Low Back Conditions

Pinched Nerve

A pinched nerve can be due to compression anywhere along the pathway of the nerve. This can be due to disc irritation, joint stiffness, muscle tightness, or many other causes. The key is to determine where the compression is occurring and therefore how best to treat it. Manual therapy including trigger point dry needling can be effective to decrease muscular tightness, while other techniques such as joint mobilizations can help restore motion. Therapeutic exercises to maintain range of motion gains and provide strengthening to prevent a re-occurrence are crucial. Sciatica is a common diagnosis referring to compression of the sciatic nerve, one of the largest nerves that runs from your low back to your feet. Read more about pinched nerves in our blog here.

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Muscle Strain

Muscle strains can occur for a number of reasons, but typically it is due to the muscle being put in a position that it was not equipped to handle. This can be due to too much load all at once or repetitive loading. It can also be related to a position or posture that is unfamiliar or irritating. An assessment to figure out comfortable ranges of motion along with manual therapy to decrease muscle irritation followed by exercises to prepare the muscle to handle load in the future is crucial. Oftentimes, people rest until the muscle is better, but this does not fix the problem and it may make the muscle weaker and more susceptible to being hurt in the long run.

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Facet Pain

The facet joints are located on the back of your vertebrae and they can become irritated and stuck. There are often muscular restrictions around the joint that can lead to the lack of mobility so it is important to treat the entire area along with mobilizing the joint. Gradually re-introducing movements that stress the joint are crucial to get back to your normal life. Read more about facet pain here.

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Herniated Disc

Herniated discs are a relatively common condition with a high success rate of at least 60% from conservative care such as physical therapy. Avoiding movements that irritate the disc (usually bending forward) are important early on along with calming the area around the segment with manual therapy including cupping and scraping. As your body heals itself, exercise can become more aggressive to allow you to return to daily function without pain.

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Arthritis

Arthritis refers to inflammation of the joint and there are many joints in the lumbar spine that can be affected. Arthritis can be a normal part of aging and is usually accompanied by other pathologies if pain or disability are present. It is important to decrease joint stress by making sure that other joints and muscles are moving as they should along with strengthening surrounding areas. Wear and tear at one segment is typically due to other segments not taking their share of the load, and sometimes gaining mobility elsewhere is all that is needed to resolve symptoms.

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Spondylolisthesis

Spondylolisthesis refers to when one vertebra shifts forward, putting pressure on the surrounding structures. It can require surgery, but lesser shifts can be rehabilitated conservatively. Often, it is a result of repetitive extension or twisting activities in younger athletes such as gymnastics, football linemen, or baseball players. It can take time to calm the tissue down, followed by slow loading and movement re-introduction. Surrounding areas such as the mid back and hips often lack mobility and this can be addressed while waiting for tissue healing to occur. Read more in our blog here.

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Stiffness

Low back stiffness can be due to many factors. Most often assume it is a purely mobility issue and try to stretch for hours at a time with no change. Mobility can be an issue, in which case manual therapy is beneficial. However, strength is also important to consider. If your muscles are not strong enough to do what is asked of them, then they will stiffen to protect themselves.

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Postoperative

Back surgery is always intimidating. Rehabilitation after surgery can also be stressful, as you want to assure that the surgery went well. We have worked with hundreds of clients after lumbar surgery so we are familiar with how the experience should progress. We are available to answer any questions, even when you do not have an appointment scheduled. We are also intimately familiar with healing timelines and can give you ideas of what your return to activity should look like. Read more about postoperative physical therapy in our blog.

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Stenosis

Stenosis is the narrowing of a canal in the body and in the lumbar spine it can affect the spinal canal or individual nerves. While it is a serious condition, conservative therapy is often effective depending on your condition. Typically, bending forward alleviates symptoms and bending backwards can aggravate them. It is important to mobilize surrounding structures so that the stenotic area is able to relax and move minimally. Strengthening can also take pressure off of the area and reduce any inflammation that is compressing nerves.