Low back pain, sometimes referred to as lumbago or sciatica, is a common disorder that affects approximately 60% of the adult population, seeking relief from back pain. The problem is so significant that in the UK alone; we lose some 150 million working days each year in industry because of absenteeism attributed to low back pain. The symptoms of low back pain are because of mild musculoskeletal problems, often caused by tension in the muscles or soft tissues of the lower back, and they improve dramatically within a few weeks with common sense measures.
To ease back pain, establishing the root cause of the back pain with a general practitioner is usually done through a combination of medical history, physical examination and diagnostic investigation, such as an X-ray, MRI or CT scan. Low back pain can be treated conventionally, including recommendations for physical therapy, which can help ease symptoms and relieve back pain. Below, I summarize the most common therapies used to relieve back pain.
Acupuncture
Acupuncture treatment originated in China over two thousand years ago. We believe that the first observations were of soldiers injured by arrows in battle and how the “punctures” from the arrows had therapeutic effects in different parts of the victims’ bodies, away from the area of injury. We based the general theory of traditional acupuncture on patterns or meridians of energy flow in the body that are essential to health. This energy is called Qi or Chi and sometimes Xue (blood). We consider disturbances in this flow as the major causes of pain and illness. Acupuncture attempts to correct imbalances in the flow, thus helping to restore the patient’s health.
How acupuncture works
Generally , acupuncture involves stimulating points along these energy flows using various techniques. Stimulation is usually done with very fine needles that create gentle sensations. We insert each of these needles into specific points along these “energy pathways” or “meridians”.
Can acupuncture help my back pain?
Acupuncture is useful for treating conditions such as back pain, sciatica, stiffness, and strains. According to the traditional theory of acupuncture, pain is caused by a blockage of energy along the body’s “energy pathways” or “meridians”, which are “cleared” when acupuncture needles are inserted. In modern medicine, we have advanced scientific reasons to explain the apparent benefits of acupuncture for people with back pain. One observation is that acupuncture stimulation causes the release of neurochemicals and hormones, which are thought to produce signals that soothe the sympathetic nervous system and release natural opioids that relieve back pain.
The Alexander Technique
The Alexander Technique is a method that aims to change the habits (of movement) in our daily activities. It is a simple and practical method to improve ease and freedom of movement, balance, support, and coordination. The technique teaches the use of the amount of effort for a particular activity, giving you more energy for all your activities. It is not a series of treatments or exercises, but a re-education of the mind and body. The Alexander Technique is a method that helps a person discover a new balance in their body by releasing unnecessary tension. It can apply to sitting, lying, standing, walking, lifting, and other daily activities.
How the Alexander Technique works
The Alexander Technique shows its students how to learn to do what they’re currently doing easily and efficiently. It focuses almost only on the process of how an activity is done, not what it is. Although there are no exercises, the Alexander Technique shows how to do exercises more effectively, with less risk of injury. We draw many people seeking relief from back pain to the technique because of its reputation for relieving back pain or lumbago, neck and shoulder stiffness, and other conditions such as carpal tunnel syndrome. Alexander Technique teachers are not doctors and do not diagnose illnesses.
Can the Alexander Technique help my back pain?
By becoming more aware of how the body works and learning to “undo” bad body practices, people with chronic or long-term back pain can ease and relieve their symptoms. Students of the Alexander Technique can learn to release unnecessary muscle tension and adopt freer movements that place less strain on the body, relieving back pain.
Bowen Therapy
The Bowen Technique is a restorative soft tissue therapy named after its innovator, Tom Bowen. We do not consider this therapy a massage, but a non-invasive muscle release and integration technique that, like massage, releases muscle tension. Her clients describe significant relaxation experiences after a session.
How Bowen Therapy Works
The therapist uses fingers or thumbs to move muscles, ligaments, tendons, and fascia in different parts of the body. The work is very subtle, relaxing and gentle, without strong or prolonged pressure. During a session, the client lies on a therapy table or bed, but we can do effectively the work on a chair.
Can Bowen Therapy help my back pain?
The most common request is for relief of back pain, and this is where Bowen excels. The average number of treatments is two or three for most therapists. There will always be exceptions to any rule, and some people will need additional or even ongoing treatments. Sports injuries are one area of corrective therapy that is learning about the Bowen Technique. The Bowen technique is being used in high-level sport, with rugby clubs and premier league soccer clubs taking an interest. Bowen therapists say it can reduce, eliminate or help back pain and promote overall health.
Source: European College of Bowen
Chiropractic
Chiropractic is a technique that focuses on the musculoskeletal and nervous systems. The principle of chiropractic is that the key to health is the nervous system, with the spine at its center. If the spine is properly aligned, movement is optimal and the patient’s health is improved.
A chiropractor usually deals with “subluxations”, which are misalignments of the bones of the spine responsible for reduced movement or loss of normal posture, resulting in an impairment of the nervous system or irritation of the nerves.
How Chiropractic Works
To relieve back pain, the chiropractor usually examines the patient’s spine and reviews the patient’s history to determine if there have been any previous injuries, accidents or strains that may interfere with normal function. Sometimes the chiropractor will request an x-ray to help determine this. A common form of chiropractic treatment is spinal manipulation or change. This usually involves manipulating the affected spinal joints by hand to increase or unlock joint mobility.
Other tools are sometimes used to promote healing, including rehabilitative exercises and nutritional and lifestyle improvement programs. The amount and frequency of treatment required varies depending on the condition.
Can chiropractic help my back pain?
A chiropractor will try to focus on the fundamental mechanical and neurological problems of the spine to reduce back pain and other symptoms caused by reduced spinal function. He will focus on natural health care to encourage the body to repair itself to achieve better health. Chiropractic care, as a therapy for back pain is safe when used in a competent and manner. We consider manipulation relatively safe, but as with all therapeutic procedures, complications can occur and adverse effects occur.
Feldenkrais
The Feldenkrais Method is a system of somatic education designed by Moshe Feldenkrais (1904-1984), based on physics, neurology and biomechanics. The Feldenkrais Method improves the movement repertoire, aiming to expand and refine the use of the self through awareness, to reduce pain or movement limitations, and to promote posture and overall well-being. We often consider the Feldenkrais Method being in the realm of complementary medicine and is a way to re-educate the neuromuscular system, redesign movement to increase efficiency and reduce stress.
How the Feldenkrais Method works
They taught the Feldenkrais Method in two complementary forms: “Awareness Through Movement”, taught in the classroom, and “Functional Integration”, taught individually.
In teaching “Awareness Through Movement”, the teacher leads the class through a sequence of movements involving standing, sitting in a chair, sitting or lying on the floor. One of the primary goals is to teach students to reduce unwarranted muscular effort and to develop an understanding of themselves during movement.
In a functional integration lesson, a trained practitioner uses his or her hands to guide the movement of a single student who may sit, lying, or standing. The practitioner uses this “hands-on” technique to help the student experience the connections between different parts of the body (with or without movement). Through precise touch and movement, the student learns to eliminate excess effort and thus move more freely and easily. Lessons can be specific in addressing particular problems brought by the student, or can be more global in scope. Although someone did not specifically design the technique to eliminate pain or “cure” physical problems, we can address these issues during the lesson. Problems such as chronic muscle pain may resolve themselves as the student learns a more relaxed approach to their physical experience - a more integrated, free way to move. Students learn to realize their movements and how they use themselves, discovering expanded movement options.
Can Feldenkrais help my back pain?
The theory behind the Feldenkrais Method is that inefficient movement behavior can lead to avoidable movement stresses and strains that cause back pain. The Feldenkrais technique expands movement possibilities and improves posture, which can ease back pain or pain in the back, while developing greater efficiency and freedom of movement.
Massage Therapy
Massage is the manipulation of the superficial layers of muscle and connective tissue to improve function and encourage relaxation, well-being, and improve postural dysfunction. It involves acting on and manipulating the body using pressure - structured, unstructured, stationary or moving - tension, movement or vibration, all done manually or with mechanical aids. The target tissues may be muscles, tendons, ligaments, skin, joints or other connective tissues, as well as lymphatic vessels. We can perform massage with the hands, fingers, elbows, knees, forearms and feet. There are over eighty different massage techniques, many of which are used to relieve back pain.
Massage manipulates the soft tissues of the body by rubbing, kneading, stretching, and other methods to achieve a therapeutic effect. We made muscles and tissues more supple, which stimulates lymphatic circulation and promotes blood flow. Therapists use a variety of techniques and methods during treatment sessions.
How does massage therapy work?
Massage manipulates the soft tissues of the body through rubbing, kneading, stretching and other methods to achieve a therapeutic effect. We made muscles and tissues more supple, which stimulates lymphatic circulation and promotes blood flow. Experienced therapists will use a variety of techniques and methods during treatment sessions to relieve back pain. There are many types of therapeutic massage for back pain, besides acupressure or Bowen (see above), such as.
Deep tissue massage
Used to relieve muscle tension or fascia, we often use it when the patient has constant back pain caused by specific musculoskeletal problems. It focuses on the underlying muscles rather than the surface muscles to relieve back pain.
Swedish massage
(or classic Swedish massage!) can relieve back pain, improving circulation and relieving joint stiffness. Swedish massage uses five styles of massage movements: gliding, kneading, tapping, friction and vibration.
Hilot
Hilot is a traditional massage and healing technique from the Philippines that can relax tight muscles and joints to treat musculoskeletal problems as a therapy for back pain.
Trigger point therapy
Can relieve back pain and poor posture by helping to loosen spasmed muscles, using techniques to release “knotted” muscles and freeing up circulation in the affected area.
Traditional Chinese Massage
Two types of massage can relieve back pain: Tui na (the Chinese equivalent of physical therapy), which focuses on pushing, stretching and kneading the muscle, and Zhi Ya, which uses pinching and pressure techniques on acupressure points. We derive these techniques from traditional Chinese medicine. Although Tui Na is described as a massage in the West, it is not in TCM. In TCM, massage is called Anmo, which is the basis of Anma in Japan.
Can massage therapy help my back pain?
Performed effectively by experienced practitioners who are familiar with the human body and muscle imbalances, massage therapy can be a useful therapy for back pain. Massage can also help relieve lower back pain by reducing tension, thereby easing poor back posture caused by muscle imbalance. Relieving mental tension and stress through massage is also a useful therapy for back pain, helping people in sedentary occupations involving hours of sitting in front of screens. While massage is undoubtedly helpful in relieving back pain, it may not treat the underlying condition and therefore a general practitioner should be consulted.
Osteopathy
Osteopathy is a non-invasive, holistic, drug-free manual therapy that focuses on the overall health of the body by treating and strengthening the musculoskeletal framework, which includes the joints, muscles and spine. Its goal is to positively affect the nervous, circulatory and lymphatic systems of the body, allowing a self-healing environment. Osteopaths do not simply focus on treating the problem area, but use manual techniques to balance all systems of the body to ensure overall health and well-being. Dr. Andrew Taylor Still established the practice of osteopathy in the late 1800s in the United States of America, with the goal of using manual techniques, without drugs, to improve circulation and correct biomechanical alterations.
How does osteopathy work?
Osteopathy uses manual therapies to treat many neuromusculoskeletal pain syndromes, such as low back pain and tension headaches, along with exercise and other rehabilitation techniques. The osteopath uses a series of gentle manual techniques such as soft tissue stretching, deep tactile pressure and joint mobilization or manipulation.
The key principles of osteopathy are because all parts of the body work together in an integrated manner. If one part of the body is limited, the rest of the body must adapt and compensate, which can lead to inflammation, pain, stiffness, and other health problems. When the body is not restricted in its movement, osteopathic treatment helps to reduce pain-related stress and improve mobility, creating a self-healing environment for the patient’s body.
Sometimes, osteopaths can complement the GP’s advice on back pain, for example by relieving pain caused by joint and muscle stiffness, improving joint mobility and blood flow to the joints, possibly besides a prescription for painkillers from the GP.
Can osteopathy help my back pain?
The British Medical Association recognizes osteopathy as “a distinct clinical discipline” that can complement conventional medicine. Trials have shown it to be effective in the treatment of back pain, and GPs often refer their patients to osteopaths for private treatment. The osteopathic technique is effective in relieving back pain by.
Reducing herniated or bulging discs and correcting any internal displacement of disc fragments
inhibiting nerve impulses,
releasing adhesions around prolapsed discs
Calming tense muscles aggravated by a sudden stretch.
Giving relief to muscle spasms
Advise on lower back exercises, posture, safe lifting, workplace/workstation ergonomics, stress, and diet
Physical Therapy
“Physical therapy helps restore movement and function as closely as possible when a person is affected by injury, illness, or developmental or other disability. It uses physical approaches to promote, maintain and restore physical, psychological and social well-being, considering variations in health status. Physical therapy is science-based and committed to expanding, applying, evaluating and reviewing the evidence that underlies and informs its practice and delivery. The exercise of clinical judgment and informed interpretation is at the heart of physiotherapy” Ref: The Chartered Society of Physiotherapy.
Low back pain can be treated by orthopedic physical therapists who diagnose, manage and treat disorders and injuries of the musculoskeletal system, including rehabilitation after surgery. They train orthopedic therapists in the treatment of back pain and spinal conditions, joint and spinal mobilization or manipulation, and therapeutic exercise to provide relief from back pain.
How does physical therapy work?
We consider physical movement an important key therapy in the treatment of low back pain. We can describe physical therapy as a non-drug technique or therapy using a series of procedures, such as joint manipulation and mobilization, physical stretching and exercise routines, massage therapy, ice and heat therapy, ultrasound, and breathing exercises. Although a general practitioner may refer a person with low back pain to a physiotherapist, a patient may go directly to the physiotherapist, although sometimes the physio may need a formal referral from the general practitioner.
Can physical therapy help my back pain?
Physical therapy identifies several factors that can cause low back pain, including trauma or injury, arthritis, poor posture, muscle tension and weakness, ligament strain, sciatica problems and disc problems. Depending on the root cause of the lower back pain, a physio can treat these problems with several procedures. These may include posture and ergonomic guidance, corrective movement advice and instruction, where manipulation, stabilization training, stretching and exercise routines to relieve back pain.
Pilates
Pilates is a holistic exercise technique designed to stretch, strengthen, and condition the body for balance, using both the mind and body through an anatomical understanding of the muscular and skeletal systems of the body. Through a comprehensive exercise or program, the patient or student can focus on a specific area while performing exercises for the client. Classes focus on specific areas individually while performing routines that fit into an environment where optimal muscular and skeletal function and mobility can be restored.
How does Pilates work?
They perform pilates through slow, controlled exercises, usually on an exercise mat, or sometimes on specific apparatus, either in a class or one-on-one. It is an exercise system that trains the body and mind through a sequence of prescribed movements. These controlled movements incorporate the concept of dynamic tension (self-resistance), which involves exercising one muscle against another. It taught pilates one-on-one or in class.
Can Pilates help my back pain?
The theory of Pilates is that an imbalance of strength and flexibility in the body can cause back pain. Pilates attempts to develop strength and flexibility to help restore mobility and prevent further back injury. Pilates claims to improve posture, muscle tone, mobility and flexibility of the spine, relieve back pain and aches, and reduce stress. We consider it a back pain therapy for certain medical conditions affecting the back, but people with osteogenesis imperfecta, osteoporosis, Paget’s disease, osteomalacia should consult a physician. Although there have been recent concerns about the effectiveness and safety of Pilates, particularly to strengthen core muscles, we recognize that it may be helpful to some people in certain cases to relieve back pain.
Rolfing
Rolfing Structural Integration is the trade name for the system of manual connective tissue manipulation and movement education aimed at releasing stress patterns, helping the client move and function with greater freedom and effortlessly maintain a more upright posture. Rolfing seeks to realign and balance the body so that the head, shoulders, chest, pelvis and legs work in an improved vertical configuration.
How does Rolfing work?
The concept of Rolfing is because injuries, poor movement function and stress training of muscles cause stiffening of the myofascia (connective tissue), which prevents free and relaxed movement. Applying deep pressure and other massage techniques to release tight myofascia allows for greater flexibility and balance between muscles, tendons and bones. Rolfing practitioners teach awareness of habits that limit movement and how to transform them.
Can Rolfing help my back pain?
By reducing tension, loosening myofacsia, and restoring the body’s natural balance and use, Rolfing practitioners believe that releasing the above techniques can relieve back pain caused by muscle tension and help the back realign, thus promoting better back health and relieving back pain. Rolfing practitioners treat back pain, including herniated discs, by focusing on relaxation, release and manipulation of muscle tissue, and creating space between the intervertebral discs.
Shiatsu
The name Shiatsu (derived from the Japanese shi, meaning finger, and atsu, meaning pressure) is a traditional manual therapy originating in Japan. There are two main schools of shiatsu: one based on Western anatomical and physiological theory, according to which shiatsu soothes the overactive sympathetic nervous system, improves circulation, relieves muscle tension and reduces stress, and the other based on a holistic system of traditional Chinese medicine (TCM). The Ministry of Health, Labor and Welfare (Japan) regulates as a licensed medical therapy Shiatsu and elsewhere by various regulatory bodies established by Shiatsu practitioners. Shiatsu is an developing form, and its various styles incorporate (to varying degrees) aspects of Japanese massage traditions, Chinese medical practice, and “Western” anatomy and physiology.
How does shiatsu work?
Shiatsu uses pressure applied with the thumbs, fingers and palms on the same energy flows or meridians as acupuncture and incorporates stretching. It also uses techniques such as rolling, brushing, vibrating, gripping and, in a particular technique developed by Suzuki Yamamoto, pressure is applied with the feet to the person’s back, legs and feet (a special facility is required for “foot” shiatsu). The theory of principle is like that of acupuncture, according to which blockages or imbalances cause diseases in the meridians or energy lines. The Shiatsu practitioner seeks to remove these blockages by applying pressure with the finger, thumb, palm or even foot to the affected areas using various massage techniques.
Can shiatsu help my back pain?
There are several reasons for back pain: Poor ergonomic posture, Physical injury, occupational (such as lifting), recreational (e.g. golf or gardening) related to poor muscle tone, or in Traditional Oriental Medicine (TOM), blockages or imbalances in the energy flows through the patients meridians. It is likely that a shiatsu practitioner can relieve back pain, backache or sciatica. Shiatsu is a complement to conventional Western medicine, not an alternative to it. We administered although back pain therapy according to Eastern practices; it is important to also get a modern Western diagnosis, and the practitioner will attempt to establish the origin of the condition. \Using the techniques described above, the practitioner will strive to create a “self-healing” environment in which the patient’s body will return to a healthier state. By understanding how the problem originated, the practitioner will advise changes in posture, exercise or physical habits that can help prevent the recurrence of back pain.
Yoga
Yoga dates back over 5,000 years and originated in India as a form of spiritual practice. In the West, yoga, as an alternative medicine, has developed from its founding philosophy into a form known as yoga therapy, which is often considered helpful in the treatment of back pain. In the United Kingdom, this evolution has taken the form of a National Occupational Standard (NOS) for the provision of yoga therapy to clients with health problems, such as back problems, or whose well-being is compromised. We usually teach Yoga in a class or group setting, sometimes as a therapy for back pain.
We believe Yoga to calm the nervous system, create harmony and balance the body, mind and spirit. Its practitioners believe it can prevent certain diseases by keeping the energy meridians open and the vital energy (Prana) flowing. Over time, many branches of yoga have developed, from the original meditative states to an emphasis on physical pose or position, breathing, body alignment or fluidity of movement.
How does yoga work?
Yoga uses movement, stretching, posture and breathing to achieve overall wellness of the body and mind. Different yoga often focus on specific aspects such as fitness, flexibility, meditation, rehabilitation, relaxation and strength.Yoga uses movement, stretching, posture and breathing to achieve overall well-being.
We often associate restorative yoga with the healing of illness. We practiced it in a very relaxed state using support rather than muscle tension to maintain the alignment of the poses. These poses help relieve the effects of chronic stress in several ways. First, the use of supports provides a completely supportive environment for total relaxation. Second, each restorative sequence moves the spine in all directions. Third, a well-designed restorative practice also includes a reverse pose, which reverses the effects of gravity. Because we stand or sit most of the time, blood and lymph collect in the lower extremities. By changing the relationship between the legs to gravity, fluids are returned to the upper body and heart function is improved. Fourth, restorative yoga alternately stimulates and soothes the organs. The movement of the blood improves the exchange of oxygen and waste products across the cell membrane. Finally, yoga teaches that it infuses the body with energy. Prana, the male energy, which lives above the diaphragm, moves upward and controls the breath and heartbeat. Apana, the female energy, lives below the diaphragm, moves downward and controls the function of the abdominal organs. Restorative yoga balances these aspects of energy in the practitioner. Most yoga classes typically include a combination of physical exercise, breathing exercises, and meditation. These characteristics make yoga a beneficial type of exercise for certain health problems, including back problems.
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Can yoga help my back pain?
Yoga can help back pain by teaching balance, flexibility, muscle strengthening, and body awareness. By gradually structuring the complexity of the movements, yoga teachers say its practice can teach the back to distribute its mass more efficiently and naturally improve posture and back balance. For yoga practitioners, an amalgam of yoga positions reduces weakness, improves spinal alignment and reduces muscle tension, creating a self-healing environment for the back. We can adapt many yoga positions to address specific back problems as part of back pain therapy or to allow for more extensive stretching.
