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.

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 

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

Now Health Network Local Practitioners: Sports Medicine Physician

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: Local Orthopedic Surgeon

When you sit for a long period of time there's different effects that are happening throughout your body. Some of the main things that we tend to see are increased compression forces going through the spine, in particular the lumbar spine. And what this means is that there's more pressure on the discs and the joints.

When you've been sitting for a prolonged period of time, that can be anywhere from about two to seven hours, uninterrupted, is we start to see different changes in our spinal posture. So what tends to happen is we start to slump back in the chair, so you start to lose the curve through your spine. You start to bring your head forward, you start to bring your shoulders forward.

                     

What this results in is increased pressure on the joints and the discs in the spine, because you're sitting for a long period of time and not being active and moving around. Your muscles aren't being stressed and your muscles are not actually actively working to counter these effects. What this means is that you can actually be more vulnerable to injury.

A physiotherapist would conduct a thorough physical assessment and work together with the client to come up with a comprehensive treatment plan to help get the individual back to their favorite activities and have them feeling fantastic.

So in today's society we know that there's numerous jobs that require sitting for long periods of time, we can't get away from it. But the good news is that research is actually showing us that small interruptions in the sitting over the course of the day can actually counteract some of the effects, the negative effects that we're seeing. And so there are just some simple things you can do everyday and this could be things like taking the long way around the office to the photocopier. Walk over to the person's desk and ask them about the task that you're wondering about as opposed to sending them an email, or even just taking little mini stretch breaks.

So what physiotherapists would suggest that you do is place both feet flat on the ground when you're at your desk. If your feet don't touch the ground use a phone book or a textbook to prop them up underneath you.

Your knees should probably be just about in line with your hips, if not a little bit lower than your hips. Your bottom should actually be pushed back in the chair as far as it will go, and if it doesn't reach, again, if you feel that your legs are a little too short or the seat is a little too deep, try using a small cushion or a rolled-up towel to actually help fill up that space.

Your hands should rest comfortably about lap height or a little bit above when you're using your keyboard, and your computer screen monitor should probably fall within about the top one third of your eye level gaze.

If someone is still having further difficulty incorporating some of these tips or having ongoing pain because of their sitting posture it's wise to consult a registered physiotherapist for further guidance and treatment.

Presenter: Ms. Stacey Benmore, Physiotherapist, Vancouver, BC

Local Practitioners: Orthopedic Surgeon