused treatment. The results are quickly noticeable and the effects are visible even after only a few repetitions. Due to the involvement of stronger muscle group supporting a particular movement, it is possible (literally) to activate muscles which were previously unused, or very weak. A simultaneous arousal of the nervous and muscular system speeds up knowledge of the movement pattern, due to the creation of new neural connections, alongside muscle strengthening.

6) Kinesio taping

Specific tapes are placed on the skin of the patient in order to support muscle work, stabilize joints, loosen muscle tissue, support the work blood and lymphatic vessels, as well as to improve elasticity of skin and scars. The tape does not irritate or bother the patient, nor limit movement. The only effect the patient feels is a slight pull on the affected muscles. The tape is usually worn for 3-7 days.

7) Nerve mobilization

Nerve mobilization is a method based on flexing the nerves through specific limb positioning. This physical therapy for back pain is directly affecting the nervous system by pressuring the nerves in order to improve their mobility and flexibility. This method does not burden the patient physically, which allows doctors and therapists to work on patients suffering from severe conditions. Even though the treatment affects the nerve directly, it is painless. It is a quick and effective way to eliminate tension in contractile tissue, to remove pain, to normalize proprioception, and to help with the psychophysical balance.

8) Physiotherapy

Laser therapy is a treatment based on the application of laser irradiation upon injured or sick areas of the body. Laser beam usage causes a quick increase in the activity of tissue and cell regeneration processes near the surface of the body. Magnetic therapy is a physical treatment for back pain which uses strong magnetic fields in order to stimulate regeneration processes in the majority of biological structures, at all levels of tissue depth.

How quickly will I get back to full strength?

If you will apply the therapists recommendations dutifully, exercise at home, and drop bad habits, then your condition should steadily improve. If, after a couple of visits, your condition does not change, or even deteriorate, you should revise your diagnosis, or possibly change the therapy. 10 visits to a therapist are the optimal number recommended, after which your condition should improve and results be maintained. Of course, in each case an individual approach must be taken, and it is crucial to follow the therapist’s recommendations.