Back Pain Physiotherapy in Bristol
There are different anatomical structures thought to cause spinal pain including the intervertebral discs, facet joints, nerves, surrounding soft tissues including muscles, tendons, ligaments and other connecting joints. Most back pain, however, can start for no obvious reason, this can be very frustrating.
Common conditions of the Back
Lower back pain
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Can be a sudden onset or develop over time
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Pain can be sharp, shooting, dull ache, hot or burning
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Pain can be anywhere on the back, central or more on one side
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Occasionally there may be some pins and needles or numbness felt
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Can disturb sleep
80% of the adult population in this country will have a significant episode of back pain in their life. Around 10% of the population have back pain at any one time.
It can come on quite suddenly, or over time, and can be caused by lifting something awkwardly, which can be extremely distressing and can sometimes stop you carrying out your everyday activities. However, more often than not, back pain comes on without any specific injury to your back.
You will often hear that the best thing you can do for back pain is to lie down and rest. However, inactivity will prolong the episode of back pain.
Click here to see how The Storm Physio clinic can help you.
Persistent Back pain
Persistent back pain can refer to recurrent back pain or pain that has lasted for several weeks and it can have a big impact on your day-to-day life.
Persistent back pain can range from a mild pain or ache, to a more severe pain. It can be influenced by a variety of factors, including:
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Poor Posture and Ergonomics: Prolonged sitting or standing with poor posture, improper lifting techniques, or using ergonomically unsuitable furniture at work can strain the lower back.
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Muscle Strain or Injury: Overexertion, sudden movements, or lifting heavy objects improperly can strain muscles or ligaments in the back, leading to pain.
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Structural Issues: Conditions like herniated discs, sciatica, arthritis, or spinal stenosis can cause persistent pain due to nerve compression or degenerative changes in the spine.
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Inactive Lifestyle: Lack of physical activity weakens back muscles and reduces flexibility, making the back more susceptible to pain.
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Obesity: Excess weight can strain the lower back, contributing to chronic pain.
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Psychological Factors: Stress, anxiety, or depression can exacerbate pain perception and make it more challenging to manage chronic conditions.
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Age: Degenerative changes in the spine, such as osteoarthritis or disc degeneration, are more common as people age and can lead to chronic pain.
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Occupational Factors: Certain jobs that involve repetitive movements, heavy lifting, or prolonged sitting or standing can contribute to chronic back pain.
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Smoking: It has been observed that smoking may interfere with blood flow to the spine, affecting the healing process and contributing to back pain.
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Genetics: Some individuals may have a genetic predisposition to conditions that affect the spine, increasing the likelihood of experiencing persistent back pain.
Addressing persistent low back pain often requires a holistic approach that may involve physical therapy, exercise, lifestyle modifications, ergonomic changes and/or medication.
Self help links:
Low back related leg pain – Sciatica
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Pain and symptoms maybe in your bottom, back of your leg, foot and toes
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You may have some back pain, often this is less painful than the leg
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Pain maybe stabbing, burning or shooting
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You may feel tingling (pins and needles)
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You may have some numbness
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You may have some weakness in the leg
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It may disturb your sleep
What is sciatica?
Sciatica is a term used to describe nerve pain in the leg that is caused by a problem in the lower back.
The sciatic nerve is a large nerve that starts in the buttock and travels into the leg. This nerve is formed by smaller nerves known as nerve roots that enter and exit the spine in the lower back. Irritation of these nerve roots can cause pain in the buttock, thigh, calf and foot.
What are symptoms of sciatica?
As well as pain travelling down the leg, people with sciatica can experience burning pain, electric shock type sensations and pins and needles.
More unusual symptoms include a sensation of coldness and running water. This is because irritated nerves send more signals. Some people may also experience numbness or muscle weakness in the leg. This is because some signals in the nerve can be blocked.
What causes sciatica?
Anything that irritates a nerve root can cause sciatica. A common cause of irritation is compression associated with disc related changes*. The good news is that nerve roots are resilient, they nearly always have wiggle room and some disc related changes shrink over time allowing nerve roots to recover. In some cases, nerve roots are irritated by inflammation without any compression and this can be just as painful. Importantly, not all disc related changes will compress or irritate nerve roots. Many people of all ages have disc related changes but do not experience any pain.
*Discs are tough circular structures that separate the bones of the lower back. They attach strongly to the bones meaning they cannot ‘slip’.
Who gets sciatica and how long does it last?
Sciatica affects people of all ages but is most commonly seen in forty and fifty-year-olds.
Pain is usually worse in the first few weeks and reduces the most over the first few months. At twelve weeks, about half of people with sciatica will have significantly improved. At a year, three quarters of people with sciatica will have recovered. For a group of people though, pain may not improve as expected or recovery may take a long-time. This is because people adapt and cope in different ways.
Do I need a scan to diagnose sciatica?
Scans are not usually required to diagnose sciatica.
Sciatica is a clinical diagnosis based on history, symptoms and physical examination. In many cases scans do not influence treatment plans. For a small group of people with sciatica, scans are appropriate as a part of surgical planning or when considering a specialist nerve injection.
Scans are also appropriate if it is suspected the pain is due to a serious medical condition. Thankfully, these conditions are rare. Book in here for an assessment to will help determine if you require a scan.
Lumbar Spinal Stenosis
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The average age is between 62 to 69 years old.
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Pain and symptoms maybe in your bottom, back of your leg, foot and toes. Pain can be in one leg or both
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You may have some back pain
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Symptoms often occur in standing and walking
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Pain maybe stabbing, burning or shooting
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You may feel tingling (pins and needles) into your legs
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Discomfort, numbness, weakness or feelings of unsteadiness in the legs
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It may disturb your sleep
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Some people will also experience pain in lying and leg cramps, particularly at night
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Symptoms are often reduced if sitting or leaning forward
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Any progression of symptoms is usually slow
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Depending on your symptoms you may be referred to a hospital specialist, who will assess and possibly request an MRI scan.
What is Lumbar Spinal Stenosis?
In the spine there is a central tunnel (canal) that protects the spinal cord as it travels from the neck to the lower back. By the time the spinal cord reaches the lower back it sends out several smaller nerves known as nerve roots. These continue to travel in the spinal tunnel of the lower back before they travel down into the legs. With age the spinal tunnel naturally matures, and this includes a gradual narrowing (stenosis) of the tunnel in most people. For some this narrowing can crowd (gently squeeze) and irritate the nerve roots.
A hallmark feature of LSS is pain reproduced with standing and
walking that is eased with sitting or with bending forwards (e.g.,
leaning forward on a shopping trolley). This is because the spine
is flexed in these positions and the size of the tunnel increases.
Other symptoms include heaviness or weakness in the legs with
walking and cramps in the legs at night time. Some people with
LSS may also experience pins and needles or tingling.
What causes Lumbar Spinal Stenosis?
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LSS is caused by spinal tunnel narrowing and irritation of the lumbar nerve roots.
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The good news is that nerve roots are structurally resilient, and harm is unlikely to be caused when pain is felt. Pain can also be influenced by general factors such as reduced sleep, stress, and emotional wellbeing. Essentially anything that impacts general health.
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An important message is that not all spinal tunnel narrowing will lead to symptoms. Narrowing of the spinal tunnel is a normal part of ageing. Approximately three quarters of people over the age of 40 are expected to have moderate spinal tunnel narrowing.
Treatment from Physiotherapy: Back pain
Along with advice, manipulation, strapping, muscle stimulation and home exercises, The Storm Clinic can also offer you (click on the links for more information)
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Acupuncture sessions could potentially help in reducing inflammation of soft tissue and cartilage, which may be common causes of hip pain and long-term discomfort.
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Shockwave therapy is a physical treatment that uses high-energy acoustic waves — known as shockwaves — to treat musculoskeletal pain and promote the healing of painful tissue. It works by stimulating increased blood circulation and cell growth, improving elasticity in the affected area, and ultimately reducing inflammation and pain. In some cases, it can be very effective in breaking up scar tissue or calcifications.
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Laser therapy helps to accelerate the healing process, reduce pain and reduce swelling.
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