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Low back pain is the most common diagnosis seen in many physical therapy clinics, and it affects nearly 85% to 90% of Americans at one time or another. It is the second leading cause of visits to a doctor, after the common cold.
Low back pain is also the leading cause of lost time at work, and billions of dollars are spent each year diagnosing and treating low back pain. The low back, or lumbar spine, consists of five bones, or vertebrae, stacked upon one another. Between the bones are soft, spongy shock absorbers called intervertebral discs. The spinal cord and nerves are protected by these bones. Multiple ligaments and muscular attachments provide stability and mobility to the lumbar spine. Causes Some common causes of low back pain are herniated discs and arthritis, which may be triggered by poor sitting posture, frequent forward bending, and lifting heavy items. Although trauma may be a cause of low back pain, most often there is no apparent reason for the onset of symptoms. Thus, it is thought that repetitive strain on the structures around the lumbar spine is the main cause of low back pain. When to Seek Help Remember, low back pain can be a serious problem and it is highly recommended to consult a physician, physical therapist or another qualified healthcare provider if low back symptoms are present and are significantly limiting function and mobility. Also, there are a few signs and symptoms that require immediate medical attention. These include, but are not limited to:
What to Do When Low Back Pain Occurs If you are currently experiencing low back pain, gentle self-care exercises should be started to restore mobility and decrease pain.Since poor posture is a major cause of low back pain, maintaining proper posture is important. Use a small pillow or towel roll to support the spine while sitting. Remember, if pain prevents you from exercising or if pain persists for more than 2-3 weeks, a visit to a physician, physical therapist, or other healthcare provider is necessary. What to Expect From Physical Therapy When low back pain is persistent or interferes with normal activities, a visit to a physical therapist may be necessary. When you go to a physical therapist, he or she will perform an initial evaluation on the first visit. Be prepared to move around quite a bit, so be sure to wear comfortable clothing and make sure that your low back is accessible. An initial evaluation will consist of several different parts. First, a history of your present problem will be taken. Be prepared to discuss your symptoms and what activities or positions make your symptoms better or worse. Some special questions will be asked to help the therapist determine the nature of your problem and to discover anything that needs immediate medical attention. The physical therapist will also take measurements of how you are moving. This may include measurements of your range of motion and strength. A postural assessment will also be included in the initial evaluation. From the results of the evaluation, a specific treatment plan will be devised and started. It is important to remember to be an active participant in your treatment and ask questions if you are unsure of what to do. Coping and Management When an acute episode of low back pain strikes, don't panic. Most studies indicate that acute low back pain is short-lived and most symptoms resolve spontaneously in a few short weeks. With that in mind, low back pain, although short-lived, tends to be episodic in nature. Many times, people have multiple episodes of low back pain during their lifetimes. Recurrent episodes tend to get progressively worse with the passage of time. Therefore, it is important to not only treat the symptoms of low back pain but also to have a strategy to prevent future low back problems One of the most important times to care for your low back is when you have no symptoms. By maintaining proper posture and appropriate strength and mobility in the spine, episodes of low back pain may be avoided completely. Check in with your physical therapist, who can help you learn what you can do for your back pain or sciatica.
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Whether you’re experiencing shoulder pain from an injury, tendinitis, arthritis, or a muscle tear, it’s certainly no fun. Our shoulder joints are made up of three sections that offer us the most range of motion out of all of our joints. It’s no wonder then that shoulder pain and injuries are as common as they are. We see well over 100 post-operative shoulder patients every year. Patients visit us for rehabilitation after surgery for rotator cuff repairs, anatomic shoulder replacements, reverse shoulder replacements, anterior and posterior stabilization surgery, and the most complex shoulder fracture care. How can physical therapy reduce shoulder pain? How can physical therapy treat a rotator cuff injury? Find out now.
Causes of Shoulder Pain A carefully assembled physical therapy plan is the first form of treatment for shoulder pain or rotator cuff injuries. The first stage to assembling a therapy program is understanding the root of your symptoms. The most common reasons for shoulder pain have to do with swelling or damage to the rotator cuff. Some common causes of shoulder pain are rotator cuff tendinitis, arthritis, dislocation, rotator cuff tears, poor posture, and more. Your physical therapist will start by conducting a thorough assessment to understand exactly where your pain is radiating from. The pain you’re experiencing in your shoulder could actually be caused by a problem with your neck or lungs. It’s important for a licensed professional to examine your shoulder to assess which part of the shoulder is experiencing pain, what motions you’re struggling to perform, and where your shoulder might be lacking strength. Sudden left shoulder pain can be a sign of a heart attack. If you feel a crushing pain running from your chest to the left jaw or arm, potentially accompanied by shortness of breath, please call .Treatment for Shoulder Pain Your Physical Therapist will examine your shoulder’s functionality and combine those findings with your individual goals to create a tailored therapy program. They’ll put together a plan that focuses on strengthening the muscles around your shoulder and improving mobility. Physical therapy is a safe, effective, non-surgical method for treating shoulder pain or rotator cuff injuries. Since physical therapy is based on a combination of stretches, exercises, and ingraining healthy postural habits, it’s effective for preventing further pain as well. The exact exercises and whether they will include other parts of the body depends on the cause of shoulder pain, as well as other patient circumstances. Physical therapy for shoulder pain will typically include:
found that 75% of people with a full tear in their rotator cuff were able to rehab their shoulder wit Why Visit a Physical Therapist for Shoulder Pain? Your physical therapist is there to help you master your technique. With improper form, the same exercises that are designed to heal you could actually harm you. By using the wrong muscles, favoring one side of the body, or improperly balancing your weight, such exercises can have a completely different effect on your body. Your physical therapist is there to guide you every step of the way. An experienced physical therapist knows exactly what questions to ask and signs to look for, indicating you’re executing the exercise properly. What can physical therapy do for shoulder pain?
Sometimes simple home interventions are enough to treat cervical disc disease, in which an abnormality in one or more discs that lie between the vertebrae cause neck pain. Often, though, it helps to see a physical therapist that can treat abnormalities, show you how to stretch and strengthen your neck and vertebrae, improve your posture, and prevent neck pain from recurring. You may also consider going to see a chiropractor. In the majority of people, certain exercises and manipulations used by these health care providers can help relieve discomfort and restore movement. When you visit a physical therapist you’ll first have a complete evaluation. They will assess how well you can move your neck. You may be asked about symptoms such as pain in the neck or between the shoulder blades, pain that radiates down the arm to the hand or fingers, or numbness or tingling in the shoulder or arm. Your strength, reflexes, and other potential sources of pain will be checked. The therapist or chiropractor will also assess joint function in your neck and back to identify limitations or dysfunctions that may contribute to your pain. Stretch, Strengthen, and Straighten Up There are several types of manipulations and exercises your physical therapist can use to relieve stiffness, strengthen the area, and restore normal function of the neck. Treatments such as cold or heat application, and deep tissue massage, may be used prior to exercise. During physical therapy, you will practice a range of exercises to stretch and strengthen the muscles that support your neck. You’ll also learn how to improve your posture and range of motion. To help you learn proper postures, the physical therapist might have you stand in front of a mirror while exercising so that you can see your mistakes and correct them. Your physical therapist or medical doctor should determine whether you are at risk of further injury from manipulations before treating you. Neck Traction for Cervical Disc Disease One technique used by physical therapists and chiropractors to provide pain relief and improve motion is cervical traction. Traction gently extends the neck, opening the spaces between the cervical vertebrae and temporarily alleviating pressure on the affected discs. Neck traction can either be done continuously or intermittently, alternating between short periods of pulling and resting. It’s also possible to do cervical traction at home. There are pulley systems that you can hook up to a doorway, or devices that will enable you to perform cervical traction while lying down. It’s important if you do cervical traction on your own to first see your physical therapist or chiropractor to make sure that you buy the right equipment and learn how to set it up correctly. By Stephanie Watson Medically Reviewed by Tyler Wheeler, MD on April 21, 2021 Physical therapists are often identified by their ability to help people rehabilitate injuries, but did you know they can help you prevent an injury before it happens? Although rehabilitating injuries is a significant component of physical therapy, these health care providers are able to provide services far beyond the injured population.
Physical therapists are experts in the way the human body moves. They are able to provide a unique perspective on purposeful, precise and efficient movement across the lifespan by evaluating the movement system through their expertise in mobility and locomotion. From this evaluation, therapists are able to design a customized and integrated plan of care to achieve the individual’s goal-directed outcomes. So the question becomes, outside of rehabilitating injuries, what else can physical therapists do that will benefit you? Prevent injury, be proactive! Physical therapists can help individuals become proactive by identifying body imbalances and risk factors that may predispose them to injury or inhibit their physical performance. By evaluating and addressing these factors, injuries may be prevented. In addition, proactive strength and balance training can help facilitate the ability to perform daily activities and participate in recreational, community, and athletic activities. Prepare individuals before surgery This is also referred to as pre-rehabilitation, or “prehab.” Research has demonstrated the positive effects of pre-rehabilitation in patients undergoing artificial hip and knee replacements. Patients who perform a supervised exercise program that includes strength, range of motion, flexibility, aerobic and balance exercises before surgery are less likely to require inpatient rehabilitation and often recover at a faster rate. In addition to improving the rate of successful surgical outcomes, prehab is also an opportunity to build a trusting relationship with your physical therapist. Furthermore, it provides prospective patients with the opportunity to ask questions regarding post-operative management and become familiar with the clinic and associated staff. Promote health, fitness and general wellness This typically focuses on building strength, flexibility, balance and endurance. Many therapists utilize a whole body approach to heal an individual patient’s unique orthopedic or neuromuscular condition and improve their functional capacity for daily tasks, work and fitness/athletic activities. Certain therapists expand their education and skill set and become board-certified specialists in orthopedics, women’s health, geriatrics and cardiopulmonary rehabilitation, to name just a few. Other physical therapy specialty areas include pediatrics, sports, electrophysiology, neurology and oncology. Improve athletic performance Adherence to a sport-specific training program for athletes can be extremely beneficial in preventing injuries. Another advantage of this type of program is enhancement of athletic performance. These programs often incorporate proper warm-up exercises to perform before games and practices. They typically have a strong emphasis on accurate body mechanics and sport-specific movements. Help to reduce fall risk Physical therapists are trained to work closely with individuals who have a history of falls or feel unsteady on their feet. Working on specific balance activities and improving core strength will help to reduce the risk of falling fall risk and promotes independence. Chronic-pain education and management Physical therapists help people who experience chronic pain with exercises that often focus on improving strength, flexibility and endurance through a graduated program. This can help to reduce pain, improve sleep, and promote the ability to take part in social, work, school, and recreational activities. Your therapist will also educate you on the mechanism of “chronic” pain, how it differs from “acute” pain, and how to manage your own pain. Posture and ergonomic assessment With technology these days, many of us are frequently using computers, phones and tablets and are often unaware of our posture while doing so. Looking down at your phone can put up to 10 pounds of extra weight on your head and neck, which can cause a multitude of orthopedic problems. Physical therapists can help teach you what correct posture actually means and how to implement it into your daily life. In addition, they can help with how to properly set your desk up for office workers and with body mechanics for people with more physical jobs. We only have one body, so why not utilize experts in the human movement system to keep things moving? Think of it like you would your regular dental cleanings. Many people typically go to the dentist one to two times per year to prevent oral health issues and to identify potential problems. Your physical therapist can provide the same type of service, by keeping you moving and doing the things you love to do! Pelvic Pain When Walking: 9 Common Causes
Pelvic pain is pain that occurs in the lower part of your torso, between your belly button and your thighs. Pain in this region may be due to conditions that affect your musculoskeletal, digestive, or reproductive systems. Many people experience some type of pelvic pain during their lifetime. Sometimes you’ll notice that this pain occurs or worsens when you walk or move around. In this article, we’ll take a closer look at what can cause pelvic pain when you’re walking, as well as how these conditions can be treated and prevented. HEALTHLINE RESOURCE Learn more ways to stay wellSign up for our Wellness Wire newsletter for health news, self-care tips, and wellness inspiration. Causes of pelvic pain while walking In most cases, the cause of pelvic pain when you walk is related to your musculoskeletal system, which includes your:
Let’s look at nine of the most common causes of pelvic pain that can happen or worsen when you’re walking or moving around. 1. Sacroiliac joint painYour sacroiliac (SI) joint is the joint in your backside that connects the lower part of your spine to the bones of your pelvis. Sometimes, this joint can become irritated and inflamed, leading to pain. This pain can become worse when you:
The pubic symphysis joint is located in the front of your pelvis. It helps hold the bones of your pelvis together and stabilizes them during activity. If this joint becomes too relaxed, it can lead to pain. This type of pelvic pain is common in pregnant women. It’s also referred to as pelvic girdle pain. In addition to pregnancy, pubic symphysis dysfunction can also be caused by:
Pain can get worse when you walk and when you:
Like pubic symphysis dysfunction, osteitis pubis also affects the area of the pubic symphysis and surrounding tissues. It can lead to pelvic soreness or pain that can get worse with physical activity. Osteitis pubis is an overuse injury. It’s common in some athletes, particularly those who play sports involving kicking, pivoting, and twisting. Examples of such sports include:
Your pelvic floor muscles are the muscles that surround and support the organs and tissues in your pelvis. Sometimes pelvic pain may be caused by tension in these muscles. This type of pain is more common source in women. Pain may be localized to the pelvis but may also involve the lower back or legs. While this type of pain can occur while resting, it can sometimes be aggravated by activities, such as:
An inguinal hernia is a hernia that occurs in the area of your pelvis or groin. These hernias are more commonTrusted Source in men than in women. The typical symptoms of an inguinal hernia include a noticeable bulge in the pelvis or groin as well as discomfort or pain. People with an inguinal hernia may experience an increase in pain or discomfort when:
While genetics may play a role, inguinal hernias can also be related to activities that require prolonged periods of standing, walking, or lifting. 6. Appendicitis Appendicitis is when your appendix becomes inflamed. It’s often not known what causes this inflammation. Medical experts believe it may happen when the entrance to your appendix becomes blocked. Appendicitis is a potentially serious condition. If you don’t get prompt medical attention, your inflamed appendix may burst. This can lead to a serious bacterial infection in your abdominal cavity. People with appendicitis feel severe pain in the right side of their pelvis, along with symptoms like:
Diverticulitis happens when small pouch-like structures that have formed in your large intestine, called diverticula, become inflamed. This can cause symptoms like abdominal pain or tenderness. In severe cases, it can cause a perforation, or tear, of the large intestine. This can lead to a serious bacterial infection in your abdominal cavity. Sometimes this pain can become more severe when you perform jarring movements, which can include walking. Other symptoms of diverticulitis include:
Pelvic pain due to PCS is generally dull or achy. However, the pain can become sharper or more intense from long periods of standing or walking 9. Bone cancerOne of the symptoms of bone cancer is pain, especially when using the area of your body that’s affected by the cancer. For example, if you have cancer in your pelvis, you may feel pain when walking, standing for a long time, or using the stairs. There are other potential symptoms of bone cancer, such as:
Home remedies for pelvic pain If your pelvic pain is mild and isn’t accompanied by any concerning symptoms, there are ways to help ease your pain at home:
When to seek care Make an appointment with your doctor if you develop any type of pelvic pain that:
These can include:
Treatment for pelvic pain The treatment that your doctor prescribes for your pelvic pain will depend on what’s causing it. Some examples of potential treatments of pelvic pain while walking include:
Prevention Not all causes of pelvic pain while walking can be prevented, but there are steps you can take to lower your risk. Some preventive steps include the following:
There are several types of health conditions that can cause pelvic pain when you walk. In many cases, the cause of this type pain is related to your musculoskeletal system. This includes your bones, muscles, joints, and tendons. In other cases, the pain can also be associated with organs and tissues in your pelvis. Mild to moderate pelvic pain can often be treated at home with rest, cool and warm compresses, and OTC anti-inflammatory medications. However, it’s important to see your doctor if your pain worsens, persists, or interferes with daily activities. The specific treatment of pelvic pain while walking depends on the cause. Initial treatment is often conservative, involving medications or physical therapy. Your doctor may recommend surgery in more severe cases. A physical therapist can develop a movement plan to help keep you active.
Physical therapy focuses on the body’s ability to engage in movement. Movement can be anything from getting in and out of chairs to climbing stairs, walking in your neighborhood, playing a sport or doing recreational activities. What Are the Goals of Physical Therapy? For arthritis, goals typically include:
To start, an individualized plan of exercises is developed. These exercises are designed to improve flexibility, strength, coordination and balance to achieve optimal physical function. Physical therapists:
The goal of a physical therapy session is to teach you how to do things in your treatment plan – such as performing certain exercises, or how to best use hot and cold compresses – for yourself. The visits are often short – about an hour – and focus on identifying problems with your physical function and giving you strategies for care that you can do at home. When visiting the PT, think clearly about what your complaint is and what you would like to be able to do after physical therapy. Your goal can be getting in and out of your car without pain, raising up on your toes or raising your arms to reach items in your kitchen cabinets, taking a walk or performing your job without pain in the hips, knees and feet, or even walking or running a 5K. Your PT can then work with you to develop a plan that is right for you to achieve your goals. In most cases, you don’t need to see the PT every week. Periodic visits every few months are sufficient to update your program if necessary. When you experience a change in your health – such as a flare in your arthritis that causes you to fall behind in your exercise program or involvement of a different joint that affects another area of function – you can return to the physical therapist to update your exercise program and treatment strategy. The key to a successful outcome is learning the exercises from a physical therapist and practicing them at home over the long term. Improvement is gradual – the body gets stronger and more adept slowly over time – so consistent practice is essential. How to Find a Physical Therapist? If you are interested in seeing a PT, ask your doctor for a recommendation an a referral for an evaluation at Zenergy Physical Therapy. While there is no special diet for arthritis, researchers have identified certain foods and supplements that may be helpful. One group of foods that reduce inflammation, called anti-inflammatory foods, has shown promise in some studies. Anti-inflammatory foods contain compounds that help control inflammation in the body, which is a hallmark of RA. These foods comprise what is known as the anti-inflammatory diet, sometimes also referred to as the Mediterranean diet. Before beginning any new dietary or supplement regimen, it’s important to talk to your doctor. What’s in the Mediterranean Diet?
Fish oil is an excellent source of omega-3 fatty acids, which the body converts to powerful anti-inflammatory chemicals. Fish oil has been studied extensively in RA and other inflammatory conditions. Studies have shown that fish oil can relieve joint tenderness and morning stiffness, reduce the duration of morning stiffness and reduce disease activity in people with RA. For some people, it has allowed them to lower the amount of conventional medicine they take for their RA. Early studies show that fish oil may have similar effects in people with osteoarthritis. Some evidence suggests that the positive effects of fish oil supplements are enhanced when fish oil is consumed in combination with olive oil. Since it is difficult to get enough fish oil from food alone, people with RA should consider fish oil capsules with at least 30 percent EPA/DHA. It’s important to talk to your doctor about the right dosage of fish oil for you if you choose to start taking it. Higher doses of fish oil may interact with certain drugs, including those for high blood pressure. Foods to Avoid with Arthritis Some foods have been found to increase inflammation and should be avoided as much as possible if you have arthritis. These include:
While some people believe gluten can worsen RA, there is no evidence to support this. However, those who are sensitive to gluten (found in wheat, barley and rye) should avoid eating it in order to avoid bowel inflammation. Alcohol and Tobacco – Call it Quits Cigarette smoking is bad for everyone, but in people with RA it has been shown to increase the severity of the disease. Smoking can also make it harder to manage RA. Studies show that people with RA who smoke are less likely to achieve remission and tend to have a worse prognosis. Smoking can also increase painful rheumatoid nodules, which form in the joints, and can lead to heart disease, the leading cause of death in people with RA. People with RA are at greater risk for heart disease compared to the general population. Drink Alcohol in Moderation Studies are mixed on the effects of alcohol on RA. While alcohol does not contribute to or worsen RA like smoking does, experts say it’s best to have one or two glasses of wine, beer or spirits occasionally, but not more than that. If you are taking non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, alcohol can increase your risk of stomach bleeding and liver problems, respectively. Drinking more than two glasses per day can also increase your risk of certain cancers. The need for physical therapists and other allied healthcare professionals at skilled nursing facilities is on the rise, driven in part by a growing need for rehabilitative services for the country’s aging population.
Other pressures also are increasing the demand for therapists and therapist assistants at skilled nursing facilities, or SNFs. These include the addition of millions of covered healthcare consumers from the Affordable Care Act or ACA, and regulations pushing reduced readmissions, fewer ER visits and better patient outcomes. “With increased emphasis on shortened hospital stays, we assist patients in recovering, getting back on their feet and becoming well and strong,” said Keith Collins, Director of Rehab Services for Life Care Centers of America. “This has increased the need for physical therapists in our centers, and we believe that demand is only going to grow in the next several years.” Life Care Centers of America operates 220 skilled nursing facilities in 28 states. Physical therapist and physical therapist assistant positions are projected to grow at a faster-than-average rate through 2022, according to the U.S. Bureau of Labor Statistics, which reports a 36% projected growth rate over 10 years for physical therapists and a 41% growth rate for physical therapist assistants. Vital to Healthcare Reform Physical therapy is vital to enhancing the long-term wellness of patients, which is key to the triple aim of healthcare reform:
As the Baby-Boomer generation continues to age, the need for physical therapists in these skilled nursing facilities is expected to gain momentum. Increased demand can lead to shortages. “The increase in the aging demographic plays a central role in the increasing demand,” Lyons said. “Baby Boomers are living longer than previous generations, and living longer increases the risk of mobility-related injuries and chronic disease. Those conditions are exactly what therapy can help address.” Another contributing factor is the growing population of those insured under the ACA. According to the American Physical Therapy Association, while an increase in graduates from physical therapist education could slightly lower projected workforce shortages, the trend of increased healthcare coverage will mean that the demand for therapists and assistants will continue to climb between now and 2022. Demand Outstrips Supply In addition, there are a greater variety of employment options for therapists today, which can further exacerbate shortages in particular specialties. Demand for therapists is not only occurring in skilled nursing facilities, but also in other patient care settings. “Therapists have more opportunities to choose among, which will create additional supply constraints in the skilled nursing setting,” Lyons said. While therapist assistants can relieve some of the shortages, they are also in high demand and Collins said that greater utilization alone of therapist assistants will not solve the supply problem. “Because demand for physical therapists is growing faster than the pipeline of professionals can effectively fill, the demand for certified physical therapists assistants is also increasing,” he said. “However, physical therapist assistants can neither assess nor diagnose patients, but are only certified to assist in executing the rehabilitation plan created by a physical therapist.” Lyons said the pivotal issue of how to find these in-demand professionals lies in strategic workforce planning and services. “For locating and recruiting the best-qualified professionals for a skilled nursing setting, a Managed Services Provider (MSP) solution is a very good option,” he said. “Generally, the SNF market is made up of larger rehab management companies that either own or manage SNFs across many states and regions. The fragmentation makes them a perfect fit for the MSP model, not only to address supply constraints but to also help them manage risk and efficiency within their organization.” Balance problems make it hard for people to maintain stable posture and stay upright when standing, walking, and even sitting. Balance problems are more common in older adults and are the most common reason they seek help from a doctor. If balance problems go untreated, they can lead to falls. Physical therapists can help people of all ages improve their balance. They perform balance testing and develop treatment plans that include physical activity to help improve the strength, stability, and movement of people with balance problems.
Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation act Zenergy. What Are Balance Problems? A balance problem exists when a person has difficulty keeping a stable and upright body position, whether moving or staying still. There are many causes of balance problems, including:
How Does It Feel? A person with balance problems may experience:
Balance problems can make people fear doing simple daily activities. As a result, they may avoid movements they deem hard or that challenge their muscles. This will cause them to sit too much. This lack of movement leads to weakness that makes balance problems worse. A person who has balance problems also may feel frustration about their condition and become depressed. How Is It Diagnosed? If you see a physical therapist first, they will conduct a full evaluation that includes taking your health history. Your physical therapist also will ask you detailed questions about your condition, such as:
People who suffer from lower back pain are encouraged to help with their own recovery by exercising and getting physical therapy, but are seldom given the knowledge and tools needed to accomplish this. This discussion will provide a basic understanding of the causes of lower back pain, and discuss appropriate steps to exercise and rehabilitate a painful back. Of course, getting better is only the beginning, since further episodes of back pain are quite common as time passes. Whether suffering from the first bout of low back pain or following extensive treatments or even surgery, the best way for patients to avoid or minimize the severity of recurrences is to rehabilitate the back through appropriate back exercises. Exercise and Causes of Back Pain There are several structures in the back that can cause and/or contribute to low back pain. These include: Intervertebral DiscsAlthough the intervertebral disc is a remarkably versatile and strong structure, essentially acting as a shock absorber during everyday activities, sometimes the disc fails when there is a sudden, unexpected force (such as a fall, lifting, or other trauma), or due to ordinary wear and tear over time. And when the disc does get injured it cannot repair itself very well, which is one of the major reasons recurrent back pain is so common. advertisementMaking matters worse, the pain often interferes with a patient's ability to exercise, which adversely affects disc nutrition. Nutrition for the disc is achieved when physical activities and exercise cause the disc to swell up with water and then squeeze it out - much like a sponge. When pain affects our physical activity, the injured disc is deprived of its nutrition and begins to degenerate. Activity is also needed to maintain the exchange of fluids in spinal structures and reduce swelling that naturally occurs in the tissues surrounding an injured disc. This swelling can further irritate nerves that are already affected by herniated disc material. Spinal Muscles, Ligaments, and TendonsThe collective soft tissues around the spine - the muscles, ligaments and tendons - are also very important in maintaining proper spinal balance and strength. With decreased activity, the connective fibers of ligaments and tendons can begin to adhere to each other and lose resilience and may tear when sudden overload occurs. Unlike discs or connective tissue, however, when soft tissues are injured, they can quickly repair themselves. advertisementSince muscles are in constant communication with the central nervous system, anger or anxiety can tense the muscles and cause muscle spasms. Ongoing tension inhibits normal muscle function and leads to muscle wasting and further stability problems, which in turn can lead to chronic lower back pain. Spinal NervesWhen nerves are cut, pinched, or otherwise irritated, the muscles that the nerves control cannot work. For example, when a herniated or bulging disc presses on the L4-L5 nerve root, it may inhibit the nerve's ability to make the muscles it controls in the ankle and foot work properly, causing what is known as foot drop - the ability to raise the foot or stand on one's tiptoes. Acute vs. Chronic Back PainIt is important to note that acute pain is different from chronic pain. We have all experienced acute pain from a sudden soft tissue injury, such as a sprained ankle, or even just a simple paper cut. The pain is immediate, but as the injured part heals the pain goes away. Unlike acute pain, however, chronic pain does not correlate to an anatomical injury. It comprises a constant low level of stimulation to the nervous system that eventually becomes a pattern. It may even persist as a "neural memory" after the initial source of irritation has resolved. The nervous system adapts to this chronic stimulation by creating an environment in which events that previously caused no pain become a source of pain. Pain may even progress to uninjured areas. Emotional distress and certain medications can exacerbate this phenomenon. An effective solution is to distract the nervous system by means of active exercise in a controlled, non-destructive manner. Active exercise also helps to create the physiological conditions that allow the injured structures to heal. |
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