Lower Back Injuries
The Lower Back:
Low back pain is the single most leading cause of disability worldwide. Experts estimate that 80% of us will experience a back problem at some time in our lives. Despite knowing this, we are all guilty of taking our lower back for granted – we continue to lift heavy objects awkwardly, and we sit slouched in front of a computer or when driving for long periods of time.
Our lower back, or lumbar spine, is the main load bearing vertebrae in our spine. It consists of 5 large vertebrae, labelled L1-5. The lumbar spine connects the thoracic spine, or mid back, to the pelvis. Between each of these vertebrae is a shock absorbing disc which prevents bone on bone compression. Over time however, with everyday stresses with work, sport and normal daily tasks, coupled with poor posture or lifting technique, and weak core muscles, failure with any of these structures can occur.
Spinal nerves exit at each level and supply different areas down the legs. Because of this nerve supply, it is possible to have a back injury that is causing pain referral or even tingling or numbness to the lower extremity.
How Physio mechanics can help:
If left untreated minor back injury can quickly develop into recurrent chronic low back pain. Physio mechanics can help. On your first visit we will perform a thorough initial assessment allowing us to confirm your diagnosis and answer any questions you have. From there we will devise an individualised short term treatment plan to relieve your current symptoms, and a long term plan to prevent future reoccurrences.
Common low back physio treatments include massage, trigger point release, joint mobilisations to encourage movement or unload discs, and stretching and core strengthening exercises. If you are suffering from any low back aches or pains ring today and arrange an appointment with one of our expert staff.
Some common low back injuries we treat are .....
Disc Sprain/Bulge – Spinal discs are made up of an outer annulus surround and an inner liquid nucleus. From your teenage years, cracks and fissures can gradually develop within the outer annulus in response to poor posture, overloading, injury, sports, or just everyday stresses. The greater the fissuring, and the weaker your core is, the greater risk you are at for lumbar disc injury. A disc sprain on bulge injury usually occurs with a twisting or forward bending movement, more commonly under load. Internally, the nucleus has pushed out through the fissuring in the disc.
This can just result in irritation at this level (disc sprain) or part of the nucleus can actually protrude out at that disc level (disc bulge). Remembering that the spinal nerves exit at each spinal level, if the disc bulge is large enough, it may push on this nerve root and therefore cause referred pain into the leg in the distribution that that nerve supplies. Commonly with a disc injury you will have pain with flexion type movements – prolonged sitting, bending forwards, putting on your shoes and socks for example.
Facet Joint Sprain – Facet joints are small joints on the side of each vertebrae connecting each vertebrae to the one above and below. A facet joint sprain usually occurs from a compression type injury, for example a sudden jarring, twisting or extension type injury. When this happens the cartilage between these joints are pinched and an inflammatory process begins. Painful movements are usually those that further compress these inflamed joints, eg. a right sided facet joint sprain may mean you cannot bend over to the right painfree. With lumbar spine degeneration, the facet joints and vertebral bodies do get closer together, therefore you are at greater risk of these type of injuries occurring.
Sciatica – Sciatica is a term used to describe irritation to the sciatic nerve which exits the spinal cord between the last lumbar vertebrae (L5) and the first sacral vertebrae (S1). This is very common because the L5/S1 joint is right at the base of our lower back and it does act as a hinge for a lot of our everyday, work and sport stresses. The sciatic nerve can be compressed from degeneration, a disc bulge or inflammation at the spinal level, or can be compressed anywhere along the nerve pathway by scar tissue, inflammation or muscle spasm. After exiting the lumbar spine, the sciatic nerve travels through the buttocks, and down the back of the leg into the foot. Sciatica is usually described as severe sharp shooting pain, or deep dull aching, with possible pins and needles or numbness anywhere along this nerve distribution.
Muscle Spasm – Muscle spasm in the lower back usually occurs after an acute injury in response to inflammation, to help protect an underlying weakness. Muscle spasm however can also be in response to chronic stresses or overuse, which will make you more prone to further injury. Muscle spasm is sometimes visible, will definitely be palpable and will cause a generalised aching type of pain.