Back Injuries & Physiotherapy

Your back is essentially a large sheet of interlinking muscles, with the ever vital spinal column running down its middle. Almost every movement you make, from walking and running to bending over and crouching, will involve your back muscles. It’s no surprise then that back pain is amongst the most common chronic conditions today, and that often its treatment and management comes down to good physical therapy.

People who lift heavy weights, exercise a lot, have poor posture, or even just spend a lot of time bending over are all susceptible to back pain.

Your back and what’s injured

Broadly speaking you can experience two distinct types of back pain, acute and chronic. Each condition is managed differently. Acute pain for example is treated with both rest and painkillers, and is often the cause of a particular trauma. Many doctors will recommend some movement to improve muscle strength and flexibility, and others will recommend you see a physiotherapist who will recommend exercises and movements to facilitate your recovery.

Chronic pain occurs over a long period of time and often has an underlying cause that must be investigated for your recovery. An example of such a condition is a slipped disc, more accurately known as a herniated disc, which can be extremely painful, debilitating, and long lasting. In the event of an injury like this, X-rays and even exploratory surgery are often needed to deal with the injury itself, followed by a period of physiotherapy which will last until you have recovered functional mobility.

Commonly occurring back injuries include:

• Facet syndrome (Zygoapophyseal joint pain) – Facet joints are found towards the back of the spine and on either side of the vertebral column. The condition will often present with pain on one side that is worsened by movement in that direction. An X-ray is often needed, followed by rest, anti-inflammatory drugs, and a consultation with a physiotherapist who will suggest exercises and postural corrections. In chronic cases, surgery might be necessary.
• Lower back stress fracture (Spondylosis) – Typically presenting with pain and stiffness, this is the most common cause of back injury in sports that occurs due to overtraining. Repeated arching and twisting motions, as in bowling in cricket, stresses a weak spot within the vertebra called the Pars Interarticularis. Over time a stress fracture forms which characteristically worsens with exercises and diminishes with rest.
• Herniated disc (slipped disc) – A condition that is a common cause of lower back pain and tends to present in the lumbar, or lower, spine. The spine is composed of units called the vertebrae which are linked by discs that are damaged here, the outer layer is damaged over time and repeated bending, lifting, and twisting, causing the soft centre to become prolapsed. The condition is acute and the pain intense, although it can present with a range of symptoms or none at all.

Physiotherapy and back treatment

Physiotherapy is a very common part of recovering from back injury, and is often used in conjunction with medical or surgical treatments.

For most back conditions, particularly the ones mentioned above, a physiotherapist will often apply heat therapy to alleviate the symptoms of stiffness and pain. In some cases your physio might recommend wearing a back brace to that end as well, and also to improve your posture, strengthen your back muscles and preventing future injury.

A regime of core stability and strengthening will often be imposed, and is tailored to your injury and needs. These exercises have been established over years of research, and are based on the fact that strengthening and recruiting specific muscles in the back, for example the Multifidus (running alongside the spine) and Transversus Abdominus (large muscles making up your sides), results in better spinal support. A physiotherapist will educate you as to the correct way to perform exercises that work to this end. Over time and practice, these muscles will be automatically recruited, hence improving posture, stabilising your spine, and reducing the risk of further injury.

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