What Is Back Pain?

What Is Back Pain?

The spine is made up of 4 regions, the cervical (neck), thoracic (mid back), lumbar (low back) and sacral (base of spine). The bones that make up the spinal column are called vertebrae, with discs in between. Ligaments, muscles and tendons surround the spine to provide support and stability, and to control movement. So back pain problems can be complex.

How We Can Help?

We (Physiotherapist) assess and treat large number of back pain patients every day and use the latest treatment techniques to help our patients, including:

• Joint Mobilizations
• Manipulative Physiotherapy
• Traction
• McKenzie Therapy
• Maitland Techniques
• Specific Core Stabilization Exercises
• Electrical Modalities
• Thermal Modalities
• Postural Advice

• Acupuncture
• Dry Needling
• Massage
• Exercise Techniques & Stretches
• Ergonomic Advice
• Lifting Techniques
• Self-Management
• Preventive Advice 

How Neck Pain Can Be Treated By Exercise

How Neck Pain Can Be Treated By Exercise:

Neck Pain

We have all experienced neck pain to some degree- it may be brought on from sitting at a computer the whole day, from playing sports or possibly from an accident. Neck pain is a relatively common complaint, affecting up to 70% of individuals at some point during their life. Approximately 40-50% of the population suffers neck pain in any one year. Our Chartered Physiotherapist Niamh Connolly discusses the problem and some measures by which to reduce the chance of the problem occurring.

It tends to be a persistent and recurrent disorder where approximately 60% of individuals can expect to get some degree of on-going pain following their first episode.

The aim of physiotherapy rehabilitation of neck pain is to prevent a first episode from turning into chronic (>3 months) or recurrent pain.

The Neuromuscular system is one of the main reasons why people get a re-occurrence of their neck pain. The neuromuscular system is composed of nerves and muscles, these allow for innervations and movement of the muscles in the body. When a person undergoes pain and injury the strategies to control movement, posture and stability are compromised.

If neuromuscular function is altered this can cause:

·         Delayed activation of neck muscle

·         Changes in muscle size

·         Changes in muscle composition

·         Impaired postural endurance

·         Altered muscle activation movement

All of which can lead to neck pain:

Some examples of this type of altered function would be:

A reduced ability to maintain upright posture during a computer task, this reflects a low level of endurance in the muscles required to control the postural function of the spine, and over time if this is a repetitive position eg office / desk related job this may lead to neck/ shoulder pain.

How Is Neck Pain Treated?

The key principles in treating neck pain involve

·         Selectivity and specificity of exercise

·         Early rehabilitation

·         Pain-free rehabilitation

·         Rehabilitation for prevention of reoccurrence

How Can Exercises Help?

Exercise has been shown to improve neuromuscular impairments in people with neck pain however the type of exercise selected should be based on careful and precise physiotherapy assessment of these neuromuscular changes and therefore be specific to the impairments of the presenting patient.

This type of exercise usually commences early in the rehabilitation process and is used in combination with ‘hands on’/manual therapy if required; these exercises do not provoke pain and are designed to address the specific changes that have been identified via assessment in the muscle and neuromuscular system.

Exercises Used

The types of exercises used

·         target and activate the deep cervical muscles

·         retraining the endurance capacity of deep neck muscles

·         retrain the patterns of activation of the deep and superficial neck muscles

·         re-educate the use of muscles in posture and in functional tasks

·         address the strength and endurance  for functional requirements

Education and explanation regarding the rationale behind the treatment approach are a large component of this physiotherapy treatment as the patient’s compliance and contribution to the exercise program is critical.

Treating Lower Back Pain through the McKenzie Method:

Treating Lower Back Pain through the McKenzie Method:

We often discuss our physiotherapy treatments in our blog posts but do not always go into detail about the techniques and methods which are used by our physiotherapists. So today Mark Dockery of our Navan Road clinic in Dublin highlights how lower back pain is treated through the McKenzie method.

So What Is The McKenzie Method?

The McKenzie Method is a system of exercises used to elucidate the type of spinal issue a patient has and how best to treat it. It is commonly used worldwide in the diagnosis and treatment of low back pain, neck pain and peripheral joint complaints.

The method was created by New Zealand-based Physiotherapist Robin McKenzie (who passed away in May) in the early 1960s and is still in use today. The McKenzie Method is best applied with the aid of a Physiotherapist trained in the Method, who can diagnosis your particular problem and teach you the appropriate exercises to use at home.

The McKenzie Method implements primarily self-treatment strategies, and minimises manual therapy procedures, with the McKenzie-trained therapist supporting the patient with passive procedures only if an individual self-treatment programme is not fully effective. McKenzie himself states that self-treatment is the best way to achieve a lasting improvement of any type of back pain .

The 3 Focus Points Of The McKenzie Method

There are three main areas addressed by the McKenzie method for back and neck pain. They are posture, dysfunction and derangement . 

- Posture: End-range stress of normal structures.
- Dysfunction: End-range stress of shortened structures (i.e. scar tissue; fibrosis; nerve root adherence).
- Derangement: Anatomical disruption or displacement within the motion segment.

(The three mechanical syndromes – posture, dysfunction, and derangement – occur in all areas of the vertebral column, from the neck to the base of the back).

So What Might A Physiotherapist Advise?

Each distinct syndrome is addressed according to its unique nature, with mechanical procedures utilizing specific movement and positions. Examples of exercises prescribed by a Physiotherapist for a home-based programme might include:

- Lying prone (on your front). [McKenzie method treatment]
- Prone back extension (arching your back whilst lying on your front).
- Rotation mobilisation in extension (whilst lying prone).
- Standing posture exercises (importantly extension of the spinal column).
- Standing toe-touch.
- Pelvic side-shift movements (lateral tilt).

The McKenzie method encourages education and patient involvement, in managing their own treatment plans. This helps to reduce pain and restore normal function. This also may reduce the number of visits to the clinic. Overall most patients are able to treat themselves successfully when they are provided with the necessary information by their physiotherapist. Customised self treatment programmes will be provided by our physiotherapists should they deem this the correct method of treatment for you.