Lower Back Pain Diagnosis and Treatment Approach 

Lower back injuries are very common.  We see them at our clinic every day.  As we’ve mentioned in previous blogs, approximately 80% of the population will experience a debilitating case of lower back pain at some point in their lives.

Treating Lower Back Pain

There are various approaches to treating lower back pain.  The chosen method for a person depends on many factors; too many to mention them all.  Perhaps the most obvious of these is the diagnosis, how intense the pain is and what has worked for that person in the past.  Another important factor is what the practitioner has found to be beneficial in their experience.  At Burlington Sports Therapy, we practice evidence based or “evidence informed” practice.  This means we try to use the best available research to guide our recommendations and decision making.  Perhaps it is best to say that we combine best evidence (science) with our practitioner experience as well as what our patients prefer.

Lumbar Disc Herniation Treatment

In the case of a lumbar disc herniation, there are various approaches to treatment.  This condition is very amenable to conservative treatments performed by chiropractors, physiotherapists, and massage therapists.  This condition often responds very well to different modalities including laser therapy, interferential current, ultrasound, manual therapy, and mobilization.  An interesting study published in the Journal of Manipulative and Physiological Therapeutics compared lumbar traction, ultrasound and laser therapy for the treatment of lumbar disc injuries.  Perhaps most surprising was that there was no difference between these treatment groups.  The patients all fared well with these treatment approaches and they all improved to the same degree.

Personally, I usually begin treatment with education about disc injuries and the movements that exacerbate or worsen this diagnosis.  This discussion also includes some positional exercises that may help to alleviate the symptoms.  When appropriate and depending on the preference of the patient, I often introduce some manual therapy and joint mobilization along with a therapeutic modality like laser or interferential current.  Over time, the reliance on passive care diminishes and the focus shifts to mobility and home exercise.  Perhaps surprising to some people is that x-rays or MRI usually aren’t necessary and most people recover rather quickly.  It is relatively rare that these patients require surgery.

In short, there are many ways to treat various injuries.  Although I may have my “favourites”, I try to base this opinion on not just my clinical experience but also the best available literature and a person’s comfort level with an approach.  I always mention to my patients that nobody ever receives a treatment they don’t want.  Patients should feel comfortable discussing the treatment methods that they are curious about and comfortable with, as well as those that they are not interested in.  The practitioner’s job is to figure out if their condition will respond well to a given approach (based on the literature and their clinical experience) and then agree on a course of treatment with every patient.

Have a lumbar disc herniation?  Give us a call… we can help!

References:

Unlu Z et al. Comparison of 3 physical therapy modalities for acute pain in lumbar disc herniation measured by clinical evaluation and magnetic resonance imaging. Journal of Manipulative and Physiological Therapeutics 2008; 31: 191-198.

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