Hunting back pain

Physiotherapist Bernice Stallard looks into lower back pain, its causes, and what you can do to prevent it.

Lower back pain is an injury that most individuals will experience in their lifetime. This pain, in most cases, is mechanical pain caused by the stretching of ligaments and other soft tissues in the surrounding area over a period time. Mechanical pain can be felt in the back and leg, depending upon the severity of the injury sustained. The pain may vary in intensity and location depending upon what you are doing, for example moving compared to sitting still.

Robyn McKenzie is a physiotherapist, who in the 1970s designed a mechanical approach to the diagnosis, treatment and prevention of lumbar spine pain. This approach is commonly used by physiotherapists. It can also be used by most individuals to treat their own back pain, after consultation with a physiotherapist. The physiotherapist will use three syndromes - postural, dysfunction and derangement, to assess and treat your symptoms.

Postural syndrome

The pain is produced when normal tissues in your back are put under an end of range stress, for example prolonged sitting. That means the pain occurs over a period of time due to sustained position.

The pain is usually intermittent in nature and present only in your back. The treatment principle for postural syndrome is to correct your posture while you are doing the offending activity. There is no on-going physiotherapy required. Students and clerks are the mostly likely candidates for this syndrome.

Dysfunction syndrome

Dysfunction syndrome is defined as a pain that occurs when abnormal tissues (scar tissue) in your back are put under end of range stresses like bending forward. This adaptive shortening of scar tissue happens when you have had previous injuries that have not fully resolved.

The pain is intermittent and usually occurs only in your back. So when you move to touch your toes there is pain at the end of the movement, but as you come up the pain stops because you are no longer stretching those shortened tissues. The treatment principle for dysfunction syndrome is to stretch and remodel the affected tissues and correct your posture.

The physiotherapist will show you specific exercises to stretch the scar tissue. Most importantly the continuation of these exercise will prevent further injury in the long term.

Derangement syndrome

In a Derangement syndrome there have been changes to the disc caused by an injury. This may cause pain in your back and/or your leg. The pain can be intermittent or constant in nature and can be made better or worse by specific movements.
Your physiotherapist will show the exercises involved in treating a derangement. Again, you can manage the condition with a quick and easy long-term exercise program, which will aid in the prevention of further injury. Those that sit a lot at work or perform a lot of lifting tasks are more likely to develop derangements.

Points to remember