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, or get back pain relief, 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 pain 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 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.
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”.
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.
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
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.
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.
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.
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.
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 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.
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.
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
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
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.
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 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.
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:-
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.
(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 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.
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.
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.
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 is a non invasive holistic drug free manual therapy that centres on total body health by treating and strengthening the musculoskeletal framework, which includes the joints, muscles and spine. Its aim is to positively affect the body’s nervous, circulatory and lymphatic systems, enabling an environment of self healing. Osteopaths do not simply concentrate on treating the problem area, but use manual techniques to balance all the systems of the body, to provide overall good health and wellbeing. The practice of Osteopathy was established in the late 1800s in the United States of America, by . Dr. Andrew Taylor Still with the aim of using manual ‘hands on’ drug free techniques to improve circulation and correct altered biomechanics.
Osteopathy employs manual therapies for the treatment of many neuromusculoskeletal pain syndromes, such as lower back pain and tension headache, alongside exercise and other rehabilitative techniques. An osteopath will utilise a range of gentle hands-on techniques such as soft tissue stretching, deep tactile pressure, and joint mobilisation or manipulation.
The key principles of osteopathy are based on all parts of the body functioning together in an integrated manner. If one part of the body is restricted, then the rest of the body must adapt and offset this, which can lead to inflammation, pain, stiffness and other health conditions. When the body is free of restrictions in movement, Osteopathic treatment helps to reduce pain stress and enhance mobility, creating an environment of self healing for the patient’s body.
In some cases, Osteopaths can complement the GP’s advice on back pain by for example, by easing the pain caused by joint and muscle stiffness, by improving joint mobility and the flow of blood to the joints, to supplement maybe a pain killer prescription issued by the GP
Osteopathy is recognised by the British Medical Association as ‘a discrete clinical discipline’ which can compliment mainstream medicine, and trials demonstrate its effectiveness in treating back pain, with GP’s often referring patients to osteopaths for private treatment. Osteopathic technique is believed to be effective in providing back pain relief by :-
Reducing of herniated or bulging discs and correcting any internal displacement of disc fragments Inhibiting nerve impulses Releasing adhesions around prolapsed discs Calming tenses muscles aggravated by sudden stretching Providing respite for muscle spasm Providing advice on exercises for the lower back, posture, safe lifting, workplace or workstation ergonomics, stress, and diet
“Physiotherapy helps restore movement and function to as near as possible when someone is affected by injury, illness or by developmental or other disability. It uses physical approaches to promote, maintain and restore physical, psychological and social wellbeing, taking account of variations in health status. Physiotherapy is science based, committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery. The exercise of clinical judgement and informed interpretation is at its core” Ref: The Chartered Society of Physiotherapy
Lower back pain can be treated by Orthopaedic physical therapists who diagnose, manage, and treat disorders and injuries of the musculoskeletal system including rehabilitation after surgery. Orthopaedic therapists are trained in the treatment of back pain and spinal conditions, joint and spine mobilisation or manipulation and therapeutic exercise, in order to enable backache relief.
Physical movement is seen as a key important therapy in treating lower back pain. Physiotherapy can be described as a drug-free technique or therapy employing a range of procedures, such as joint manipulation and mobilisation, physical stretches and exercise routines, massage therapy, ice and heat therapy, ultrasound, and breathing exercises. Although a GP may refer a lower back pain sufferer to a physiotherapist, a patient can go directly to the latter, although in some instances, the physio may require a formal GP referral.
Physiotherapy can identify several factors as potentially leading to incidences of lower back pain, including trauma or injury, arthritis, poor posture, muscular strains and weaknesses, ligament strains, sciatic conditions, and disc trouble. . Dependent upon the root cause of lumbar pain, a physio can treat these issues with a number of procedures. These could include posture and ergonomics guidance, advice and remedial movement courses, where, manipulation, stabilisation training, stretching and exercise routines to give backache relief.
Pilates is a holistic exercise technique, intended to stretch, strengthen and condition the body to balance, engaging both mind and body, through an anatomical comprehension of the body’s muscular-skeletal systems. Through a comprehensive exercise or programme, the patient or student can concentrate on focus area whilst carrying out for the client. Classes will focus on specific areas individually whilst carrying out routine that incorporates into an environment where optimum muscular- skeletal function and mobility can be restored
Pilates is carried out through slow controlled exercise, usually on an exercise mat, or sometimes on specific apparatus, either in classes or one to one. It’s a system of exercises that take the body and mind and body through sequence of proscribed movements. These controlled movements integrate the concept of Dynamic Tension (self-resistance) which is the act of exercising muscle against muscle Pilates is taught one on one or in a class.
Pilates theory is that imbalance in strength and flexibility of the body may cause back pain. Pilates attempts to build strength and flexibility to help restore mobility and avert further back injury. Pilates claims to improve posture, muscle tone, mobility, and flexibility in the spine, alleviate backache and pains, and reduce stress. It is considered therapy for back pain for some medical conditions affecting the back but those suffering from Osteogenesis imperfecta, Osteoporosis, Paget’s Disease, Osteomalacia should seek medical consultation. Whilst there have been recent concerns expressed over the effectiveness and safety of Pilates especially relating to strengthening the core muscles, it’s accepted that it can be useful for some people in some instances for back pain relief.
‘Rolfing Structural Integration’ is the trademarked name for the system of hands-on connective tissue manipulation and movement education aimed at releasing stress patterns, and helping the client move and function with greater freedom, and effortlessly maintain a more upright posture. Rolfing seeks to realign and balance the body so that the head, shoulders, chest, pelvis, and legs work in improved vertical configuration
The concept of Rolfing is that injuries, poor movement function and muscle taughtness through stress cause the myofascia (connective tissue) to stiffen, inhibiting free and relaxed movement. By applying deep pressure and other massage techniques to ease tightened myofascia, therby allowing greater flexibility and balance between muscles, tendons and bones. Practitioners of Rolfing teach awareness of those habits restricting movement and how to transform these patterns
By reducing tension, softening the myofacsia, and restoring natural balance and body use, Rolfing practitioners believe the release from the above techniques can relieve back pain caused by muscle tension and help the back to realign itself, promoting improved back health and giving backache relief. Rolfing practitioners address lower back pain, including disk herniation usually by focussing on relaxing, releasing, and manipulating the muscle tissue, and forming space between the intervertebral disks.
The name Shiatsu is derived from Japanese from shi, meaning finger, and atsu, meaning pressure) is a traditional hands-on therapy originating in Japan. There are two main Shiatsu schools; one based on western anatomical and physiological theory where it soothes an overactive sympathetic nervous system, improving circulation, relieving muscle tension and reducing stress, and the other based on a holistic system of Traditional Chinese Medicine (TCM). Shiatsu is regulated as a licensed medical therapy by the Ministry of Health, Labour and Welfare (Japan), and elsewhere by various governing bodies set up by Shiatsu practitioners. Shiatsu is an evolving form, and its various styles incorporate (to differing degrees) aspects of Japanese massage traditions, Chinese Medicine practice, and “Western” anatomy and physiology.
Shiatsu is an uses pressure applied with thumbs, fingers and palms to the same energy flows or meridians as acupuncture and incorporates stretching. It also uses techniques such as rolling, brushing, vibrating, grasping and in one particular technique developed by Suzuki Yamamoto, pressure is applied with the feet on the persons back, legs and feet (special set up is required for the “foot” shiatsu). The principle theory is similar to that of acupuncture whereby illness is brought about as a result of blockages or imbalance in the meridians or energy lines. The Shiatsu practitioner seeks to clear or remove these blockages by applying finger, thumb, palm, or even foot pressure to the affected areas using a variety of massage techniques
Lower Back pain results for a number of reasons: Poor ergonomic posture, Physical injury, occupational (such as lifting), recreational (eg golf or gardening) related to poor muscle tone, or in Traditional Oriental Medicine (TOM), blockages or imbalances in energy flows through the patients meridians.. It is likely that back pain relief for back pain for back ache or sciatic conditions can be provided by a shiatsu practitioner. Shiatsu is complementary to mainstream Western medicine, not an alternative to it. Though therapy back pain will be administered according to Oriental practice it is important that a modern Western diagnosis is obtained as well, and the practitioner will attempt to establish the origin of the condition. \through the techniques outlined above the practitioner will strive to create an environment of ‘self healing’ whereby the patients body will revert or return over time to a more healthy condition. By understanding how the condition arose the practitioner will advise on changes in posture, exercise, or physical habits which may help prevent reoccurrence of the back pain,
Yoga dates back to over 5,000 years, and originated in India as a form of a spiritual practice. In the West, Yoga as an alternative medicine has evolved from its founding philosophy into a form known as Yoga Therapy, often considered useful as a therapy for back pain. In the UK this has taken the form of a National Occupational Standard, (NOS) for the delivery of Yoga Therapy to clients with impaired health, such as back problems or compromised well being. Yoga is usually taught in classes or groups, sometimes as a lower back pain therapy Yoga is believed to calm the nervous system, create harmony, and balance the body, mind, and spirit. It is thought by its practitioners to prevent specific diseases and maladies by keeping the energy meridians open and life energy (Prana) flowing. Over time many different branches of yoga have involved from the original meditative states to the emphasis on physical pose or position, breathing, bodily alignment, or flow of movement.
Yoga engages movement, stretching, posture and breathing to achieve overall wellbeing of body and mind. The different types of yoga often focus on specific facets such as Fitness, flexibility, meditation, rehabilitation, relaxation, and strength.Yoga engages movement, stretching, posture and breathing to achieve overall wellbeing. Restorative yoga is often associated with healing disease, and is practiced in a very relaxed state by using supports instead of muscular tension to maintain the pose alignments. These poses help relieve the effects of chronic stress in several ways. First, the use of props provide a completely supportive environment for total relaxation. Second, each restorative sequence is designed to move the spine in all directions. Third, a well-sequenced restorative practice also includes an inverted pose, which reverses the effects of gravity. Because we stand or sit most of the day, blood and lymph fluid accumulate in the lower extremities. By changing the relationship of the legs to gravity, fluids are returned to the upper body and heart function is enhanced. Fourth, restorative yoga alternately stimulates and soothes the organs. With this movement of blood comes the enhanced exchange of oxygen and waste products across the cell membrane. Finally, yoga teaches that the body is permeated with energy. Prana, the masculine energy, residing above the diaphragm, moves upward, and controls respiration and heart rate. Apana, the feminine energy, resides below the diaphragm, moves downward, and controls the function of the abdominal organs. Restorative yoga balances these aspects of energy within the practitioner. Most yoga classes usually comprise a combination of physical exercises, breathing exercises, and meditation. These characteristics make yoga a particularly beneficial kind of exercise for certain health conditions, including back problems
Yoga can help back pain through the teaching balance, flexibility, strengthening muscles and promoting body awareness. By progressively structuring the complexity of movement, yoga teachers advocate that its practice can educate the back in distributing its mass more efficiently and improve back posture and balance naturally. For practitioners of yoga, an amalgamation of yoga positions reduces weakness, improves the alignment of the spine and reduces muscle tension, creating an environment of self healing for the back. Many yoga positions can be adapted to address particular back conditions as part of a therapy for back pain or to afford greater stretches.