Physiotherapy for Lower Back Pain

What Causes Lower Back Pain?

There are different reasons for why lower back pain develops. Most common causes of back pain are such factors as poor posture, lack of exercise causing spinal stiffness and muscle weakness, as well as muscle strains or sprains. Back pain can also be caused by inflammatory arthritis disorders or other medical conditions in certain cases. It can happen unexpectedly from accidents, falls, or heavy lifting, or it can slowly develop due to age-related spinal degeneration.

Did you also know that lower back pain can be caused by an old injury to another part of the body? When an inner organ is not sitting in the right place or is unable to move in the way that it needs, this can agitate the muscles of the lower back.

On the mental health side, it has been observed that lower back pain can often be experienced or exasperated when people are experiencing anxiety due to a sense of financial insecurity or lack of safety. 

By consulting with a holistic physiotherapist, a holistic approach can be used to assess the pain that you are experiencing and create an individualized treatment for your specific presentation. For example, this could be working directly with the muscles and skeletal system through traditional physiotherapy, or restoring harmonious functioning in another area of the body through visceral manipulation therapy. This can also include collaborating with a holistic psychologist to create increased resilience around external life stressors. 

Symptoms of Lower Back Pain

Postural back pain initially appears as a mild ache accompanied by lower back stiffness. Lifestyle practices such as light exercise and avoiding prolonged sitting can help alleviate symptoms. It is important to consider that ignoring symptoms will make it worse as it can lead to constant pain, though it may fluctuate in intensity. The stiffness level might also rise. The pain can vary from a constant, dull ache to a sudden, shooting pain down the leg.

Sometimes symptoms can be attributed to conditions other than bad posture, such as a herniated disc, fracture, impingement of facet joints, or compression of a nerve root. You might notice any of the following symptoms:

• Numbness or tingling in the buttocks, legs, or feet.
• Pain that travels down your leg.
• Increased back pain with movement such as bending forward, extending or twisting to reach for something.
• Excessive stiffness in the lower back.

These symptoms need to be carefully examined by an experienced physiotherapist. The therapist is skilled at pinpointing the cause of your lower back pain and providing the right treatment, management, and guidance. It is not uncommon for a treatment plan to include weekly or twice-a-week sessions for a one-month period up to a three-month period.

Types of lower back pain that benefits from physical therapy for back pain

Physical therapy is beneficial in treating different types of lower back pain, including:

Lower back pain may be caused by weakness in the core muscles and overall muscle imbalances.

Poor posture is often caused by weak or imbalanced core muscles. This may also be coming from decreased visceral mobility leading to a pull on the structure of the body, changing the position of the spine and making it more of a challenge to keep the body in an upright position. Maintaining strong core muscles is important as it serves a crucial role for keeping the spine upright and well-aligned, which also help give the inner organs the space they need. Clinical Pilates can be a valuable support for treatment of lower back pain alongside holistic physiotherapy, since it helps strengthen core muscles and elongate the torso in a safe and guided way. 

Keeping your spine in the correct position is very difficult when core muscles are weak. Poor posture and the propensity for back ache tends to worsen when there are long periods of sitting as, over time, the soft tissues surrounding the spine lose their tone resulting in a dull ache in the lower back. Not moving, nor stretching and strengthening the core muscles creates a lack of tone which can progress into pain and stiffness in the lower back. 

Prolonged periods of inactivity, sitting, or driving can also cause tightness in the hips and leg muscles - especially the hamstrings and quadriceps. When these muscles become tense, they can cause the pelvis to shift and tighten, placing more strain on the lower back. Extended sitting will only make matters worse. Check out our Chair Yoga videos for useful tips on stretching the legs and spine even while at the desk (this video will be posted in October).

Lower back pain in relation to sports and exercise 

People cultivating a healthy lifestyle may take up jogging or running, and that is a good thing. However, it is important to be ready and warmed up. If the hip/pelvic stabilizer muscles are weak, the lower back may have to overcompensate and this can lead to lower back pain. Similarly, if there is tightness or laxity in the pelvic floor muscles, the lower back will take on more that it should. 

Running with improper form, especially weak gluteus medius activation, often leads to lower back pain. Proper alignment of the pelvis, spine, hips, and knees is maintained by this crucial muscle. Runners who struggle with activating their glute medius often adopt a hunched running form, resulting in strained lower backs and discomfort.

For cyclist, something important to keep in mind is the setup of the bike seat. Incorrect bike positions, like short or long saddle to handlebar distances, often lead to lower back pain in road cycling and mountain biking. When in doubt about your bike position, seek advice from a skilled bike mechanic. 

Back pain and stiffness can also occur when the lower back is overworked by having too much to carry on the shoulders. Carrying heavy backpacks while mountain biking can strain the lower back and stress soft tissue structures. 

Whether jogging, running or cycling, it is important to maintain toned pelvic floor, hip stabilizers and glutes in order avoid undue strain on the lower back. 

If you’re unsure what’s causing your back pain, consult an experienced holistic physiotherapist to help determine the cause of your pain and get advice on how to resolve the issue.

Treatment for lower back pain in physiotherapy

With the assistance of your holistic physiotherapist, you can identify the root cause of your lower back pain and take proactive steps to manage it.

The first appointment with a holistic physiotherapist usually includes a thorough assessment. The assessment includes medical history-taking, inquiry into previous injuries or surgery, previous incidents of strain, overall lifestyle, and physical assessment. It can be helpful to take a moment prior to your first appointment to remember your medical history and write a simple, brief list. You will also be asked about lifestyle, workplace, stress levels, and if you are on any current medications. Your symptoms and usual triggers will be inquired about too. Then a physical assessment will be made focusing on your back function and mobility. In this assessment, the therapist will look at overall movement, both active and passive, assessing mobility and strength as well as palpation of the body, assessing various other factors. 

The therapist will then discuss the recommended treatment and its potential to alleviate your lower back pain, as well as inform you about any possible treatment risks. Feel free to ask for more clarifications as needed. Understanding your physiotherapist’s recommendations is crucial and improves treatment. It is also our way of ensuring a more collaborative approach and mutual understanding between our therapists and our clients, which are values we seek to uphold at BMY. Then, with your consent, treatment can begin. 

The treatment will be integrative, following BMY’s holistic model. Our holistic physiotherapist may integrate other modalities as part of your treatment plan such as visceral manipulation, craniosacral therapy and clinical pilates. Further support and benefit from the collaboration of the rest of our team may also be recommended as helpful, especially biofeedback therapy, homeopathy and holistic psychotherapy, depending on the particularities of your symptoms and context. By developing a holistic personalized plan, you increase overall health and improve your odds of reducing lower back pain. 

Length of Physiotherapy Treatment

Your physiotherapist will inform you at the conclusion of your first holistic physiotherapy session approximately how many sessions you may need and how frequently they should happen. Your physiotherapist might recommend a single appointment or a series of sessions spread over a few months. Communicating with your therapist to share any developments will also help to customize the care as needed.

BMYs Approach to Holistic Physiotherapy for Back Pain 

Holistic physiotherapy is a comprehensive approach that covers all aspects of a person’s well-being, including physical, emotional, social, and psychological. In addition to working with the dynamics of muscles and joints, a holistic physiotherapist investigates how the craniosacral rhythm as well as how the viscera are positioned inside the body and how they are affecting the overall balance and flow of the system. A holistic physiotherapist also embraces the body-mind connection, seeing the person as a whole, and identifies areas of need, such as the possible need for holistic psychotherapy or homeopathy in order to provide more holistic care that can create a positive shift in health and promote a greater sense of well-being overall. 

Get in touch with BMY for holistic physiotherapy to recover and regain strength.