Back Pain

Sciatica / Disc Herniation

Sciatica is widely known as back pain with buttock or leg pain that runs down the leg (referred pain) and is associated of 8-10% of all back pain cases. Often the buttock and leg pain can be worse than back pain. As this condition can be felt in different areas people report a variety of symptoms. Sometimes patients will experience back pain associated with this and sometimes it will just be the leg that’s painful. Symptoms that are felt in the buttock, down the leg or to the foot can be reported as hot burning leg pain, sharp pain, pins and needles, numbness in areas and even weakness in some cases that makes it harder to move muscles. 

The main causes of sciatica are the nerves being irritated, compressed or injured at the point where the nerve exits the lower back. Typically, a disc herniation or age-related joint changes can increase the risk of these symptoms developing but patients can develop these symptoms without any meaningful structural changes around the nerve. 

Our physiotherapists would normally conduct a detailed examination in order to get an accurate diagnosis and a plan to manage these symptoms. Having an early assessment can be very helpful in looking to reduce the length of time the problem persists. However, even patients with persistent symptoms over longer time have been shown to improve through hands on treatment, specific exercises and providing individual advice physiotherapy. 

 

Mechanical Lower Back Pain

Back pain that arises from the muscles, joints, discs and tendons of the lower back is widely referred to as ‘mechanical back pain’. This differentiates it from pain coming from other structures such as the organs, from an immune system reaction or from an infection. Mechanical back pain is extremely common and reportedly affects around 80% of us at some point in our lives. It commonly causes pain when moving in a certain way or when we adopt certain postures/positions.

Most patients experience it as either an acute episode or as an ongoing re-occurring problem. The good news is that there are lots of things that can be done to relieve the symptoms, and more importantly, to improve our ‘back health’ and thus prevent the issues coming back.

Our physiotherapists are specialists in the diagnosing of this problem (including ruling out other causes and including GP/specialists where needed) and also in the treating of back pain, whether that be through manual ‘hands on’ therapy or through a tailored exercise regime.

Lumbar Spondylosis

Spondylosis is a term that relates to bony changes of the spine that happen over time, very much like arthritis of the knees and hips. As we age our body adapts along the way to the forces we apply. These forces over time can mean the joints can gradually change shape and our discs reduce in hydration therefore reducing in height. Rarely these changes ever cause pain however at times in the lower back (lumbar) where these slowly formed changes occur it can lead to joint pain, stiffness and reduced range of movement. Common symptoms are pain localised to the lower lower lumbar spine (L4, L5 area), a gradual onset of symptoms, clicking. Additional symptoms are pins and needles and intermittent numbness in the legs or feet. 

This condition has been shown to benefit from physiotherapy treatment through an individualised management plan and manual therapy when indicated.

Spondyloarthropathy

In in simplest sense, this term is used to describe a range of conditions that are linked to pain and stiffness of the spine associated the immune system attacking the joints. Spondyloarthropathies can be difficult to diagnose and can require onward referral to a Rheumatologist. Clinicians such as physiotherapists or GPs will often ask about specific features or symptoms to guide the process, and may arrange a blood test to look for certain markers in the patient’s blood that could indicate a reaction from the immune system. However, the blood tests aren’t regarded as a ‘catch-all’ and the clinical features and examination will often be used to help lead towards a diagnosis.

Thoracic spondylosis

Spondylosis is a term that relates to bony changes of the spine that happen over time, very much like arthritis of the knees and hips. As we age our body adapts along the way to the forces we apply. These forces over time can mean the joints can gradually change shape and our discs reduce in hydration therefore reducing in height. Rarely these changes ever cause pain however at times in the upper trunk and lower neck where these slowly formed changes occur it can lead to joint pain, stiffness and reduced range of movement. Common symptoms are pain localised to the lower neck and upper thoracic area, a gradual onset of symptoms, clicking. Additional symptoms are pins and needles and intermittent numbness in the arm or hand. 

This condition has been shown to benefit from physiotherapy treatment through an individualised management plan and manual therapy when indicated.

Scoliosis

Scoliosis is when a curvature of the spine to the side and or a twist is observed. This can result in a “C” shape single curve or a “S” shape double curve that can cancel each other out to appear as a “straighter” spine. It is important to note that Scoliosis is not a disease and generally has no known cause. There are many different types of scoliosis that can develop at various stages of someone’s life from child to adulthood with the most common type being Adolescent Idiopathic (ages between 10-19 with no known cause). Many people are able to lead a pain free life with these changes, while some experience symptoms of back, rib, chest and hip pain. These symptoms vary from person to person and are not linked to the shape or amount of change detected. Physiotherapists can help develop strategies that are important to help manage Scoliosis and at times can prevent further changes. Treatments that may help include hydrotherapy, massage along with exercises that strengthen and stretch your back and stomach muscles. Physiotherapists are also able to identify and work with the health care professionals that may be able to help with ongoing or changing symptoms if indicated.