What is rehabilitation for back pain?

Comprehensive rehabilitation (rehab) programs offer a variety of treatments for low back pain. They may use physiotherapy, pain management with medicine and mental skills, and other medical treatments. These programs teach people how to care for their backs and how to prevent reinjury.

Dr. Grant Lum, MD, CCFP, Dip Sports Med, Sports Medicine Physician, discusses lumbar pain and injuries, diagnosis and common treatment options.

Quiz: Do You Understand Back Pain?

Test your knowledge by answering the following questions:


Lumbar back pain is the most common type of back pain.

Back pain symptoms can be mild or severe, and cervical (neck pain), thoracic (middle back pain), lumbar (lower back pain) or tailbone/sacral (coccydynia). Lumbar back pain is the most common type.

Back pain isn't caused by medical problems involving the gallbladder or kidneys.

Back pain can come from muscles, bones, joints or nerves. It can also be caused by medical problems involving the gallbladder, aorta, kidneys or pancreas.

Scoliosis is a back condition but it doesn't cause back pain.

Back pain causes include injury or activity, arthritis, back strain, sciatica, poor posture, aging and scoliosis.

Back pain symptoms include pain that radiates down your leg.

Back pain symptoms include shooting or stabbing pain, pain that radiates down the leg, muscle aches, pain that worsens when you walk, lift something, bend or stand, and pain that improves when you recline.

Most patients with back pain will require surgery.

In most cases, back pain will resolve on its own with treatment at home and over-the-counter medications. Some patients benefit from spinal traction, a physiotherapy technique that applies a longitudinal stretch to the reachable joints and soft tissues that is commonly used on the cervical, lumbar spine and thoracic spine. Surgery is not usually recommended.
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Stacey Benmore, BSc, MSc (PT), Dip.Manip.PT, FCAMPT, Physiotherapist, discusses back problems from sitting.

Gordon Bohlmann, BSc (PT), CGIMS, OMT, BSc HMS, Physiotherapist, discusses physiotherapy for sciatic pain.

Mr. Carman Wong, BCScBiol, BCScPT, FCAMPT, CG (IMS), Physiotherapist, discuss spinal traction and back pain treatment.

Jackson Sayers, B.Sc. (Kinesiology), discusses isometric lower back exercises using body weight.

Lumbar Pain and Sports Injuries of the Back

There are lots of different types of lower back pain. In particular, in sports one of the most common ones we see is called lumbar facet syndrome.

The facet joints are the stabilizing joints on the back of the spine. And so as you extend, meaning as you straighten up, then you’re applying pressure to those joints. In sports where people could get stood up suddenly, so for example in a tackling sport where you’re meeting head-on with an opponent, that can certainly lead to an injury of those joints.

But in other sports where people are rotating over repeated – they’re rotating repeatedly or if they are rotated suddenly, again in a contact-type situation, that can also lead to this problem.

So for example, in golfers, in baseball players when they’re batting, in hockey players when they’re taking shots, all of those rotational movements will also create pressure in the lumbar facet joints and could lead to injuries either chronically, so slowly overtime, or acutely if there’s some sudden moment.

When people are not very strong in their core muscles, this increases the probability of injury. So in our recreational athletes who have perhaps less time to keep themselves in shape than our elite or professional athletes, they run a somewhat higher risk of injuries of this type.

For many people who spend most of their day sitting, in particular, you know, in office jobs or these types of situations, this also leads to weakening of these muscles and again, makes them more vulnerable to injury. Local Orthopedic Surgeon 

The treatment for these kinds of problems of course include strengthening in and around the back and the core muscles, stretching of the hamstrings and other muscles that have an impact on how the back functions. And of course posture throughout the day is a very important consideration.

If you’ve had a lower back injury or this type or have other questions about lumbar facet syndrome, there are various treatment options that are available to you. Local Orthopedic Surgeon.

Video provided in conjunction with Dr Grant Lum and Athletic Edge Sports Medicine http://www.aesmphysiotherapytoronto.ca/

Presenter: Dr. Grant Lum, Sports Medicine Physician, Toronto, ON

Local Practitioners: Sports Medicine Physician

How Can Spinal Traction Help Treat Back Pain

Spinal traction is a physiotherapy treatment technique that applies a longitudinal stretch to the reachable joints and soft tissues, and it’s used commonly on the cervical spine and the lumbar spine, and also the thoracic spine by physiotherapists.

So spinal traction is often used when there’s a spinal injury or there’s pain in spine or pain down the arms from, or the legs from nerve injuries. There are two ways that traction may be applied. First one is by physiotherapists using their hands, so that’s manual traction, and it tends to be very specific. Maybe a shorter duration of traction.

The second way that traction may be applied is through a decompression machine, where the patient lies on a machine and the traction is applied at a relatively low grade and weight but for a longer duration, up to about 30 minutes even.

Spinal traction has several effects on the spine. It can obviously decompress the spine and the reachable structures, such as the discs and the reachable joints, and therefore decrease irritation on the nerves by increasing the space in the, the, the spine where the nerves exit. It can also decrease muscle spasm, increase blood flow, and decrease sensitivity and pain in the spine.

The conditions that can often be helped are disc injuries, where there are nerve injuries or nerve pain down the arms and legs. It can help in advanced degenerative changes, such as stenosis. And it can help in just simply stiffness in the spine created by the joints from things such as sitting too long at the desk or traveling or lifting heavy objects.

So for a person that spinal traction might be helpful for, the first step is to see a physiotherapist to assess the condition and assign some symptoms and to eliminate any risks to the patient.

And when the patient receives spinal traction, there are some things that can happen after traction, such as post-traction soreness, which is quite normal. And, but generally it should be quite comfortable.

Traction can be used over time. Usually it’s over several weeks, two to three times a week, where the patient comes in and receives either by the physiotherapist or by machine, and the results are generally progressive, and people feel better as treatment goes on. Not every condition has a certain number of treatments a week. It’s dependent on the patient and the signs and symptoms of the patient.

You want to bring down your pain and any discomfort in your back and legs before continuing with exercise therapy because the muscles will strengthen and respond better to exercise after the pain and sensitivity has come down. Local Physiotherapists

If people have more questions about spinal traction or if they think that it might help them, they should consult their physician just to rule out any risks and to see a physiotherapist to rule out any risks and assess them properly before applying traction. Local Pain Specialist

Presenter: Mr. Carman Wong, Physiotherapist, Vancouver, BC

Local Practitioners: Physiotherapist

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