Back Pain Physiotherapy- does physio matter?
Back pain physiotherapy has changed a great deal in the last 20 years. We used to look at back pain purely ‘pathoanatomically’ (what injury is there – patho and which bit is injured – anatomical), but now we realise that pain is more complicated than that. Firstly, you can get back pain from injury to almost any tissues in or around the area (most of which we cannot test accurately) and even more importantly you can get back pain without any injury! https://youtu.be/BOjTegn9RuY. So we now describe our approach for back pain as being ‘biopsychosocial’ (we do love our techno speak!). In simple terms the pain is likely to have biological, psychological and social aspects, which we try to identify during our consultation, and allow this to lead the treatment we provide.
So, is back pain is all in our heads?
Well, the answer to this is yes. The place you interpret signals and blend it with memories and learnt behaviours is in the brain. So everybody’s pain is in the head! But that does not mean it is not real. There are lots of articles for those more interested (here), but in practical terms it means we need to broaden the range of things we do as physiotherapists when treating back pain. We still use our hands to gain some pain relief (manipulation, mobilisation or massage) and give out exercises to help restore normal movement and function, but we have improved the understanding of a range of aspects surrounding our patients back pain. Poor management of back pain is more likely to return or stick around as persistent pain, long after the tissues are healed.
Back pain treatment should be individual.
Whilst we recognise that some back pain problems will have common themes, pain is highly individual. Establishing which components of the problem need the greatest focus means that our skills in assessment need to be broad so that it is possible to be specific in directing the treatment. Since the components of your back pain may not be purely physical, communication is vital. We take care to listen to your worries and concerns about your pain and deal with any inconsistencies in your beliefs regarding your problem. Persistent back pain problems are often associated with faulty beliefs that are perpetuated by friends, relatives and some well meaning health and fitness professionals. This can be quite an epiphany for some people who have had back problems for years and a huge step to getting better.
As physiotherapists, we are experts in pain. That is what we deal with on a daily basis. Over 99% of people that seek our help do so because they are in pain. Having a reasonable understanding of pain as a patient can make a huge difference to your recovery.
But it is not all talk. We are physical therapists at heart and have the skills required to pick up movement restrictions, muscle imbalances and movement control issues. This means we can provide physical treatments that will give you relief from your back pain, such as massage, mobilisations, joint manipulations, acupuncture dry needling, electrotherapy or taping. All these treatments can help reduce your back pain, but they are not the cure.
This means you may benefit from treatment within the clinic, but you may only need to do some simple exercises out with the clinic to allow you to return to normal. Any exercises or postures will be individualised to your body type, work and social background. Simple changes in the way you sit or stand, from gentle exercise to more intense workouts and looking more broadly at your general health and fitness. What you get will depend upon your goals and achieving a cure may be possible.
But the cure requires the whole package- the bio-psycho-social directed treatments and the modifications of your behaviour that go with it.
So does physiotherapy matter?
Ask anyone in the medical profession about back pain and they will tell you that 95% of all back pain should be managed conservatively without the need for specialist hospital interventions. Physiotherapists are ideally placed to manage back pain. The physiotherapy you receive for your back pain does matter as this provides you with the tools to get yourself better.
If you would to discuss your pain or injury and want to see an Edinburgh physiotherapist or another physiotherapist at one of our other clinics please make an appointment or contact us on: 0131 478 4646.
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