low back pain, the disease of the century …
You feel functional discomfort in the lumbar region when waking up in the morning, pain when bending forward, and maybe when you sit… there is no doubt your spine suffers. Most people do not take care of their back, through ignorance or simply carelessness they submit it to the worst postures, that is when our back is manifested by more or less severe pains but most of the time troublesome. These pains usually appear where our spine supports its maximum load: the lumbar spine.
What does our spine consist of?
Our back is an incredibly support for the rest of our body because it may support many years of bad treatment and negligence for symptoms of suffering to come up and it is only then that we realize the utility of its maintenance. You should know that our spine is formed by overlaying 24 vertebrae of which: 7 cervical, 12 thoracic and 5 lumbar, it ends with a triangular bone: the sacrum which itself ends with a tiny cartilage coccyx , these latter two correspond to several vertebrae welded to each other thereby forming a bone block. Between a vertebra and another there is a fibro-gelatinous substance called intervertebral disc that plays the role of shocks and pressures absorber, all connected by ligaments that ensure cohesion and stability of the joints. This spinal pain, often mechanical, is due to a disorder in the spinal unit. A vertebral unit consists of two layered vertebrae, the intervertebral disc, the ligaments that ensure the stability of two vertebrae and the two nerve roots that emerge from both sides of a vertebra.
What makes our back so strong?
Viewed from the side our spine includes 4 corrugations called physiological curves, they were formed gradually as the anthropological development of the human being that has transformed it from a quadruped to biped. Our physiological curvatures have a prominent role in the static body because without the past resistivity our spine would be reduced by 50 times.
Yet our back seems so weak …!
However if these curves are disturbed by awkward postures, for example, laying on a chair to watch TV or carrying a heavy bag on one hand, the strength of the complex static drop and therefore the pressure increases at the risk areas and sooner or later your back will crack. We understand quickly that a sedentary is more threatened to suffer from back pain than a person who regularly handles heavy loads. Other causes that are less frequent but sometimes serious as infectious or malignant diseases can take the clinical picture of low back pain, fortunately one person who suffer from low back pain on 200 is subject to serious diseases but in most cases lower back pain comes a benign origin and regresses in a few days by the ability of the body to regulate itself.
A vertebral education…
Indeed, expensive visits to several specialists to find a therapy that « may work » often leaves the wallet thin and the causes of the painful back unclarified. On this point there scientific studies focused on the need of having healthy and toned abdominal and back muscles. All the treggering factors of back pain known so far (obesity, physical inactivity, heavy work, emotional stress …) cause dystonia of the abdominal and back muscles whether by lack of physical activity or then by muscular tension, unnecessary energy burning source, which immediately cause a loosening of the abdominal strap and from there a significant mechanical stress in the lumbar vertebral units. Having a toned lap belt and a proper spinal hygiene can relieve the back and above all can preserve it, the physiotherapist must teach his patient the principle of joint economy that it can easily adapt to the demands of everyday life without using his spine.
A multidisciplinary therapy but especially of a mechanical nature
in the case of a disco-radicular conflict physiotherapist may need to use other methods called « disc rebalancing maneuvers ». In this sense, the McKenzie method is very suitable for disc abnormalities and intra-disc that a game of alternating postures managed to relieve the tension of the intervertebral disc on the nerve root, the same for lumbar traction performed on the table can be more beneficial than spinal manipulation. This background therapy is associated with physiotherapy or a prescription to remove the disruptive effect of pain. However, for nine out of ten cases the pain disappears on its own after resting a few days with or without taking medication. However, it is not advisable to go to bed if the pain is somehow troublesome because this will cause muscle relaxation which will exacerbate the patient’s condition.
low back pain of therapy is meant to be multidisciplinary: physiotherapist, occupational therapist, physician, psychologist and possibly the surgeon, all are invited to cooperate and to bring their patient to a true spinal education so that it is the unique which can avoid the impotence for the patient and prevent expensive costs for the society.