Rob is a successful International Chartered Physical Therapist. He has been a lecturer, researcher and therapist for over two decades. His rich experience of International and Premiership Football underpins his specialist knowledge of sports medicine. His latest work, a self help guide to the successful resolution of back pain, is available at:
This article will explain to you the principles that lie behind the successful resolution of mechanical low back pain (and other disorders). They are a series of logical simple to understand steps that underpin successful treatment practice and effective exercise prescription
DIAGNOSIS The first step is diagnosing what the problem is. This is done by doctors and therapists basically using two methods. The first one being what the patient says or complains of and the second being what is actually found by the practitioner from their physical examination. Both of these are vital suppliers of information for a correct diagnosis. The sum total of all the information gleaned from both methods should build a picture of the exact problem that leads on to the diagnosis. Sometimes it is possible to ascertain an EXACT diagnosis and other times it is not. Having an exact diagnosis is desirable but not absolutely essential to successful treatment. What is important is that the existence or absence of certain conditions is ascertained so that the correct treatment and advice can be followed. In the case of back pain it is important to be able to put the cause of the pain down to a mechanical problem affecting the back. With reference to back pain there are certain conditions from other body systems that give pain in the back and these must be ruled out before treatment of the back can begin
PAIN RESOLUTION Before normal movement and function can be looked at the aspect of pain must be considered. This is because in the initial stages of an episode of back pain the pain is there to prevent further damage occurring. It is important that this pain is allowed to settle and further damage is not caused. A few days of the CORRECT rest is normally sufficient to achieve this. Longer than this and there are likely to be more negative effects than positive from resting unless a specific reason is given by a qualified medical person. There are modalities that are helpful in resolving pain such as medication and electrotherapy that can be beneficial.
MOVEMENT RE EDUCATION The next stage is the regaining of the normal amount of movement in the back. This is the stage at which most problems occur. This is normally for a number of common reasons. These generally revolve around the fact that there is a degree of overlap between the pain stage and this stage and people are unsure of when to begin moving, which specific movements to do, how many to do and for how long. It is here that is so often the KEY CRITICAL POINT in the recovery process because with the CORRECT ADVICE INSTRUCTION AND ENCOURAGEMENT regarding movement and exercise therapy most back pain can be improved. If this point is missed problems begin and little by little get bigger and more difficult to resolve until ultimately if left long enough, which often can be just a matter of weeks, you can become a chronic back pain patient, with all its associated problems.
STRENGTH RE EDUCATION The next stage once the movement is well on the way to recovery is the re education of the muscles that control the area. Here again the skill is knowing when to begin the exercises, which ones to do, how many and for how long. With the back you may be lucky and be able to resume your normal everyday activities without needing any specific strengthening exercises. There are however great many people with low back pain who would be so much better and be much more able with again the CORRECT EXERCISE PRESCRIPTION. For some it would undoubtedly totally solve their problem.
NORMAL FUNCTION ACTIVITY RESUMATION Following the successful resolution of pain, movement and strength all these three come together to allow the patient to resume their normal everyday activities. Here again the key is the skilful and correct advice as to how much how soon. If the previous three stages have been addressed properly this stage will follow naturally but the correct advice is paramount in preventing re injury.
SUMMARY So there we have it. The basic stages behind the successful resolution of mechanical low back pain. This can essentially be transferred to many other musculo skeletal problems. Although in black and white it appears relatively simple do not confuse something being simple and think it means it is unskilled. It requires specific knowledge at each of the particular stages. In fact I would go as far as to say categorically how important it is to get as far as possible a definitive diagnosis of your problem before engaging in any form of therapy whether by a third party or self help.
This article was written by successful International Chartered Physical Therapist Rob Ryles. Rob has been a lecturer,researcher and therapist for over two decades. His rich experience of International and Premiership Football underpins his specialist knowledge of sports medicine. His latest work, a self help guide to the successful resolution of back pain, is available at:
http://www.solveyourbackpain.com
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