Updated: Oct 26, 2021
Hey guys so our first official Active Therapy Clinic blog topic - Back pain well it's a Biggy so we may do a couple of posts on it and there is a video to go with it on our YouTube channel so be sure to head over and check it out. So Back pain lets dig straight in! and don't forget to leave us a comment with your thoughts - good and bad we love the feedback!
So whether you call it back pain, sciatica, buttock pain if you have ever had any of these you will know its no fun. Its important you know that you are not alone! Back pain is the number one musculosketal condition in the United Kingdom affecting over 2.5 million people per day, equating to 31 million working days lost in 2016. So safe to say it's a BIG problem not only for those unfortunate suffers but also for their employers and the general UK health system.
I have good news! In the majority of cases (up to 95% depending on whose research you read!) Back pain can be treated effectively with manual therapy, exercise and addressing any unhelpful beliefs about what your pain actually means. No need for expensive MRIs, or injections or surgeons cutting you up and removing bits!! Note in Most cases! Ill elaborate on this a little bit!
Ok so we have established that you are not alone in your back pain, and that most of you reading this will not need an MRI or surgery, and now we should probably discuss why your back is hurting!
Very broadly speaking the cause of back pain can be split into 3 main subcategories, these are -
1. Intervertebral disc issues
2. Facet joint issues
3. Sternotic issues.
Now I appreciate that most of you have not been to medical school and don't really know what any of that means - alas I will explain!
Intervertebral Disc Issues - or disc bulge.
The Intervertebral disc is for want of a better word the squishy bit that sits in-between each of the vertebrae (spinal bones). It is made of tough fibrous material that has a jelly like substance inside. Sometimes for a number of reasons this can bulge out and irritate or in bad cases touch the nerve. This is bad, and generally quite painful. You may have heard this called a "slipped or prolapsed disc“. Prepare my soap box please - lets be clear here, discs do not slip. End of conversation, it is not physically possible, they are attached above and below to the vertebrae. They can and do however bulge. This is generally characterised by pain in the back and a sharp pain in the back of the leg - this can go all the way to the foot. It can also lead to pins and needles, numbness and or weakness. In severe cases and depending on where in the spine the bulge is it can effect your manly bits, lady bits and ability to pass water or control your bowels if you experience either of these last 2 symptom - stop reading this, do not pass go, do not collect £200 and proceed directly to your nearest medical centre for an immediate examination by a medical professional.
The Picture below nicely shows what a Lumbar spine disc bulge looks like.
So as you can see above the discs sit between the vertebrae (bony bits) and the nerves (those are the yellow wiggly things) come out of a gap between each of those vertebrae. Occasionally the jelly like material can push out and cause this bulging effect on the nerve.
As we get older as with most things our discs can become worn and not as plump as they once were. This can make us more prone to our discs bulging, the most common age for disc problems is between 30 and 55. Here in lies a problem not all disc bulges cause pain or are symptomatic.
Back to my point about MRI scans - Over the last 20 years or so the imaging technology has improved beyond recognition with smaller more powerful scanners producing amazingly detailed and accurate images, this is on the whole good thing. However what this does mean is that the detailed images they produce show every little error or bulge or strain, the skill is pairing what the images show with the patients symptoms. "Treat the patient not the scan", a very wise man one told me!!