Chronic Back Pain Physio in Newcastle

 

Our understanding of what the causes of chronic back pain has improved through research over the last number of years. 

This has lead to treatments that are more effective in reducing chronic back pain and disability.  

Cognitive Functional approach to treatment that addresses all the factors contributing to back pain has been shown to be more effective in keeping people active and reducing their pain.

 

back pic

What is causing my chronic back pain?

 

We now understand that chronic back pain is no longer just related to a local injured part of the spine. When back pain persists after a time where the injured tissue should of healed than other factors can contribute to the ongoing pain and disability. The pain that we experience is also related  multidimensional factors in our lives.

 

What are the multidimensional factors?

 

Dr Peter O'Sullivan and his fellow researchers at Curtin University have looked into this over a number of years and have recently published a great article on these factors.  These include

  1. Factors that we can modify
  •  

 

Peter Osullivan pic on factors in LBP

 

 

Back injuries are often described as:

  • disc bulge

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  • ruptured disc
  • herniated disc
  • prolapsed disc
  • slipped vertebra
  • spinal degeneration 
  • joint subluxation
  • scoliosis

 

However pain is not simply related to the spinal changes on a scan or what you may have been told by your practitioner, but has more to do with a range of other factors

Back pain occurs when the nerves report to your brain that an area has become inflamed or sensitised. 

Our understanding is that structures in and around the back can be injured or overloaded and this may result in some inflammation causing discomfort.  

Sometimes our brain overprotects us and will continue reporting pain after an initial injury has healed.

However, back pain does not necessarily always correlate with the degree of injury to a structure and a large percentage of us walk around with "abnormal" findings in our back still being able to do the things we enjoy.  

The following graph gives us a nice visual representation of this point.  

 

MRI normal people

 

So what other factors cause back pain?

 

Social and psychological factors have a large impact on how you respond to a low back pain episode.

Some of these factors include

  • Beliefs
  • Emotions
  • Behaviours
  • Loading demands
  • Lifestyle  

The cognitive functional approach addresses all these factors to help people achieve long term back pain relief.

 

So what can I do about my back pain?

 

  • Relative rest in the early stages is beneficial, however, continue to do what you feel capable of managing.
  • Over-the-counter pain-relieving medication has not been shown to be of any added benefit over placebo.
  • Ice packs or warm packs.
  • Move in any positions that you are comfortable.
  • Good sleep is important.
  • Relaxed sitting is important.
  • Gentle exercises to strengthen the back.
  • Gentle walking program as pain permits.

 

What treatment can I get for back pain?

 

  • Physiotherapy
  • Medication 
  • Epidural steroid injections into the disc region
  • Manipulative therapies
  • Surgery
  • Alternate therapies, trigger point therapy, chiropractic care, osteopathy, massage therapy

 

Do these treatments work?   

The current research does not necessarily support manipulative "hands on" techniques for long term pain relief.  However, some of these treatments have been shown to provide a short term benefit.

There is also little evidence to support the alternative therapies as well as spinal fusion for chronic back pain or injection therapy and some medication including panadol.

 

Keeping active and addressing all the psychosocial factors have been shown to give the best back pain relief and return to daily activities.

 

What do we do?

 

Our clinic uses the Cognitive Functional approach for long term back pain relief.

  •  We do a full assessment to get a clear understanding of your situation, covering all aspects of what we know causes pain and injury.

  •  We develop a holistic program to address all the factors to enable a full recovery.

  • We integrate a functional conditioning program to get you pain free and back to sport and physical activities.

 

ABC report on this approach for back pain.