About Back Sprain / Strain
Although you may think your back pain or strain happened quite easily, there was likely some build-up toward a threshold over time before it finally gave. A sprain refers to an overstretching injury of your ligaments in your spine, whereas a strain refers to an overstretching injury to your muscles, likely while it was under some contraction. There are hundreds of small muscles in the spine, which guide the intricate movements of each bone and multi-level joints, but can get into trouble when loaded beyond its capacity at a particular moment in time.
The majority of people sprain or strain their back when they combine lifting with twisting; and often it is thought that the best way to avoid an injury to the low back is to use your legs when lifting, bending at the knees and keeping your back fairly straight. However, in a recent systematic review of the available research, there is a reasoned argument that lifting in this manner may be unhelpful, and the slow, cautious, guarded lifting style does not bode well for your future experience with back pain. Furthermore, this review pointed out that free-style lifters, or targeting cautious lifters beliefs for treatment, has more of a positive impact on future low back pain.
About Mid back pain
Mid back pain refers to pain in the “thoracic” spine. This is the area from the shoulders down to the mid back area. Pain in this area can be for a variety of reasons, but typically occurs from prolonged posture without regular movement. Pain can often feel like an aching or burning that sometimes radiates around the ribcage, making it difficult to take a deep breath, cough, or sneeze. At times, pain can even feel like it is piercing through to the chest or abdomen leading you to believe that there is something more sinister going on. If this is you, by all mean, go get checked out by a doctor to rule these things out. But if your tests come back negative, then it’s likely that physiotherapy can help.
About Low Back Pain
Low back pain is one of the most common conditions seen by physicians across the country. It is said that over 80% of people will suffer some sort of low back pain during their lifetime. Low back pain can occur for a variety of reasons, but typically all have one or more of the following factors:
- Negative beliefs about low back pain (ex. “I need to lift carefully, or I’ll hurt my back”, “my doctor told me I have spinal degeneration”, etc).
- Spinal loading exceeds capacity of spinal tissue (ex. Prolonged posture, lifting excessive weight or repetitions, etc).
- Poor lifestyle factors (ex. Poor stress management, lack of sleep, poor diet, sedentary lifestyle, etc).
- Extrinsic situations (ex. Social status, poor family dynamic, stressful work environment, etc)
While there are many treatments that mask low back pain, such as medication, it is important to address the true causes of low back pain. Most low back pain is caused by the factors listed above. It’s not a coincidence that exercise seems to help with a lot of these, sometimes generic and sometimes specific. So it’s best to meet with an experienced physiotherapist to see what exactly it is that you need.
What is Herniated or Bulging Disc?
A disc is a jelly like, fluid filled sac that acts as a cushion between the bones of your back (vertebrae). The fluid center of the disc (nucleus) is held in place by many rings (picture a cross section of a tree trunk). It is common to have situations where the rings become compromised and the fluid middle starts pressing outward to the edges of the disc. This can produce pain in its own right. But additionally, as this occurs, the disc can begin to bulge, which in turn can irritate the nerve roots exiting your spine.
Symptoms can range from localized pain and numbness/tingling to a burning radiating pain and complete lack of sensation. In severe cases, you can experience muscle weakness or loss of muscle control.
What is Sciatica?
Sciatica is the term used to describe radiating pain into the buttock and down the leg. It can have several different causes, but it likely is the result of irritation to one or more of the sciatic nerve roots that exits the spine.
What is Radiating Pain?
Radiating or referred pain to the leg doesn’t necessarily mean you have sciatica, but it does tell you that something is wrong. Discs, muscles, and joints can all refer pain.
What is Spinal Arthritis?
The spine is a very common area for osteoarthritis and systemic arthropathy, like rheumatoid arthritis or ankylosing spondylitis. Arthritis describes a condition in which the cartilage on the joints at each level of the spine can wears away, resulting in inflammation or sensitivity. It’s still a common notion that factors like “poor” posture, excessive bending, and “improper” lifting mechanics throughout our lifetime, are contributing factors. But it’s likely more attributed to genetics, age, previous injuries, and lifestyle factors like diet and exercise.
What is Spinal Stenosis?
Spinal Stenosis is a condition that typically goes hand in hand with spinal arthritis. Spinal stenosis refers to a narrowing of the central spinal canal or the canals where the nerves exit the spine to the lower legs (called foramen). With degeneration of the spinal joints, collapsing of the disc height, or abnormal bone growth, the canals can narrow. This leads to rubbing and even pressure on the nerves, which can cause a multitude of symptoms, like pain, numbness or tingling, and weakness.
What are Degenerative Diseases?
As a normal part of the aging process, the fluid filled discs between our lower back bones (vertebrae) dry out and shrink. However, in some individuals, this can be excessive, leading to a severe loss of height in one or more sections of the back. This loss of height can cause some bone or nerve sensitivity, and symptoms can range from aching pain in the back, to radiating pain in the legs, and numbness / tingling.
What is Osteoporosis?
Osteoporosis is a very common condition in women after the age of 40, but men do suffer from this condition too. Osteoporosis is a thinning of the bones due to the change in calcium depositing and uptake. As we age, this cycle tends to take out more calcium than is put into our bones. Common areas for osteoporosis are in the spine and hips.
Osteoporosis makes people more susceptible to fractures from ordinary activities. Often, compression fractures in the spine result in a crumbling of the bone. A lot can be done to address osteoporosis and even improve bone strength. This comes from strengthening exercises, a good walking program, medication/supplementation, and proper nutrition.
What is Spondylolisthesis?
Spondylolisthesis is a condition in which one spinal bone (vertebrae) is not in alignment with the other; typically, a slippage forward of the 4th or 5th lumbar (low back) vertebrae. Spondylolisthesis can occur from a stretching of the ligaments that hold the bones together, or possibly a fracture within the bony configuration of the joint.
Spondies can be asymptomatic (no pain) or symptomatic. The ones that are symptomatic vary in degrees of severity, most falling into a mild to moderate category. These symptoms can be improved through a guided exercise program. In severe cases, where the spondy is very unstable and compressing the spinal cord – resulting in pain, numbness or tingling, motor loss of the lower extremities, and bowel/bladder issues – surgery may be necessary to fuse the area and bring stability back.
About Compression Fractures
Compression fractures in the low back typically occur in older individuals and those suffering from osteoporosis. However, with severe trauma, such as in a motor vehicle accident, the force can cause a compression fracture in the bones of the spine (vertebrae).
About Post-surgery Rehab
There are many surgical procedures for the low back including discectomies, laminectomies, and even spinal fusion surgeries. The goal of most of these surgeries is to remove any broken bone, tissues, or discs that may be pressing on nerves as they exit from the spine. Furthermore, bringing stability to the spinal area is critical. It is important that you discuss with your physician conservative treatments first, such as physiotherapy before surgery is absolutely necessary.