Lower BackPain

Today’s session

• Develop a better understanding of chronic low back pain• Learn about the anatomy of the spine• Common causes of low back pain (LBP) and injury• Chronic/persistent pain• How to look after your back and manage your pain

BACKINJURIES

Common causes of LBP

•Disc lesion (bulge, herniation, protrusion)•Degeneration of vertebrae/discs•Muscular strain/tightness•Nerve root compression•Instability•Postural related pain•Wear and tear (osteoarthritis and degeneration)•Other.......

DISCS•Thought to be one of the most commonly injured structure s in the back

•Extremely strong structures and can bear a lot of force

•Discs will naturally lose height and degenerate

•Outside layer is highly innervated with nerves

•Poor blood supply and heal slower

MUSCLES

•Actually very hard to strain a muscle

•They can weaken, or tighten, and therefore contribute to pain

•Fast healers – rich blood supply

•Important for dynamic stability of the spine

JOINTS•Also commonly injured in the back

•Provide static support, so prevent movement in certain directions

•Joints love movement!!

NERVES•Composed of neurones (nerve cells) and ligaments

•May notice pins and needles, numbness, tingling, burning night pain, skin changes (reduced sensation)

•Nerve compression can occur by the discs and joints

•Nerves move and slide, and will get irritated if stuck in an area

Acute vs Chronic LBP

•Acute & Subacute – 0-6 weeks (can be longer)Tissue healing and inflammation

occursPain and swelling subsides slowly

as tissue heals

Chronic Pain•Pain lasting longer than 3 months•Inflammation no longer • Tissue may have already healed

•So where is the pain coming from??

PAIN• 5-10 % of people experience ongoing pain after an injury

• Many people suffer ongoing disability after a back injury

• Back pain is on of the most common pain complaints and cause of work loss in the general population

When it hurts...

• We are likely to be less active, as we associate movement with pain• Avoid certain activities as we believe they may hurt• May have the wrong beliefs of what we can and cannot do

Tissue injury and pain

•The pain you feel does not always reflect the amount of tissue damage

•If you experience pain, it does not necessarily mean you are causing further damage

PAIN PATHAYS

• In a nutshell: Pain pathways become heightened

immediately following an injury Nerves (in your back) detect painful

stimuli much more than they used to (sensitization)

The brain learns to recognise pain easier (cortical smudging)

Responses are heightened

The end result is

•You feel pain more often, and at times when there is no real threat to your tissues

•The Brain is extremely clever, and is only doing this to protect you!!

How is this affecting recovery??• Muscles and joints stiffen and become weak from not being used

• Core becomes weaker, and strain and tension on spine and ligaments is increased

• The less you move, the more your brain learns to avoid that movement

• The sensitization of pain pathways persists, so you continue to feel pain

Emotional effects of LBP

•Decreased mood•Loss of motivation•Stress•Time off work, so more stress!•Family problems

Management

• Get treatment If you have never had treatment,

get some! Physiotherapists/doctors can help

diagnose your condition May be shown useful stretches

and exercises to do You will be better educated and

prepared to deal with your low LBP

Management

•Exercise! Evidence has shown that general exercise

can help improve the general strength of your body and therefore your back

Exercise is a great way to de-stress, so you feel great afterwards!

Releases endorphins and improves mood, which helps you to deal with pain

Recommended guidelines of 30 minutes per day

Management

•Take care of your back Lift CORRECTLY Good sitting and standing

postureFrequent changes in posture Work place postures

Pain Management Strategies

• Get to know your pain: knowledge is the great liberator!• Know that your hurts won’t harm you• Pacing and graded exposure• Accessing the virtual body• Relaxation techniques

Catalyst Injury managementWe can provide you with the following:•Supervised exercise program with physiotherapist•Hydrotherapy sessions•Physiotherapy treatment: assessment and education •Pilates assessment and treatment•Gym Program

That’s all!Thank you for coming todayLook forward to seeing you next session