Back pain is a common complaint experienced by almost every one of us at some point in our lives. It is usually accompanied with a discomfort in the back which can have varied causes.
Causes of Back Pain
- Muscle strain
- Injury and trauma
- Pinched Nerve
- Slip disc
- Narrowing of spinal canal
Physiotherapy for Back Pain
Physical therapy is an excellent, but extremely neglected modality for back pain relief. It can help alleviate the acute pain as well as prevent further pain by strengthening the back muscles. It has been noted that physical therapy can provide as much, if not more, relief as surgery and can delay the need for surgery in most cases.
Pain Relief through Physical Therapy
Physiotherapy in back pain relief involves two types of therapies: active or passive therapy.
Active Therapy
Exercises
There are specific exercises that relieve pain, strengthen weak muscles, stretch the muscles of the back and improve the range of motion. Strengthening the abdominal muscles provides more support to the back, thereby, relieving back pain. Do not perform any exercise that causes pain, or adds strain to the back.
Some useful exercises to relieve back pain:
- Engage your core: Lie on your back. Inhale, and stretch the abdominal muscles. As you exhale, pull your belly button in toward the spine, inward and upward.
- Pelvic tilts: Lie on your back, with the knees bent. Slowly, press your pelvis and lower back into the ground. Hold for 10 seconds, and relax.
- Partial crunches: This exercise strengthens the abdominal muscles, without putting a strain on the back. Lie on your back, with the knees bent. Place your hands behind your neck, with your elbows parallel to the ground. Inhale, and engage your core muscles. Now, exhale, and slowly raise your shoulders off the ground. Do not pull your neck up, and do not point your elbows toward the sky. Slowly, lower your shoulders to the ground. Repeat this 10 times.
- Bridge: Lie on your back, with the knees bent, and arms by your side. Engage the core. Slowly, lift your hips off the ground. Your body should be in a straight line, from the shoulder to the hips. Hold this pose for 10 seconds. Slowly, lower the hips to the ground. Repeat 10 times.
- Supine hamstring stretch: This exercise stretches the back of your thighs. Lie on your back, with your knees bent. Inhale, and engage your core. Now, slowly straighten out one leg, and raise it toward the ceiling. Grasp the thigh, and pull it toward your body, keeping the knee straight. You can wrap a towel around the raised foot, for extra traction. Hold this pose for 10 seconds. Lower the foot to the ground. Switch sides and repeat, 10 times for each leg.
- Wall-sits: Stand with your back against a wall, feet slightly apart. Slowly, with your lower back fixed against the wall, bend your knees, and lower your body, like you are sitting in a chair. Hold this pose for 10 seconds, then straighten up again. Repeat 10 times.
- Prone back extension: This is to stretch your whole back. Lie on your tummy, with your hands under your shoulders. Inhale, and as you exhale, slowly raise your upper back off the floor. Now, slowly move your head from one side to the other and back to the centre. Hold this pose for 10 seconds. Slowly lower yourself down. You should not feel any pain in your lower back while doing this exercise. If you do, stop at once. Repeat this exercise 10 times.
- Low-impact aerobic exercises like walking, that do not put pressure on the spine.
Passive Therapy
- Ice packs or hot fomentation
- Manual therapy like manipulation
- Ultrasound
- Dry needling, where a non-medicated needle is inserted into the trigger points in a muscle, to treat myofascial pain
- Electrical stimulation for relief from pain
- Transcutaneous electrical nerve stimulation provides immediate short-term relief from pain.
- Intradiscal electrothermal therapy relieves pain caused by a prolapsed intervertebral disc. An electrothermal catheter is passed into the affected disc, which uses heat to destroy pain receptors and alter the nerve fibres in the disc.
- Radiofrequency discal nucleoplasty uses a radiofrequency probe to destroy a small part of the central portion of the disc. This partially decompresses the disc, relieving the pain caused by the pressure of the bulging disc on nerve roots.
There is a lot of advocacy going on against the use of opioid drugs like methadone, OxyContin, and Vicodin. These are painkillers that cause addiction, depression and a strong possibility of death by overdose. As a side-effect free alternative, physical therapy offers similar pain relief without any complications.
