Meet today’s guest blogger:
Dave Rubsam, PT, OCS
Dave has been a physical therapist for over 20 years, having graduated from the University of Iowa in 1989 with his masters in physical therapy. He practices at Marion Physical Therapy in the Marion, Iowa area, and has worked in outpatient settings most of his career. Dave has been board certified as an orthopedic specialist since 2001, and has been certified in the Astym system since 2003, which he uses extensively in his practice.
The statistics in the United States say that 8 out of 10 of us will suffer enough back pain at some point to have to change our plans and likely seek medical attention. But why is back pain so common? Let’s explore some reasons why, and we can each think of which of these (in any combination) might apply to us personally.
First, where does back pain come from? I like to tell my clients that it can originate from at least 5 different structures anatomically. The most feared is the disc, commonly diagnosed as a “disc bulge” or a “slipped disc” or a “herniated disc,” among others. The disc itself may create pain if injured, or it may create pain by pushing on or irritating a nerve running next to the disc. Next is nerve pain, most frequently called “sciatica” if affecting the large sciatic nerve running to the lower extremity, or nerve pain can affect any of the smaller nerves in the back itself, the abdomen or pelvis or groin areas. Nerve involvement may also create numbness, tingling, burning, or other abnormal sensations in the areas affected. Third, back pain may come from the facet joints, which are the small joints joining each vertebra in the spine to the ones above and below. Like any joint, these can be sprained or have arthritis affect them, creating pain in the middle of the low back, or just to either side. Fourth, the ligaments that link the vertebrae together may be sprained, just like an ankle sprain. And lastly, the muscles that surround the spine and pelvis and hip joints can be injured, creating spasm or tension in the low back, and possibly affecting any of the prior four structures, creating pressure and pain from them as well.
While not an exhaustive description of back pain, the discussion above should highlight the complexity of back pain, and should lead us to realize that “back pain” is not generic, and should not be treated generically—not every episode of back pain is the same, so treating back pain shouldn’t be the same every time. If you are experiencing back pain, look to the experts to help you obtain a plan of care that fits your situation. Your doctor can help with the medical management of your symptoms, and your physical therapist can help with the appropriate treatment and exercises to get you back to your regular activities as soon as reasonably possible. Treatments may include medications, modalities (the term for treatments such as heat, cold, ultrasound, electrical stimulation), and hands-on interventions like spinal mobilizations or manipulations, Astym treatment or other soft tissue work, exercises specific for your type of back pain, and help with proper lifting techniques and injury prevention ideas to keep your pain from returning.