Your Spine Is Important
Your spine. It’s a very vital piece of your body’s structure that we often take for granted until we have done something to damage it.
Back pain is actually a very common affliction, it’s the most common cause of disability within the working age population globally, with up to 84% of people experiencing disability from it at sometime in their life. (ref: https://link.springer.com/article/10.1007/s00296-019-04273-0 )
The function of the spinal column is to connect and transfer the weight of your upper torso (head arms, shoulders, thorax and abdomen) to the pelvis. Without an intact spine you can’t sit, stand, walk, roll, reach, or really do anything in an upright position.
Of course, the spinal column also contains the vital structures of the spinal cord and all of its neural connections connecting the brain and the body. Vital really.
As you can imagine, such a complex structure is prone to many types of disorders from traumas including fractures and malignancies, osteoporosis and vascular disorders, but fortunately these are all extremely rare, with the majority of back pain cases being mechanical in nature.
In fact 90% of people with acute low back pain will recover within 6 weeks with no loss of function resulting.
For those that don’t recover within this time, or have a specific injury endangering the spinal cord, or haven’t resolved their symptoms with targeted physiotherapy treatment and rehabilitation, surgery could occasionally be necessary.
Physios Help People Recover From Mechanical Problems
As Physiotherapists our skillset and interest is in helping people recover from mechanical problems.
Part of your initial assessment with a Physiotherapist is to ensure that your spinal problem is mechanical – ie, something that can be safely treated with mechanical modalities, like postural and lifestyle modifications, manual therapy, exercise and rehabilitation.
This is to evaluate first if it is safe to proceed and if you need any other further investigations, and secondly what will be the most effective way to treat your condition.
Fortunately, with improved understanding of the mechanics and healing of the spine, back surgery is becoming less and less necessary. We now know that both the short and long term risks associated with spinal surgery are less and less worth it, while conservative management, personalised treatment, advice, exercise prescription and rehabilitation have been shown to reduce the longer term recurrence rate and overall morbidity of back pain.
Do You Need Back Surgery
The most common reason for needing back surgery is when there is compression of the spinal cord and or spinal nerves from one of the following conditions:
Spondylitis – is an overgrowth of bone – in an arthritic condition called spondylitis, excess bone can be laid down around the facet and intervertebral disc joints causing narrowing of the foramen (openings the nerves travel through), and nerve root compression.
Spinal rehabilitation programmes like our individualised PhysioEx classes are recommended for conservative management of this condition.
The last resort – surgery for this condition is called a laminectomy – literally removal of the bony lamina to make more space for the nerves.
Disc rupture – a ruptured and extruded disc can compress the nerve root causing pain, sensory loss and muscle weakness.
Many of these will resolve with the natural healing power of your body, with good advice and management from a Physiotherapist trained in the McKenzie Method but some persistent and disabling disc injuries will require a surgery which is now performed laparoscopically (keyhole surgery) called a micro discectomy.
There are other conditions that are acutely dangerous and require medical care that can also cause back pain, such as Abdominal Aortic Aneurysm, tumors of the bones and nervous system structures, but fortunately these are extremely rare, and it is most likely that your back pain can be resolved with timely and effective advice, exercises and treatment from your friendly qualified physiotherapist.
This blog was written by Nicole Brammy from the City East Physio practice.
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