3 Simple Ways To Stop Frustration & Get Better Results With Lower Back Pain Patients
Posted By: Andy Barker
…the job is then to try fix it.
Maybe you have identified a loss of range of movement, over-active lower back extensors or pain with certain movements like bending forwards.
Alongside the rehab you will prescribe, using hands-on treatments can be a great way to reduce a patients pain.
Hands-on treatments are also very effective at improving range of movement and allowing patients to complete certain movements like a squat or putting their socks on.
However, many of these effects are short lived with patients coming back to see you at their next session much the same.
You then find yourself treating the same muscles, the patient again feels better, maybe for a few days, sometimes only for a few hours, before their symptoms return again.
This can go on for weeks, sometimes months.
I know this first hand…
My early days in sport were filled with days like this with the players I was working with.
I’d massage their lower backs and they’d jump off the bed feeling great!
But as quickly as they jumped from my bed, they were back on it.
The next day they’d be back in my room as their symptoms had returned.
Sometimes this wasn’t even the next day.
The often came back the same day, after their gym or field training session.
In this blog you will discover 3 simple strategies that will help you get better results with your patients with lower back pain, stop their symptoms quickly returning, saving you time, effort and stop you having to deal with frustrated patients that don’t feel like they are improving.
First…Check The Hips
For every lower back pain patient you see you must assess hip range of movement.
You remember being told to always assess the joint above and below and injury at University.
This was great advice!
The hip is the joint below the lower back.
The ability of the hips to move, or not move, will affect the work the lower back has to do.
Take this example…
You see a patient that gets lower back pain when bending forwards, with activities like putting their socks or shoes on or picking something up from the floor (very common).
The lower back needs to flex to complete these movements
The hip also needs to flex to complete these movements.
If hip flexion is limited the body will still likely be able to complete these movements but what it will do is flex more at the lower back, because hip flexion is limited.
In short, the lower back is doing the job (flexion) for both itself and the the hip.
So no wonder the lower back becomes over worked, unhappy with all the extra load and in turn starts to become painful.
Lower Back Pain – Do Patients Need Mobility Or Stability?
The answer is they need both.
In the previous section we spoke about how the lower back needs to be able to move to complete simple tasks like bending forwards i.e. it needs mobility.
But it also needs to be stable in other activities – think lifting up bags of heavy shopping or deadlifting a weight in the gym.
It is not then quite as simple as just giving a patient mobility or stability exercises as they most often they will need both.
What you prioritise, mobility or stability, will depend on the individual and their symptoms and how they present during their objective assessment.
Generally speaking you will likely focus on restoring mobility first then work on improving lower back stability, if you have identified this as a problem.
This is where I see many New Grad’s go wrong as they have been taught that lower back management is aimed just at improving stability.
They focus on ‘core stability’ and prescribe exercises for this problem, often forgetting about lower back mobility.
Its all well and good a patient being stable in certain positions but what happens when they need to move their back?
If you haven’t addressed their mobility issue, thinks will likely go to #$%* once they start to move.
It is well evidenced that regular movement helps lower back pain sufferers.
Those patients that have to spend longs periods in prolonged positions are often those patients that are harder to get out of pain.
Think of those patients you have seen that have long commutes to work sat in the car or have a desk job, where they are spending all-day, everyday, in the same sitting position.
Allowing the body and the lower back the chance to move is a quick fire way to help even the most persistent of lower back pain cases.
This comes down to you educating your patient to regularly change positions, get out of that chair at work, or give advice on easy exercise options, like walking, that will get them to move and help their symptoms.
You might even prescribe exercises to complete at work that will give the lower back some respite during the day.
This is simple advice but advice that can help get your patients out of pain faster, keep their symptoms away and get them back quicker to the activities they want to do.
First…Check The Hips: Always check the hips with any lower back pain patient. If you identify a lack of range at the hips, treat this problem.
Lower Back Pain: Do Patients Need Mobility Or Stability? – It’s not one or the other, patients need both. As a general rule fix the mobility issues first then add stability on top.
Move: Getting your patient to move and get out of positions that aggravate their symptoms is simple but effective advice to help them get back to full health sooner rather than later.
The New Grad Physio Mentor
PS. If you want to learn how to get quick results using a simple assessment and treatment method for any patient with lower back pain then get in touch.
The lower back can be complicated, so let me show you a simple way to assess, treat and rehab lower back pain patients.
Email me at firstname.lastname@example.org with the subject ‘Lower Back’ and I’ll get right back to you and help you out.