MY VIEW ON BACK PAIN MANAGEMENT.

Back pain with/without radiating pain to the “leg” is a common condition attended by the physiotherapist. We attend to such cases in hundreds yearly, some with complete recovery, some for referral and others may require surgery. Back pain can be devastating, hence the need to seek earlier intervention.

Causes and Diagnosis.

In our previous articles, we have highlighted different causes and management of sciatica. Read more. This post will explain mostly my experience in managing back pain.

Back pain is a symptom of the underlying condition and is not an actual diagnosis. Once we identify the cause, the management will be directed to address the underlying condition.

Mechanical back pain is relatively common. This kind of back pain will require a physiotherapist approach. Medications especially NSAIDs offer temporary relief. With physiotherapy interventions, the outcome is often great.

The location (spinal, paraspinal or gluteal) of back pain and its nature ( radiating to the lower limb/s or static) gives us an idea of the underlying pathology.

To diagnose, a detailed history of the condition will be required ( including how it started, any medical and surgical history, activities that worsen or ease pain and such).

Physical examination (will include monitoring your gait, giving you tasks like walking on toes or heel, and performing spine movements both flexion, extension and side flexion. Other tests may include slump test, straight leg raise and other tests to rule out other causes like sacroiliac joint dysfunction and piriformis syndrome.) is done.

If need be, imaging is done (x-ray/MRI/Ultrasound among others). Don’t shy away from providing details. No information is insignificant.

Pain can be referred i.e from internal organs like ovaries. Such pain will present like back pain hence the need for history and examination. Such conditions may require a referral to the appropriate practitioner.

Management

Management will be directed to address the identified cause and not the cookie-cutter kind of management. Depending on the cause, heat, electrotherapy, manual therapy, exercises, education, mobilization or the combination of the above can be used.

Where to find help.

In case of back pain, you can check in with your General practitioner/ Orthopaedic doctor/ physiotherapist or clinician among others.

You DO NOT require a referral request to see a physiotherapist.

No pain is little, seek professional help.

To take care of your back, eat healthily, exercise regularly, go for check-ups and take care of your emotional well-being.