This article focuses on good back care and includes a comprehensive summary of the differences in approach to low back pain from a sports massage therapist, chiropractor and physiotherapist.
Types of back pain
Firstly, it is very important to mention that there are many types of low back pain, such as; muscular tension in the lower back muscles, instability through the core muscles, nerve root irritation (sciatica), bulging/herniated disc, postural deformities and arthritis. These listed are some of the more common conditions, however the full list is far more extensive. The point we are trying to make is each patient is unique and any treatment for back care should be tailored to their needs. Being given a hand out on ‘exercises for low back pain’ is not the answer.
Back Care from the Sports Massage Therapist:
A Sports Massage Therapist (SMT) primarily deals with muscular tension and postural issues. The majority of patients that come to see a SMT present with non-specific low back pain caused by a postural issue inflicted through normal daily activities. Examples of such are, sitting at a desk or driving for long periods, working at laptops or PCs, tradesmen that are required to maintain awkward positions; plasterers, electricians, roofers, etc. All of these cause an unequal strain on the body’s muscles, joints and nerves.
Sports Massage works on the principle of restoring length and quality to muscles. Once this is achieved, it is vitally important to make sure that the skeleton and its joints are set in the correct position. Specifically with the lower back, the core muscles around the spine and pelvis help to stop any uneven wear and tear on the vertebrae, discs and nerves.
SMT’s work closely with Physiotherapists and Chiropractors to make sure that each problem is correctly diagnosed, addressed and managed for the long term benefit of the patient.
Back Care from the Chiropractor:
Often low back pain comes in the form of a “niggle” or “ache” after a long day at work or over doing it shopping or in the garden. Many of the population and chiropractic patients just ignore this because it goes away after a few days. This pattern will often go on for many years and once the body can no longer cope with the joints and muscle compensation the body will give off pain signals. These signals show as low back pain, which prompts people to seek chiropractic care.
Often this pain is described as unlike any experienced before or different to normal. Patients will say they have had low back pain only for a few days, however by getting to know the patient and taking a detailed history the chiropractor is able to discover the low back pain complaint has often been present longer. This information greatly helps the chiropractor to discover the true root cause of the low back pain problem.
There is often the question, is it the muscle or the joint causing pain, by knowing the anatomy of the body and how it works; it is clear if the joint is involved so is the muscle. When a joint is dysfunctional the nerve signals may be altered and therefore involve the muscle. Vice-versa it occurs when the muscle is strained thus causing unequal pulling on the joint at the muscle attachment; therefore a “chicken and egg scenario”
In treatment chiropractors use quick thrust movements termed adjustments to impulse across a joint, in the case of low back pain patients may be laid on their side to perform an adjustment, or with the use of specific drop pieces on the bench.
Back Care from the Physiotherapist:
Physiotherapists will take a slightly different approach to both Chiropractors and Sports Massage Therapists. Although the original assessment and some initial treatment may be similar, the types of treatment employed and long term injury management strategy may be quite different.
Considering muscular function, vertebral joint range, muscular length and nerve tension and movement quality and patterns, the physiotherapist will also look at secondary factors in the cause of the problem, for example tight hamstring or hip flexor muscles and your natural postural type.
As well as day to day back aches and pains, it’s important to consider how your back works during more dynamic movements, perhaps associated with manual work or sport, and ensuring that the spinal column is appropriately strengthened and conditioned to cope with the demands of that sport, whether you are a social golfer or an Olympic level sailor your back needs to be able to cope with the forces being applied through it.
Frequently rehabilitation programmes can be of significant benefit, particularly if your back has been an issue for some time. The amount of time and effort needed though to rectify the situation varies from case to case and you won’t typically need to ‘do your exercises forever’.