Low Back Pain

Back pain treatment varies based off how you present at your evaluation:

• Training into a specific movement: If there is a movement that reduces your symptoms, your therapist will encourage and create an exercise plan based off of that movement.  They will recommend you try to avoid movements that worsen your symptoms in order to reduce irritation and improve tissue healing time.  There will become a time during your treatment where challenging movements will be encouraged, but not at the beginning of this approach and not if a movement worsens your symptoms.

• Mobility training: If you are very stiff to your spinal joints (also known as facet joints) or have muscular or fascial restrictions, you're therapist will focus on improving mobility.  Mobility to the ankle, hips,  SI joint, and mid back can also influence how the low back feels and moves.  These regions will also be assessed and treated accordingly.

• Strength training: If you do not have appropriate muscle coordination, motor control, or strength to areas surrounding the low back including your superficial and deep core, your spinal muscles, and hip muscles that stabilize your pelvic, a plan for strengthening will be discussed.   

• Traction:  If you have pain that follows a radicular pattern (a referring nerve root pain) or symptoms associated with sciatica, traction may help decompress your injury site and provide you with relief.  At Therapeutic Pilates, your therapist will encourage active traction to allow you independence with symptom management at home (as opposed to being left on a traction machine).  Your therapist will give you specific postures and exercises that help gap/open the compressed area of your spine.

Your treatment approach will vary based off of you severity of symptoms:

High irritability: If your pain is severe, lingering, or it occurs mid way through your motion, your irritability is high, and you are likely having a chemical response within the body. During this phase of injury, your therapist will prescribe active rest, encourage movements that do not increase your irritability, and may train posture to offload or decompress injured ares of the body.  Taping and bracing may be utilized to help encourage a posture that promotes healing and inflammation reduction.  Exercise movements may be limited to a specific plane and range of motion, and they will likely be focused on appropriate motor control and activation (as opposed to heavy resistance training).

Low irritability: If you have a lower severity of pain, non-lingering symptoms, and your pain is at your end range of motion, your symptoms are likely more mechanical.  In this instance, therapy can be more aggressive. Exercise will become more focus on multi-planar movements that are more functional and activate a larger group of muscles within the body.

Tension or dysfunction in your abdomen can keep your spinal muscles guarded and stiff.  If this is the case, no matter how much you stretch muscles or mobilize the joints around your spine, your symptoms won't change. If traditional orthopedic therapy has failed, see a therapist that does visceral manipulation.

Here's an example of a restriction in the abdomen that can influence your back:

The root of the mesentary of your small intestine connects to your spine.  When someone can't bend forward, sometimes this region is locked.  This can happen because of an infection, problems with nutritional absorption, or simply use of antibiotics.