Making Sense of Lower Back Pain

Posted By: Andy Barker

Lower back injuries can worry you as a therapist.

Injuries in this area can be challenging and if not managed well you can easily flare up patient symptoms…

Making you feel like you are doing more harm than good.

You know there are many different injuries that can occur in this area and the importance of a thorough assessment to make sure you do not miss anything serious.

A simple but well structured assessment should help you do this.

I’m sure you know all your red flag questions and have practiced your neuro assessments (dermatomes, myotomes and reflexes) over and over again…

But when it comes to doing it for real you still feel something is missing and second guess yourself.

You finish your assessment and feel unsure of your patient’s diagnosis… 

And have that nagging feeling that you might be missing something. 

Without a definitive diagnosis you fear giving your patient any hands-on treatments or progressing their rehab as you think you might make their symptoms worse.

So what you do is become super conservative.

But this is a big reason why your patients with lower back pain are slow to progress…

And why some patients symptoms actually get worse even though you are trying your best to get them better. 

Slow patient progress is a one-way ticket to poor patient adherence to your treatment plan…

As patients lose faith in you and they stop doing their rehab exercises.

When you first assess any patient or athlete with lower back pain the first thing you want to find out is…

If your patient’s main problem relates to FLEXION or EXTENSION.

The reason to do this is to help you simplify your diagnosis and put your patient or athlete in a ‘bucket.’

Either a ‘flexion’ bucket or a ‘extension’ bucket.

This is as simple as it sounds.

For example…

A patient that tells you that prolonged sitting or driving makes their back pain worse would go in your ‘flexion’ bucket.

A patient that tells you that prolonged standing, walking or running makes their back pain worse would go in your ‘extension’ bucket.

Some patients may have mixed patterns…

Where they get symptoms with both flexion and extension movements and positions, but almost always they will have one dominant problem.

This simple technique allows you to identify your patient’s biggest problem.

And once you know this it will help you be more direct with your hands-on treatments and the rehab exercises you prescribe.

This way you know exactly what problem you are trying to fix up which stops you just throwing all types of different treatments and rehab at a patient…

Hoping something works…

But in all reality you are not sure. 

Do you struggle with the management of lower back pain patients?

If so, then my upcoming lower limb course will help you out.

I’ll be covering lower back assessments, treatments and rehab, along with how to manage hip, knee and ankle injuries on this 1-day course…

1 day New Grad Physio LIVE Lower Limb Course 

I have only have 12 spaces left so do not wait around too long to secure your place.

The course is taking place at Emerald Headingley Stadium, the home of the Leeds Rhinos, where I started my own new grad journey back in 2009.

I’ve learnt so much over the last 12 years and I’ll be sharing my biggest secrets on this course…

Including content that I have never taught previously outside of my membership. 

1 day New Grad Physio LIVE Lower Limb Course – Saturday 4th December 2021 (Emerald Headingley Stadium, Leeds, LS6 3BR) 

On the course you will learn all this…

  • Why You Must Assess Gait & Global Movement Patterns Even With Every Lower Back & Lower Limb Injury You See & How This Information Helps You Identify The True Cause Of Patient Symptoms

  • How Your Lumbar Spine & Lower Limb ROM Testing Tells You Exactly Which Tissues To Treat With Your Hands-On Treatment Techniques

  • Learn How To Use Motor Output Testing (A Different Way To Test Muscle ‘Strength) To Tell You What Specific Rehab Exercises You Should Prescribe To Your Patient

  • Why You Are Wasting Your Time With Core Stability Exercises For Lower Back Pain & What Exercises You Should Be Prescribing Instead

  • Why You Need To Include Foot & Ankle Rehab With Any Patient You See With Lower Back, Hip Or Knee Pain

  • How To Select The Correct Manual Therapy & Rehab Exercises Individual To Every Patient You See With Lower Back Or Lower Limb Pain

  • How To Progress Rehab For Patients With a Lower Back or Lower Limb Injury And Know When They Are Ready To Return To Higher-Level Activities Like The Gym & Sport, Without Worry That They Might Break Down Again

Book your place here. 


The New Grad Physio Mentor

 PS. I’m also running a 1-day upper limb course the following day…

1 day New Grad Physio LIVE Upper Limb Course – Sunday 5th December 2021(Emerald Headingley Stadium, Leeds, LS6 3BR)

You can attend either 1-day course on it’s own, or attend both days and save yourself £50.

You can do that by hitting the link here.