Insight into Physiotherapy Treatment for Low Back Pain

Low back pain is a common musculoskeletal issue that could affect people of all ages and backgrounds. This condition affects four out of five people at some point in their lives. Pain in the lower back usually happens because it is the area that supports most of your body’s weight.

The pain you may experience from the condition ranges from mild discomfort to severe pain, and consequently, this affects your ability to perform your daily activities. Symptoms of low back pain may vary from one person to the next and might even have a slow onset or happen suddenly. In this blog, we give you more insight into low back pain and the different physiotherapy treatments available in Singapore that can help in your optimal recovery.

Types of Low Back Pain

Generally, there are two common types of lower back pain: acute lower back pain and chronic lower back pain. Acute lower back pain, or acute mechanical back pain, typically lasts in your back for less than four to six weeks. The pain may be from the spinal joints, vertebrae, discs, and soft tissues. Often, a specific accident or strenuous activity. However, simple care techniques can alleviate the pain, such as bed rest, ice and heat application, and medications. Physio treatment for low back pain  is also a common alternative.

Chronic lower back pain is the type of lower back pain that continues for three months or longer, even after treating an underlying acute lower back pain or an injury. This type of back pain possibly occurs in episodes and is sometimes more severe than others. This condition can cause movement and coordination impairments, pain triggered by carrying objects in the arms or bending, and difficulty maintaining a standing, sitting, or lying position. When this occurs, you must consult a healthcare professional to get specialised treatment to manage the symptoms.

Common Causes of Lower Back Pain

These are some of the conditions commonly linked to lower back pain:

1. Sprains and strains

You are more likely to develop sprains and strains in your tendons, muscles, and ligaments in the lower back if you constantly lift heavy objects or do not practise proper postures. In some instances, you might even strain your back from twisting your body too hard.

2. Backbone fractures

This condition typically happens when you’ve been in an accident or suffered a major fall. Bone fractures can weaken your spine and flatten the curve, resulting in lower back strains. You are also at high risk of developing bone fractures if you are diagnosed with osteoporosis or spondylolysis.

3. Disc issues

If discs between your spinal bones bulge from their original position, they can press on a nerve and result in severe pain in your back. Disc tears, like herniated discs, can also be a factor in lower back pain. Discs becoming flat as you age also affects how they function, leading to severe back pain.

4. Spinal stenosis

This condition can cause your spine to narrow, adding pressure on the spinal cord and causing lower back pain. Spinal stenosis commonly occurs when the discs between the vertebrae start to deteriorate, resulting in spinal cord compression by soft tissues. The condition then causes numbing, weakness, and cramping in the back.

5. Arthritis

Two types of arthritis typically cause lower back pain – osteoarthritis and ankylosing spondylitis. Osteoarthritis is one of the most common types of arthritis and develops as people age. The effects of this type of arthritis include degeneration of tendons and ligaments, as well as the breakdown of cartilage, which results in body pain. On the other hand, ankylosing spondylitis is a type of arthritis that causes spine inflammation, specifically in the area of sacroiliac joints found between the spine’s base and the pelvis. Over time, ankylosing spondylitis can result in your spine fusing into a rigid structure, resulting in a hunched posture and lower back strains.

6. Spondylolisthesis

This is a condition that occurs due to the instability of the spine, meaning the vertebrae are moving more than they should. When a vertebra slips out of place onto the vertebra below, it can cause pressure on the nerve, causing lower back pain and numbness.

7. Underlying Medical Conditions

Chronic conditions, like spine tumours, cancers, and kidney stones, can also cause chronic back pains. Spine tumours can compress the spinal cord or press against the nerves, causing back pain. Cancers that develop in the bone close to the spine can create pressure on it, leading to back pain. And lastly, kidney stones can block the flow of urine, which may lead to lower back pain or pain in the side.

Physiotherapy as Treatment for Low Back Pain

If you’re looking for physiotherapy treatment for your low back pain, Benchmark Physio may have just what you need. To understand the severity and cause of your low back pain, you must first undergo a comprehensive physical examination. Our physical examination typically includes range of motion assessment, palpation of affected structures, and testing for muscle strength and flexibility. In cases where neurological compromise is suspected, a neurological examination is performed.

After conducting the physical examination, our physiotherapist will then create a personalised physio treatment plan for your lower back pain. Some of the common approaches and treatment options involved include the following:

1. Manual therapy

Depending on your condition, our physiotherapist will determine which of the three manual therapy will be suited for your lower back pain: soft tissue release of tight/painful paraspinal muscles, trigger point releases, myofascial release, and spinal manipulation.

Soft tissue release of tight/painful paraspinal muscles is a physio treatment that is used to address muscle tension and pain in the muscles that are adjacent to the spine. Our physiotherapist will apply pressure and massage the affected muscles to release any knots or tension that may have developed in the lower back.

The trigger point release is a technique that relieves muscle pain and discomfort caused by tight knots or trigger points within the muscle fibres. For this, our physiotherapist will apply pressure to these points to release the tension and treat the low back pain.

A myofascial release is an approach in manual therapy that targets the fascia, which is a layer of connective tissue that supports and surrounds the muscles. In this physio treatment, our physiotherapist will apply gentle pressure and stretch the fascia to release any tension or adhesions that may have developed.

And lastly, we have spinal manipulations, which consist of joint mobilisations. Our physiotherapist will perform either Passive Accessory Intervertebral Mobilisations (PAIVMS) or Passive Physiological Intervertebral Mobilisations (PPIVMS). PAIVMS is a technique that involves applying force to the mobile vertebral segment without moving the muscles associated with it. This modality helps in reducing pain in patients, specifically low back pain. On the other hand, PPIVMS is used to identify a range of properties of spinal movement so that the physiotherapist can determine which manual therapy techniques are appropriate for lower back pain physio treatment.

2. Therapeutic exercise

Physio treatment for your low back pain will involve therapeutic exercises as well. Exercises usually focus on strengthening the muscles of your lower back to reduce tightness and fatigue. Some of the exercises our physiotherapist will guide you in performing include:

• Lower back stretches – This therapeutic exercise can help reduce lower back muscle spasms and tightness.
• Lower back strengthening – Lower back extensor strengthening focuses on increasing the endurance of your back to prevent fatigue.
• Core muscle strengthening – This exercise is useful for people who have to maintain static positions for long periods of time.
• Gluteal muscle strengthening – Strengthening weak hip/musculature reduces strain on the lower back, a common occurrence among those with sedentary lifestyles.

3. Electrophysical Agents (EPA)/Modalities

Another physio treatment used for low back pain is electrophysical agents. These are modalities that administer mechanical, thermal, electrical or light energy that provide therapeutic effects on back pain. The EPAs our physiotherapist uses for treatment include:

• Therapeutic Ultrasound – Unlike your typical ultrasound, this does not produce images; rather, the waves it transmits help tissue healing through increased blood flow to the lower back. In some cases, it can be used to heat tight tissues to make them more extensible. Additionally, they are used to reduce inflammation.
• Interferential therapy/TENS – Stick-on electrode pads are applied to generate an electric field over the lower back and help relieve pain and relax the muscles. This treatment can be beneficial if you are experiencing acute lower back pain.

4. Patient education on ergonomics, lifting and load management

To prevent the possibility of re-injury, our physiotherapist will also offer patient education on proper lifting techniques, workstation habits, and load management. They will also teach you how to avoid aggravating factors that may lead to lower back pain.

If our physiotherapist feels that you may have particularly tight back muscles that may benefit from a sports massage, you will be referred to our physiologist. A strength and conditioning programme may also be recommended if you are exposed to a job that requires a lot of manual lifting. Bikers who suffer from lower back pain may also be recommended to undergo a bike fitting.

How Benchmark Physio Can Help with Treatment

When it comes to physiotherapy treatment for low back pain in Singapore, you can consult our professionals at Benchmark Physio. Our physiotherapist, Ng Hong Kai, has been a practising musculoskeletal physiotherapist for over a decade. He has dual credentials as an APA Titled Musculoskeletal Physiotherapist and a tertiary-trained Exercise Scientist. His extensive skillset allows him to create tailored solutions to meet your health needs.

To know more about our physio treatment for the lower back, feel free to book an appointment today.