By Alex Fielding, D.PT, M.Chiro, B.Sc, ICSSP, Principal Physiotherapist at Your Health Sport and Spine (located within Dural Family Medical Practice, your local medical centre in Dural / Hills District)

Lower Back Pain is one of the most common reasons why people from the Dural and Hills District areas come to see our Physiotherapists, Chiropractors, and Exercise Physiologists.

It is so common that it is now the number one cause of disability in the world, and 8 out of 10 Australians will experience an episode of lower back pain at some point in their lives1.

The Causes

There are numerous causes of lower back pain. Causes can range from more serious things like fractures, arthritis, cancers, infections, and other organs in the body causing referred pain (e.g. kidney stones or pancreatitis). It can also be from less serious things like irritation to the intervertebral discs, facet joints, sacroiliac joints, muscles, ligaments, and the nerves around the spine.

Interestingly, lower back pain is also strongly influenced by our mood, thoughts and beliefs, stress levels, and even sleep quality. The challenge can be trying to figure out exactly what is causing the pain due to the often multifactorial causes.

The Diagnosis

With all the research on lower back pain, and all the advances in scans and tests, it is often still very difficult to find the exact cause and most of the time clinicians can’t be one hundred per cent sure.

Our Dural Physiotherapists, Chiropractors, and Exercise Physiologists are all experienced and well trained to help figure out what the most likely cause is. This educated guess is based on understanding the probability of each condition and how this changes with your symptoms and special tests. To illustrate this point, if there’s a dark room with a cat, dog, and elephant, and something barks, it’s most likely a dog.

Key “red flag symptoms” (warning symptoms) we will always screen for to make sure there isn’t a sinister underlying medical condition to your back pain include a history of unintended weight loss, fevers, recent physical trauma, suspected osteoporosis (to suggest vertebral fracture), bladder or bowel symptoms, or cancer history.

Should you have any red flag symptoms, it is generally best to follow-up with a General Practitioner for further examination and investigations. Our medical centre in Dural has a team of comprehensive, holistic male and female doctors who are passionate about thorough, evidence-based medical care.

The Treatment

The good news is that it doesn’t really matter which anatomical part exactly is “the one causing the pain” because the best treatment for it doesn’t really change on a population scale. However, it has been shown that individualised treatment options for each patient is superior than a generalised exercise program alone.

The best guidelines for managing lower back pain, all recommend ruling out the serious stuff first (we can ask certain questions and do certain tests to help rule out any serious issues aren’t there).

The next step is in trialling a course of treatment where we can use techniques such as manual therapy (massage, mobilisations, manipulation, dry needling acupuncture) and evidence-based exercises (stretches and/or strengthening).

How do we manage Lower Back Pain at Your Health Sport and Spine?

Our Dural physiotherapists, chiropractor and exercise physiologist – located near Glenhaven, Castle Hill and Galston – start by taking a very detailed history where we ask lots of questions to better understand your unique case.

These questions include how long you’ve had the issue for, anything that might have caused it, any other joints or issue you might have, what treatments you’ve tried in the past, and how it is affecting your life.

We also use this time to go over any scans you might have and help exclude any sinister conditions that could be presenting as back pain. At the end of this we usually have a pretty good idea of what is going on, and can set some goals for what you’d like to get out of seeing us.

The Testing

The next part of our session is testing out the back to see if there’s any movements that make it better or worse.

This includes checking the nerves out to see if they might be involved (especially for people with sciatica and pain that travels down the legs), checking the hips, pelvis, and middle back to see if they might be involved. We often test to see how strong the muscles are around the back.

Our main goal is to figure out what muscles and joints could be looser, what muscles could be stronger, and the points of weakness to focus and hone in on.

The Treatment

There are many types of treatment that our Dural Physiotherapists, Chiropractors, and Exercise Physiologists can use to treat lower back pain.

This includes things like massage, spinal mobilisations, spinal manipulation, nerve mobilisations, dry needling acupuncture, shockwave therapy, stretching exercises, and strengthening exercises. Choosing what treatment to use is guided by what we find whilst testing and is also influenced by what you’ve responded well to in the past too.

How do I book an appointment?

To book and appointment with our Dural physiotherapy, chiropractic or exercise physiology team at Your Health Sport and Spine you can either call us on 9651 1395, or book online at www.yhss.com.au

To make an appointment with a doctor at Dural Family Medical Practice, please book online at www.dfmp.com.au or give us a call on 9651 2077. Our medical centre in Dural is open Monday – Saturday and has male and female General Practitioners, passionate about providing comprehensive, compassionate care to locals in Dural and the Hills District.