Help My Back Pain – Therapies to Ease the Misery

Therapy to help back pain
Lower back pain sometimes known as Lumbago or Sciatica is a common disorder affecting some 60% of the adult population, seeking to get rid of back pain. So great is the problem, that in the UK alone, some 150 million man days are lost each year in industry, as a result of absenteeism attributed to lower back pain. Generally, the symptoms of low back pain are due to benign musculoskeletal problems often arising from strains in the lower back muscles or soft tissue, and these ease considerably within a few weeks using common sense measures to address.

To help back pain, establishing of the fundamental origin of the back pain with a GP is usually made through a combination of a medical history, physical examination, and, when necessary, diagnostic investigation, such as x-ray, MRI, or CT scan. Usually, low back or lumbar pain can be treated conventionally, with one recommendation being physical therapy which may help alleviate the symptoms, and give back pain relief. A summary of some of the more common therapies used to provide back pain relief are listed below:-

Acupuncture
Acupuncture treatment originated in China over two thousand years ago. It is reputed that the first observations were of soldiers, wounded in battle by arrows, and how the arrow ‘punctures’ caused therapeutic effects in different parts of the victims body well away from the wound area. The general theory behind traditional acupuncture is based on patterns or meridians of energy flow through the body that are essential for health. This is referred to as Qi or Chi and sometimes Xue (blood). Disruptions of this flow are thought to be the primary causes of pain and disease. Acupuncture attempts to correct imbalances of flow, thus helping to restore the patient’s health.

How acupuncture works
Broadly, acupuncture involves stimulation of points along these energy flows through a range of techniques. Stimulation is typically performed using very fine needles that create gentle sensations. Each of these needles are inserted into specific points along these ‘energy pathways’ or “meridians”.

Can acupuncture help my back Pain
Acupuncture is considered useful in treating such conditions as lower back pain, sciatica, stiffness, and strains. In traditional acupuncture theory, pain arises due to blocked energy along ‘energy pathways’ or “meridians” of the body, which are ‘cleared’ when acupuncture needles are inserted. In modern medicine, scientific reasons have been put forward for the apparent benefits that acupuncture provides for the sufferers of lower back pain. One observation is that acupuncture stimulation causes the releases neurochemicals and hormones, regarded as producing signals that soothe the sympathetic nervous system and release natural opioids which provide back pain relief.

Alexander technique
The Alexander Technique is a method that works to change (movement) habits in our everyday activities. It is a simple and practical method for improving ease and freedom of movement, balance, support and coordination. The technique teaches the use of the appropriate amount of effort for a particular activity, giving you more energy for all your activities. It is not a series of treatments or exercises, but rather a re-education of the mind and body. The Alexander Technique is a method which helps a person discover a new balance in the body by releasing unnecessary tension. It can be applied to sitting, lying down, standing, walking, lifting, and other daily activities

How Alexander Technique works
The Alexander Technique shows its students how to learn to do whatever they currently do as easily and efficiently as possible. It is concerned almost exclusively with process – how an activity is performed not what it is. Although there are no exercises, Alexander technique shows how to exercise more efficiently, with reduced risk of injury. Many, seeking back pain relief are drawn to the technique because of its reputation to help back pain or lumbago, stiff necks and shoulders, and other conditions such as carpal tunnel syndrome. Alexander teachers are not doctors and do not diagnose diseases.

Can Alexander Technique help my back pain
By becoming more aware of how the body works and learning how to “undo” bad body practices, those suffering with long term or chronic back pain are able to soothe and ease their symptoms. Pupils of Alexander technique can learn how to pupils how to liberate needless muscle tension and, freer means of movement which impose less strain and therefore back pain relief.

Bowen Therapy
The Bowen technique is a soft tissue remedial therapy, named after its innovator Tom Bowen. This therapy is not considered massage, but as a non-invasive muscle release and integration technique, but similar to massage, it releases muscular tension. Its clients describe experiences of significant relaxation after a session.

How does Bowen Therapy work
The technique involves the therapist using fingers or thumbs to move over muscle, ligament tendon and fascia in various parts of the body. The work is very subtle, relaxing and gentle involving no hard or prolonged pressure. During a session the client will lie on a therapy table or bed, although the work can be effectively carried out with the client in a chair.

Can Bowen Therapy help my back pain
The most common presentation is for back pain relief and here Bowen excels. The average number of treatments would be two or three for most therapists. There are always going to be exceptions to any rule, and certain people will need further or even on-going treatments. Sports injury is a field of remedial therapy that is becoming very aware of The Bowen Technique. The Bowen Technique is being used at high levels of sport in this country, with rugby clubs and premiership football clubs showing interest. Bowen therapists advocate that this can reduce or eliminate or help back pain and promote general health
Source: European College of Bowen

Chiropractic
Chiropractic is a technique which focuses on the musculoskeletal and nervous systems. The principal of Chiropractic is that the key to health is the nervous system with the spine at its centre. If the spine is aligned correctly, then optimal movement can occur and the patient can achieve improved health.

A chiropractor will generally address “subluxations”- misalignments to the spinal bones responsible for reduced movement or or loss of normal posture, causing impairment to the nervous system or nerve irritation.

How does Chiropractic work
In seeking to help back pain, a chiropractor would usually examine the patient’s spine and review any patient history to determine any previous injuries, accidents, or tensions that may be impairing normal function. Sometimes the Chiropractor will order an X-ray to help determine this. A common form of Chiropractic treatment is a spinal manipulation or adjustment. This is generally carried out by hand manipulating the spinal joints affected in an attempt to increase or unlock the joints mobility.

Additional tools are sometimes used to promote healing including rehabilitative exercise, nutritional and lifestyle improvement programmes. The amount of, and frequency of the treatment required would vary according to the nature and severity of the condition.

Can Chiropractic help my back pain
A chiropractor will attempt to focus on the fundamental mechanical and neurological trouble in the spine to decrease the back pain and other symptoms caused by reduced spinal function. He will concentrate on natural health care working to encourage the body to self repair back towards improved health. Chiropractic care as a therapy for back pain in general is safe when employed skillfully and appropriately. Manipulation is regarded as relatively safe, but as with all therapeutic interventions, complications can arise, and it has known adverse effects

Feldenkrais
The Feldenkrais Method is a somatic educational system designed by Moshé Feldenkrais (1904-1984), based on physics, neurology, and bio mechanics. The Feldenkrais method is designed to improve movement repertoire, aiming to expand and refine the use of the self through awareness, in order to reduce pain or limitations in movement, and promote posture, and general well-being. The Feldenkrais Method is often regarded as falling within the field of complementary medicine, and is a means of re educating the neuromuscular system, redefining movement to increase efficiency and reduce stress

How does Feldenkrais work
Feldenkrais Method is taught in two complimentary formats – “Awareness Through Movement’ taught through classes and Functional Integration taught on a one to one basis.

In teaching ‘Awareness Through Movement’ classes, the teacher will lead the class through a sequence of movements involving standing, sitting in a chair or sitting or lying on the floor. One of the key aims is to instruct pupils how to decrease unwarranted muscular exertion and develop understanding of their whole self during movement.

In a Functional Integration lesson, a trained practitioner uses his or her hands to guide the movement of a single pupil, who may be sitting, lying or standing. The practitioner uses this “hands-on” technique to help the student experience the connections among various parts of the body (with or without movement). Through precision of touch and movement, the pupil learns how to eliminate excess effort and thus move more freely and easily. Lessons may be specific in addressing particular issues brought by the pupil, or can be more global in scope. Although the technique does not specifically aim to eliminate pain or “cure” physical complaints, such issues may inform the lesson. Issues such as chronic muscle pain may resolve themselves as the pupil may learn a more relaxed approach to his or her physical experience-a more integrated, free, and easy way to move Students are taught to become aware of their movements and of how they use themselves, thus discovering expanded movement options.

Can Feldenkrais help my back pain
The theory behind Feldenkrais is that inefficient movement behaviour may lead to avoidable tension and movement constraint leading to back pain. The Feldenkrais technique provides for expanded movement alternatives and enhanced posture which can provide backache relief or back pain relief, whilst developing greater efficiency and freedom of movement

Massage therapy
Massage is the manipulation of superficial layers of muscle and connective tissue to improve the function and encourage relaxation, well-being, and improve posture dysfunction. It involves acting on and manipulating the body with pressure – structured, unstructured, stationary, or moving tension, motion, or vibration, done manually or with mechanical aids. Target tissues may include muscles, tendons, ligaments skin, joints, or other connective tissue, as well as lymphatic vessels, Massage can be carried out using the hands, fingers, elbows, knees, forearm, and feet. There are over eighty different recognized massage techniques with many used to help back pain.

Massage manipulates the soft tissues of the body by rubbing, kneading, stretching and other methods for therapeutic effect. As a result, muscle and tissue is made more pliable, energising lymph circulation and promoting blood flow. Therapists will employ a range of techniques and methods during treatment sessions.

How does Massage therapy work
Massage manipulates the soft tissues of the body by rubbing, kneading, stretching and other methods for therapeutic effect. As a result, muscle and tissue is made more pliable, energising lymph circulation and promoting blood flow. Experienced therapists will employ a range of techniques and methods during treatment sessions to help back pain. There are many types of massage therapy for back pain in addition to acupressure or Bowen (see above) such as:-

Deep Tissue Massage
Used to relieve severe tension in muscle or fascia, often used where the patient suffers consistent lower back pain caused by specific muscular-skeletal conditions. It concentrates on the underlying muscles rather than those at the surface in order to help back pain.

Swedish massage
(or Classic massage in Sweden!) can be used to help back pain, by improving circulation and easing joint stiffness. Swedish massage uses five styles of strokes to massage: Sliding, kneading, tapping, friction, and vibration

Hilot
Hilot is a traditional healing and massage technique originating in the Philippines that can be employed to relax stressed muscle and joint manipulation to treat muscular-skeletal conditions as a lower back pain therapy.

Trigger point therapy
Can be used to help back pain and poor posture, by helping to release muscles in spasm, employing techniques to release ‘knotted’ muscles, and freeing up circulation in the affected area.

Traditional Chinese massage
There are two types which can provide back pain relief and – Tui na (the Chinese equivalent of physiotherapy) which concentrates on pushing, stretching and kneading the muscle, and Zhi Ya which utilises techniques of pinching and pressing at acupressure points. These originate from Traditional Chinese Medicine. Although Tui Na is described as massage in the West, in TCM it is not. In TCM massage is called Anmo, which forms the basis of Japan’s Anma.

Can massage therapy help my back pain
Carried out effectively by experienced practitioners, knowledgeable of the human body and conversant with muscle imbalance massage therapy can be a useful therapy for back pain. Massage can also assist in relieving lumbar pain by reducing tension in turn alleviating poor back posture caused by muscle imbalance. Relief of mental tension and stress by using massage is also useful a useful therapy for back pain helping those within sedentary occupations involving hours of sitting in front of VDU’s. Although massage is undoubtedly useful for back pain relief it may not address the underlying condition so GP advice should be sought.

Osteopathy

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Understanding Back Pain Causes And Treatment

Back pain affects nearly 80% of Americans and the most common form is Low Back Pain. Because you rely on your back for almost every move you make, it is vulnerable to injury. Back pain can even be disabling. It is one of the most common problems prompting a visit to your doctor and for missing work. In fact, it is the second highest cause of disability in persons under the age of 45.

Although people complain of back pain, it is not a diagnosis but rather a symptom of an underlying disorder. There are two types of back pain, acute and chronic. Acute back pain is pain with a new onset. It comes on suddenly, usually due to injury. This is the most common type of back pain. It is usually resolved in less than one month but no more than 6 weeks duration. Chronic pain is pain that can have a quick or slow onset, but it lingers for long periods of time. Although it may last three months or longer, some people experience a lifetime of chronic back pain. Chronic pain is the least common type of pain.

What Causes Back Pain?

To begin to understand the causes of back pain, we need to understand the spine. The back is made up of 33 vertebrae or bones. It is divided into 5 groups: Cervical, Thoracic, Lumbar, Sacrum and Coccyx. The cervical spine (upper back or neck) consists of 7 vertebrae. The thoracic(middle back) has 12, and the lumbar spine(low back) has 5 vertebrae. The sacrum consists of 5 fused vertebrae, and the coccyx(tail bone) has 4 vertebrae fused together.

The vertebrae are held together by ligaments and muscles with discs between the vertebrae. The discs are filled with a jellylike center, allowing them to act like a shock absorber. The vertebrae link together to provide stability and support. They protect the spinal cord and spinal nerves that run through the spinal canal.

Because the neurological system is complex, it is difficult to pinpoint the exact cause of back pain. The causes of back pain are divided into categories: Mechanical, Injuries, Acquired disorders or diseases, Infections or tumors.

Mechanical causes: These are problems with how the spine works. For example, Spondylolistesis(deterioration of the disc one vertebrae to slip forward over another, causing the vertebrae to rub together, therefore causing pain). Other mechanical problems are fractures, herniated discs, spinal stenosis, spinal degeneration and sciatica.

Injuries- This category includes common forms of back pain due to injury to the spine or the ligaments and muscles involved with the spine. Sprains, for example, result if a ligament that supports the spine is pulled or torn due to improper lifting or body mechanics, even twisting the wrong way, Fractures can occur from osteoarthritis which causes the bones to become brittle and weak. Sever injuries can result from an accident or fall.

Acquired disorders- These are medical problems that you might have been born with such as scoliosis(an abnormal curvature of the spine) to other problems that you acquired, such as arthritis(osteoarthritis and rheumatoid arthritis) which can lead to fractures; musculoskeletal pain syndromes such as fibromyalgia, spinal stenosis (Narrowing of the spinal canal putting pressure on spine or nerves); and even pregnancy.

Infection/Tumors- Infection, although not common, can cause pain if it involves the vertebrae. Two examples of this are Osteomyelitis(infection and inflammation of the vertebrae) and Discitis(infection in the discs).Tumors, although rare, can also cause back pain. These can be benign or cancerous, but usually result from a tumor that has spread from another area of the body.

How is back pain diagnosed?

In order for your physician to discuss the proper treatment for your back pain, he will need to do a thorough medical history and physical exam. You will need to give a clear concise description of your pain. Your physician will need to know how the pain started, what you were doing when it started, how severe it is, does it come and go or is it constant, and what makes the pain better or worse. You will need to undergo some diagnostic tests. Common tests done to diagnose back pain are x-rays, bone scans, and MRI’s. These diagnose problems due to bone or soft tissue injuries. Your doctor may order blood and urine tests to look for infection. If your physician feels the pain might be caused by a nerve problem, then you will have an EMG(electromyography) or nerve study. An EMG is an assessment of the electrical impulses of nerves and the response of the muscles.

How is Back Pain Treated?

The common goals of treatment are to relieve back pain and to restore mobility. Treatment varies depending on the severity and type of injury. The most common and basic treatment used for strains or minor injury is Rest. Heat can be used to promote circulation to the area and relieve spasms. Cold packs can be used to decrease the swelling in the affected area of the back. Common OTC (over the counter) medications such as Aspirin, Motrin, Tylenol, and Aleve are prescribed to help the pain and inflammation.

Long term bed rest is not usually recommended because it can make recovery slower and can ultimately cause other problems. Usually the doctor will have you gradually resume normal activities after 24-72 hours of rest. He may start you on a physical therapy program which should include heat, massage, ultrasound and an individualized exercise regimen. If the pain does not subside and it is interfering with your normal daily activities, your doctor may order prescription pain medications such as Darvocet, Vicodin, or Percocet and anti-inflammatory agents to relieve muscle spasm.

If your pain becomes chronic and all other treatments have failed, your doctor may refer you to a Back or Pain specialist. Because the back is a complex entity, specialists are more up to date on new advances in the treatment of back pain. Some treatments you might encounter are epidural nerve block (injection of anesthetic, anti-inflammatory, or steroid into the epidural space of the back for long term pain relief)and trigger point injections(injection of steroids and anesthetic into the muscle that is triggering pain.)This should also provide long term pain relief. Other medications such as antidepressants and anticonvulsants have been found to help relieve pain caused by nerve injuries.

Other types of treatment include:

Use of TENS(transcutaneous electrical nerve stimulation) unit. Electrodes are placed on 2-3 painful areas of the back and attached to a unit that provides mild electrical stimulus to the area in order to relieve pain.

Chiropractic adjustments of the back.

Acupressure or acupuncture treatments.

Relaxation and breathing techniques and stress management instruction.

Massage and basic stretching exercises to promote mobility and relieve spasm.

Yoga-and Pilates- This can help relieve pain and stress. Some Yoga postures may help relieve low back pain and help improve strength, flexibility and balance. Yoga is good for stress reduction and can help with the psychological aspects of pain.

Aquatic or water therapy- This can be very beneficial in relieving pain and improving mobility in those with chronic low back pain. There is no resistance to movement in the water, and water is soothing, comforting, and relaxing for the body.

How can Back Pain be Prevented?

Although some people say that you can’t avoid injuring your back, most doctors are in agreement that the common causes of back pain can be prevented by following a few lifestyle changes:

Exercise: You will need to consult your physician prior to starting an exercise program because there are some exercises, such as high impact aerobics and weight lifting that can make back pain worse. Other exercise, such as swimming, walking and biking can help overall health and strengthen the back. Nonetheless, exercise should not be avoided as it helps to improve overall health.
Lumbar support belts: Some people that work jobs that do heavy lifting on a daily basis are required to wear lumbar support and undergo back training on the job to learn how to prevent lifting injuries.
Do not wear high heels.
Keep head up and stomach in when standing. If standing for prolonged periods of time, place one foot up on a stool and alternate your weight frequently.
Sit in a chair with good lumbar support. Maintain good posture, sit up straight and keep both feet flat on the floor. Make a lumbar roll out of a rolled towel to place behind the low back when you drive or sit for prolonged periods of time.
Use proper body posture when lifting. Keep objects close to your body. Keep your back straight and your head up with stomach tucked in. Don’t lift objects that are too heavy. Get help when lifting awkward or heavy objects. Don’t bend forward to pick something up, rather bend at the knees and lift straight up from the knees.
In conclusion, back pain can be difficult to treat but there are many options out there for you. Specialists are finding new research every day. You can take care of your back by making good lifestyle changes and eliminating or reducing the amount of stress in your life. By maintaining good posture, using proper lifting techniques, and educating yourself on how to avoid back pain, you can prevent more back injury.

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