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What could my back pain be?

WHAT COULD MY BACK PAIN BE?There are many different types of back pain and a lot of them can either be avoided or rectified with minor treatment or changes to your lifestyle.

A lot of people believe they are stuck with back pain simply because they were told or imagine they have Arthritis. The fact is everyone over the age of 21 basically has some form of Arthritis as the bones start to break down once we reach full growth around that age. Some medics see people and automatically make a lazy diagnosis, and sometimes without a scan and tell them “sure what do you expect, you’re xx years old”,” or you have been plumbing all your life” etc.

Here at our Physical Therapy clinic in Mexilhoeira Grande, we do not accept that as a reason for pain. You may have age related Arthritis but that rarely causes strong pain, as the body works around this slow forming issue. However the compensation onto the muscles or tendons to aid this issue is what’s generally causing the pain.

In at least 90 % of the sciatic cases we see, where they have been given a diagnosis; we are able to either ease or eradicate the sciatic pain. Sciatica is very rare as it means the sciatic nerve is damaged and in my 15 years of treating people I have seen only 3 true definite cases of the many 100s of people, who have told me they have it.

Ordinarily, it’s one of the adjoining muscles being forced into a position of compensation and thus closes to defend itself and catches the sciatic nerve, it doesn’t damage it, but more irritates and strangles it. This, in turn, can set off pain into the glutes area and lead to a band like pain across the lower spinal area especially if you are standing for a while or tired. This is generally easily rectified with some physical therapy on the gluteal muscles and is often overlooked in other treatments.

Along with this issue, I have included the common causes of back pain below, with a brief explanation of each with suggested treatment needed:

Piriformis syndrome: As above where the piriformis is irritated by compensation and sometimes its genetically growing through the nerve and causing pain into the lower back and spine.

*Treatment is dry needling to open the gluts and restore full pain free movement. Depending on severity and length of time you have it, the treatment can take anywhere from 3 to 8 sessions.

Degenerative disc disease: The discs, or “shock absorbers” between your spine’s vertebrae, shrink or tear. That causes the bones to rub together. This may happen as you get older as explained above but while the rubbing may cause pain the body auto corrects posture and this is what’s likely more painful.

*Treatment is as above to use dry needling and rehab stretching to release and reform the correct posture. Therapeutic exercises can help strengthen the muscles supporting the spine, improve flexibility, and promote proper posture and body mechanics. A physical therapist can also provide manual techniques to relieve pain and improve mobility.

Herniated or slipped discs: If your doctor mentions this, the soft tissue in the discs between your joints has come out. It’s usually caused by wear and tear. Herniated discs can cause pain in your lower back or hip because the nerves there are pressed.

*Treatment is once again similar to above and once you ease the pressure on the soft tissue around the area the pain subsides, if it’s severe, we refer you for MRI and possible Orthopaedic intervention with a referral letter.

Bulging discs: These protrude, or “bulge,” but not as much as with a herniated disc. You don’t usually have symptoms with this. You'll feel it if it pushes on a nerve root, though.

*Treatment is easy on this one as the disc is not damaged to some soft tissue manipulation and rehab sorts this issue very quickly

Inflammation / wear of the SI (sacroiliac) joint. This lies where your spine and pelvis come together in a kind of V shape. It doesn’t move much, but it’s important because it moves the load of the upper body to the lower body. Swelling and wearing away of the joint cartilage can happen after an injury, because of arthritis, infection, or even pregnancy.

*Treatment is to assess and release the soft issue around the SI joint and Glutes as above. Then re-educate the joint as to its original function. If severe and needed, we can refer you to a local Osteopath or McTimoney chiropractor so the joint can be realigned correctly. An injury chiropractor can also provide various treatments to help manage inflammation and wear of the sacroiliac (SI) joint.

Spinal stenosis: If you have this, your spinal canal has narrowed. That adds pressure on your spine and nerves. As a result, your legs and shoulders probably feel numb. This happens to many people older than 65+.

*Treatments are assessment and release the surrounding soft tissue and strengthen the area so the flow is better and less stressful on the narrowing. This includes physical therapy, manual therapy, postural correction, low-impact exercise, pain management, orthotic support, and surgical intervention if necessary. Work closely with healthcare providers for developing a personalized treatment plan for a better quality of life and mobility.

Cervical radiculopathy: This is a pinched nerve. It’s usually caused by a bone spur or a herniated disc.

*Treatment this can be detected on a MRI scan and either managed conservatively with Physical therapy or if more severe can be treated using Orthopaedic surgery intervention. Surgical interventions for cervical radiculopathy include Anterior Cervical Discectomy and Fusion (ACDF), which involves removing the herniated disc or bone spur and stabilizing the spine with a bone graft and metal hardware. Additionally, Posterior Foraminotomy may be performed to relieve nerve root pressure by removing bone or tissue from the back of the spine.

Spondylolisthesis: A bone in the spine slips forward and out of place, typically in the lower back. The degenerative form of this condition is arthritis, which weakens the joints and ligaments keeping spine aligned. It can cause a disc to move forward over a vertebra.

*Treatment here is to completely clear the area of any scar tissue using “Graston technique” that we are proficient here in our clinic and then a full strengthening program to support the weaker more painful areas.

Spine or vertebral fractures: A break to your spine can be caused by a hit to the back, a fall, or if you have osteoporosis, a condition that weakens your bones.

*Treatment: Obviously the initial treatment is surgical intervention if needed but once treated, it badly needs Physical Therapy to ensure the strength returns to the spine and stops arthritis and stiffness setting in.

Sprains and strains: Injuries to ligaments, muscles, and tendons that support the spine and its joints can lead to back pain. This often happens when you lift something and twist at the same time. It can also happen because of car accidents and sports injuries.

*Treatment is again as above using “dry needling” or STR (soft tissue release) as this is usually the cause of most back pain but people accept it because they are ageing. Wearing a brace or using supportive devices such as lumbar supports or orthotic inserts may also provide stability and relieve pressure on the injured tissues during daily activities.

Spasms: You can get these when muscles and tendons are torn in your lower back. They usually happen when you’re weightlifting or playing sports.

*Treatment is to assess which areas are affected and realign and build back up the affected areas using a full rehab program designed specifically for you. Water-based therapies, such as hydrotherapy or aquatic exercise, can also be helpful. The water provides gentle resistance and support, allowing for controlled movements that promote muscle relaxation and reduce the intensity of the spasms. Additionally, transcutaneous electrical nerve stimulation (TENS) can be used. This treatment delivers low-level electrical impulses to the affected muscles, helping to decrease pain, improve circulation, and further promote muscle relaxation.

Lifestyle Triggers

Back pain can be brought on by things you do -- or don't do -- in your day-to-day life, like:

*Treatment is postural assessment and Soft issue release to realign the area and bad posture and coupled with lifestyle changes and stretching and strength program that doesn’t require you to go to the gym etc.

I hope this helps anyone with prolonged back problems who feel they are a lost cause. I have helped so many of these “lost causes” that’s its great to see them pain free once treatment starts. Please feel free to read our reviews on our Face book page for more proof of what we do and how you can eradicate your ongoing pain. Don’t accept it as part of your daily life.

About Us

Having studied in Ireland, England and America over the last 15 years, we have gained a wealth of information and effective techniques to treat most if not all Musclo-Skeletal issues presented to us. 

Please feel free to read our reviews on our Facebook page for more proof of what we do and who we have helped in our almost 3 years in Portugal and 12 years in Ireland, and how you can eradicate your ongoing pain or avoid needless surgery.  

We treat and speak English and Portuguese and a little German if necessary. 

Don’t accept pain and discomfort as part of your daily life. Treatments are by appointment only so please message, call number below or tag yourself here with a comment or if local to Portimao, drop by our clinic and make your appointment. 

Muito Obrigado!
David and James - Neuro Back Pain Clinic 
(Formerly Largo Damaso Clinic) Mexilheoira Grande 

T: 928 022 494  
Facebook: https://www.facebook.com/Neurobackpainclinc

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