Back pain is one of the commonest health problems in the world, impacting millions of people of different ages and backgrounds. According to the NHS, it is the leading single cause of disability in the UK, with lower back pain alone accounting for 11% of all cases of disability countrywide.
Back pain can have a huge impact on the quality of life, productivity, and well-being of individuals and society as a whole. It is a complex and multifaceted condition with a variety of back pain causes, which can include:
- Mechanical/structural problems such as sprains, strains, degenerative disc disease, and fractured vertebrae
- Inflammatory conditions such as ankylosing spondylitis
- Other medical conditions like fibromyalgia, osteoporosis, endometriosis, and infections involving the bones of the spine
Different back pain causes require different treatment approaches, one of which can be physiotherapy. Physiotherapy includes guided therapeutic exercises that strengthen the back muscles and condition the tissues and joints of the spine. It also helps restore the patient’s ability to perform daily activities with little or no discomfort.
In this article, we will explore the different types of back pain, their causes and treatments, and the role of biofeedback therapy and physiotherapy in back pain management.
Acute vs Chronic Back Pain: what's the difference?
There is a general misconception that all back pain is the same and that it can easily be managed with some rest and painkillers. Another common misconception is that back pain only affects older persons. Although back pain is more common among older people, it can occur among people as young as 18 years of age.
Back pain can be categorised into two main types: acute and chronic. It is important to understand each type, as they have different causes and treatments.
Acute back pain: causes and treatments
Acute back pain occurs abruptly, usually due to damage to the muscles and ligaments that support the spine. This can be a result of strains or sprains following heavy lifting, awkward movements, or direct impact.
Acute back pain is usually short-lived, lasting between a few days to a few weeks. Most of the time, it resolves on its own or with simple treatments like rest, pain medications, and hot or cold compresses, which are a remedy for inflammation and pain.
If the acute back pain persists for more than a few weeks or is very severe, it may be a sign of a more serious problem like a herniated disc, spinal stenosis, or infection. In such cases, the acute back pain may become subacute or chronic, requiring a multidisciplinary approach that may include physiotherapy.
Chronic back pain: causes and treatments
Chronic back pain usually lasts longer than 12 weeks and persists even after the initial injury has been treated. It can have various causes but is usually due to age-related causes like degeneration of the discs, joints, and bones.
Other chronic back pain causes include:
- Arthritis of the spine
- Spinal stenosis
- Herniated or bulging discs
- Myofascial pain syndrome
It can also occur in the context of underlying health conditions or psychological factors;
- Diabetes
- Cancer
- Fibromyalgia
- Stress
- Depression
- Anxiety
Chronic back pain can be challenging to treat since it often involves a multidisciplinary approach involving different investigations and treatment strategies. Although a diagnosis of chronic back pain is often made based on a patient’s history and a physical examination, sometimes doctors may order tests to identify the specific cause of your back pain, and these tests include:
- X-rays
- Magnetic resonance imaging
- Computerised axial tomography
- Electrophysiological tests like electromyography
- Bone scans
The choice of treatment for chronic back pain varies depending on the cause, and some of these treatment approaches include physiotherapy exercises, medications, lifestyle changes, and, in some cases, surgery. However, surgery is usually looked at as a last resort, as it may not always be effective and carries many potential risks and complications.
Biofeedback therapy: a revolution in back pain relief
Biofeedback therapy is an emerging and innovative treatment for back pain. It teaches you to control your vital functions like heart rate, breathing, and muscle tension to relieve back pain. The therapy is based on the idea that your mind and body are interconnected and that by becoming aware of your body’s response to pain, you can learn how to modify it and reduce its negative impact.
Biofeedback therapy works by using sensors that are attached to your body and connected to a device that provides feedback on certain body functions. By observing this biofeedback, you can learn to recognise when your body is in a state of stress or pain and how to relax and calm it down.
The different types of biofeedback include:
- Electroencephalography
- Respiratory biofeedback
- Heart rate variability
- Electromyography
- Galvanic skin response training
- Thermal biofeedback
Biofeedback techniques rely on relaxation and mental exercises to teach you how to lower your muscle tension and heart rate, resulting in pain reduction. Biofeedback therapy is usually done with the guidance of a biofeedback therapist, who can teach you the skills and techniques to use at home.
Some of these techniques include:
- Deep breathing
- Progressive muscle relaxation
- Guided imagery
- Mindfulness meditation
Physiotherapy for back pain: your road to recovery
Physiotherapy is one of the most effective and widely used treatments for back pain. Its main aim is to restore and maintain the optimal function and movement of the body. Playing a central role in alleviating back pain from both preventive and curative perspectives.
Physiotherapy can help prevent back pain by improving your posture, flexibility, strength, and endurance, all of which are essential for maintaining a healthy and balanced spine. It can also help you correct any biomechanical issues that may contribute to back pain, such as muscle imbalances, joint stiffness, or spinal alignment.
In this section, we will help you understand how different physiotherapy techniques work and how they can be tailored to your unique recovery road.
How physiotherapy provides back pain relief
There is a wide variety of physiotherapy techniques used by physiotherapists to help reduce pain and inflammation, as well as improve your endurance, strength, and range of motion.
Two types of physical therapy are used to treat lower back pain: active and passive.
- Active physical therapy is the most preferred treatment option for chronic back pain before exploring aggressive treatments. It can be used alone or in combination with other treatments like traction, massage, and ultrasound. It involves the individual performing the exercise themselves and includes examples like walking on a treadmill, hip strengthening exercises, or straight leg raising exercises.
- Passive physical therapy, on the other hand, requires you to relax while someone else, such as a physiotherapist, applies the stress, and examples of this include hamstring stretches and passive range of motion exercises. It is more suited to acute back pain.
Other commonly used physiotherapy modalities include:
- Therapeutic ultrasound: a deep heating treatment administered by your physiotherapist using an ultrasound machine to relieve pain and inflammation.
- Electrical stimulation: used occasionally to help reduce pain. A well-known form is transcutaneous electrical neuromuscular stimulation (TENS).
- Traction: used in the treatment of low back pain to decrease pain and improve mobility in the spine. It can be lumbar, cervical, or supine traction.
- Massage: helps to reduce pain, improve circulation, and decrease muscle tension.
- Heat: may be applied in the form of moist heat or hot packs to increase circulation to the injured tissues, relax muscles, and provide pain relief.
Since different back pain causes require different treatment approaches, our physiotherapists develop personalised treatment plans for each patient based on their specific needs and problems.
Our typical physiotherapy sessions may include a mixture of manual therapies, general advice, exercise and movement, and high-tech treatments like therapeutic ultrasound. The duration and frequency of the sessions may vary depending on your progress and needs, but improvements are usually seen within a few weeks or months.
Back pain exercises: stretch and strengthen
Regular exercises that stretch and strengthen the muscles supporting your spine are one of the best ways to improve your back health and prevent back pain. These exercises can help you maintain good posture, flexibility, and stability. They also reduce the risk of injury or age-related degeneration, as well as help relieve existing back pain and hasten your recovery.
There are many exercises that target the back and relieve pain. However, some of the most common and effective ones are:
- Knee rolls: This exercise elongates the muscles of the lower back and hips, and improves spinal mobility.
- Pelvic tilts: These strengthen the muscles of the abdomen and lower back, and improve spinal alignment.
- Single and double knee hugs: With these, the lower back and hamstrings are stretched, and tension and pain are relieved.
- Cat camel: This exercise stretches and mobilises the spine, and improves posture and flexibility.
For further details on how these exercises can be carried out, you can speak to one of our registered physiotherapists.
How to prevent back pain causes
Besides doing regular exercises, there are other lifestyle changes that can help you prevent back pain causes and maintain your back health. Some of the most important ones are:
- Maintain a healthy weight: being overweight can put extra pressure on your spine and increase the risk of back pain.
- Stay active: regular physical activity helps to strengthen your muscles, improve your blood circulation, and prevent stiffness and inflammation in your back.
- Avoid prolonged inactivity or bed rest: staying too long in bed can make your back pain worse and delay your recovery.
It is also important to understand proper body mechanics. How you move and position your body during physical activities can affect your back health and prevent back pain.
When you lift, carry, push, or pull objects, for example, keeping your back straight, bending your knees, and using your legs to lift will help to keep your back safe. Also, avoid twisting your spine too much and hold the object close to your body to distribute the weight evenly. If the object is too heavy or awkward, ask for help or use a device like a cart.
The power of spinal manipulation in treating back pain
Spinal manipulation involves our physiotherapists using their hands or a device to apply controlled force to a joint in the spine. The amount of force may vary, but the thrust moves the joint more than it would unaided.
This promotes movement in the spine, reduces pain, and restores function in the back. It achieves these effects by:
- Improving the alignment and mobility of the spinal joints
- Stimulating the nervous system, which can modulate pain signals and enhance the body’s natural healing response
- Releasing endorphins, which are natural painkillers
- Relaxing the muscles, which can reduce spasms, tension, and soreness
Spinal manipulation is generally safe, but it may have some transient mild-to-moderate side effects, like increased pain or discomfort, stiffness, or headache. These side effects usually resolve within 24 hours.
In order to reduce the risk of complications, you should share your health and medical history information with the practitioner before you start treatment and avoid spinal manipulation if you have conditions like osteoporosis, spinal cancer, or spinal instability.
Don't suffer in silence: treating back pain with CK Physio
Back pain is a common and complex condition that affects people of all ages. There are many causes of back pain, all requiring unique attention and treatment approaches. It is particularly important to understand the difference between acute and chronic back pain and how to deal with them appropriately.
Biofeedback therapy and physiotherapy are two of the most promising and effective treatments for back pain, as they can help to relieve pain, improve function, prevent recurrence, and enhance the overall quality of your life.
At CK Physio, we are committed to helping you with your back pain issues by providing the best possible care and service. Our team of qualified and experienced physiotherapists will assess your condition and design a personalised treatment plan that suits your needs and goals.
If you are suffering from back pain, don’t wait any longer. Contact us today and book a consultation with one of our physiotherapists.
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