Back Pain & Sciatica
Prevalence of Low Back Pain:
Worldwide, back pain is the single leading cause of disability and one of the most common reasons for missed work. Most people with low back pain recover, though reoccurrence is common.
Physical Therapy can certainly help with most types of back pain, many times with complete resolution of pain within 4-6 visits. The first step is determining the cause of your pain.
Why do I have low back pain?
Though there are many causes of low back pain, the vast majority of back problems are a result of what is called degeneration, or wear and tear on the parts of the spine over many years. Over time, the normal process of aging can result in degenerative changes in all parts of the spine.
Injuries to the spine, such as a fracture or injury to the disc, can make the changes happen even faster. There is strong evidence that cigarette smoking also speeds up degeneration of the spine. Scientists have found links among family members, showing that genetics plays a role in how fast these changes occur.
What is Disc Degeneration?
The intervertebral disc changes over time. When we are young and healthy, we start off with a disc that is spongy and firm. The nucleus in the center of the disc contains a great deal of water. This gives the disc its ability to absorb shock and protect the spine from heavy and repeated forces, like a pumped up tire.
With age and certain repetitive movements, the annulus around the nucleus weakens and begins to develop small cracks and tears. The body tries to heal the cracks with scar tissue. But scar tissue is not as strong as the tissue it replaces.
The torn annulus can be a source of pain for two reasons. First, there are pain sensors in the outer rim of the annulus. They signal a painful response when the tear reaches the outer edge of the annulus. Second, like injuries to other tissues in the body, a tear in the annulus can cause pain due to inflammation.
With time, the disc begins to lose water, causing it to lose some of its fullness and height. As a result, the vertebrae begin to move closer together.
The Relationship Between Back Pain & Sciatica:
A disc that has been weakened may rupture or herniate. If the annulus ruptures, or tears, the material in the nucleus can squeeze out of the disc, or herniate.
A disc herniation usually causes compressive problems if the disc presses against a spinal nerve. The chemicals released by the disc may also inflame the nerve root, causing pain in the area where the nerve travels down the leg. This type of pain is referred to as sciatica.
Even a normal disc can rupture. Heavy, repetitive bending, twisting, and lifting can place too much pressure on the disc, causing the annulus to tear and the nucleus to rupture into the spinal canal.
How Physical Therapy Can Help:
There are exercises you can do to push the disc away from the spinal nerve, thereby reducing your pain.
Utilizing a highly researched system called Mechanical Diagnosis and Treatment, Dr. Trinh will assess your lumbar spine movements and determine where the disc herniation is pushing on the nerve root. Treatment will involve a combination of manual therapy and specific exercises that will help push whatever is irritating the nerve away, thereby improving your mobility and reducing your pain. Most patients with a true disc herniation and sciatica show rapid resolution of pain within 4-6 visits. Most patients experience improvement in pain within the first visit.
Core muscle training and education on how to prevent future recurrence are both an integral part of treatment.
Research has shown that Physical Therapy is safe and effective for those who suffer from low back pain and sciatica. The Centers for Disease Control and Prevention highly recommends it, stating “Physical Therapists partner with patients, their families, and other healthcare professionals to manage pain, often reducing or eliminating the need for opioids. Research has shown that a simple education session with a Physical Therapist can lead to improved function, imoproved range of motion and decreased pain.”