Treatment Methods for low back pain.
In todays' way of living, including mostly sedentary lifestyle, the problem that physiotherapists come across most is postural issues. When someone sits there for long time in the same position, muscles get "taut". Trigger points are activated.
Trigger points activated in the low back can be treated by first using electrotherapy modalities to reduce the pain. And once the pain subsides we proceed with further treatment.
We, as physiotherapists, use different methods such as myofascial release, cupping, needling, therapeutic massage, to unload the trigger point. Thereafter, plan a exercise regime for the patient, including, stretching of the tight muscles as well as strengthening of the weak muscles. As we strengthen the muscles, its capability to handle regular stress increases and thereby we prevent re-occurrence.
Now, if the muscles are weak and triggered, when we put undue stress, either by forward bending and in addition lifting a heavy weight, the muscles are unable to tolerate and pressure is transmitted to the other parts such as ligaments and vertebral shock absorbers namely the disc. When intolerable, the ligaments tear and the discs bulge out. Now they might or might not press on the nerves. If they start pressing on the nerves, the condition worsens, resulting into radiation of pain to the parts supplied by the nerves. In the region, sciatic nerve is the basic. We come across sciatica.
For this condition, earlier the treatment was immobilization, relieving the pain with modalities, giving time to heal. And now, due to high physical demands, we treat with help of modalities to first relieve the pain, then add a certain immobilization to it with help of lumbo-sacral or pelvic belts. Then we try to put the disc back into place if only the outer part has bulged, with help of traction. We generally do not get victory over that. We also devise exercise plans in less severe cases following the flexion and extension regimes based on acute and chronic cases. in addition to this strengthening of weak muscles and stretching of tight muscles is advised. In case of radiation of pain, its first centralized and then same treatment routine is followed.
Thus it is better to keep the muscles up to date with exercise and visit a physiotherapist as soon as a small pain arises.
There are certain cases such as osteomyelitis, tumors, and tuberculosis. In these cases, we as physiotherapists, cannot treat the cause. Pain can be handled and that too with a lot of considerations and precautions.
In case of spondylolisthesis, which is overriding of one vertebral body over other disturbing the alignment, and putting pressure on nerves, surgery is a good option. We, as a physiotherapist, advice external supports such as braces, exercise regimes are planned such as stretching and aerobic exercises to help the patient. Surgery involves facetectomy.
Fractures are also painful. And that is certainly a different field involving immobilization and rehabilitation.
I have observed that there is a lot of bodily stress in people due to high work demands. There is requirement of relaxation methods. One way to achieve this is Cranio-sacral therapy aka CST. It is a method involving light touch to bring homeostasis and balance of the cerebrospinal fluid and its rhythm and flow.
I had posted an article on this topic before, which was a general description for mainly the diagnosis. Here, I have tried to throw some light on treatment methods.
Hope to see you soon with some more insights. Take good care of your health.