….Try Massage, Acupuncture, or Pilates Before Medication.

One of the most frequent reasons clients come to see us if due to back pain. It can come on for no apparent reason, may be getting stiffer over time, or maybe a recent trauma has brought it on.

The position in which you sleep, the condition of your mattress, the shoes you wear, the number of hours a day you are sitting, as well as the amount of exercise (and type) you are doing; can all have a link on your back health. 

It doesn’t necessarily mean it’s severe, even though it can feel like it.

It is estimated that around 30 million people (50% of adults) will experience back pain at some point in the next year. With up to 85% of people reporting it at some point in their life (backcare.org.uk). Accounting for more than 264 million lost work days a year in the US alone.

Around 45% of Brits reported that sitting for long periods, related to their job, was a key trigger for their back pain. This is typical due to the lumbar spine under constant stress. With the demands of sport and exercise training, manual work, pregnancy and sleeping position also being triggers.

A heath care professional such as a Sports Therapist, Osteopath or Physiotherapist will conduct a consultation and physical assessment. This will rule out any underlying issues. They will screen for structural abnormalities, such as; sacral torsions, pelvis malalignments, open/ closed facet fixation and muscle movement patterns, to name a few.  They may also examine the hip joint to rule out referred pain. A treatment plan will be given if any underlying alignment issues are found.

If pain is mild and muscles in the back typically feel stiff, inflexible or if pain comes down the buttocks; it’s important to look at your everyday posture. For those sitting for long periods of time- incorporate more exercise and general movement into your day. Simply sitting on an Exercise/ Swiss Ball instead of a chair can help to alleviate pain. Sport and exercise is paramount to long lasting health, staying strong and reducing the chances of back pain. It is important to build up intensity slowly and ensure an appropriate warm up and stretching routine.

After a systematic review of randomised controlled trials, new guidelines for acute, sub- acute and chronic lower back pain are required (The American College of Physicians).

Acute and sub- acute pain

Taking into account that most patients with acute or sub- acute (than a month) back pain improve over time regardless of treatment. Therapists and patients should select non- pharmacological treatment; such as superficial heat, massage, acupuncture, or spinal mobilisations. One should select non- steroidal anti-inflammatory drugs (such as Ibruprofen, Naproxen, Aspirin), or skeletal muscle relaxants (such as Baclofen, Diazepam) if pharmacological treatment is desired.

Chronic/ long term pain

For clients with chronic/ long term lower back pain, clinicians and patients should initially select non- pharmacological treatments. Exercise, multidisciplinary rehabilitation, acupuncture, yoga, Pilates, motor control exercise, electrical stimulation, low-level laser therapy, or spinal mobilisations.

In clients with chronic low back pain who have had an inadequate response to non- pharmacological therapy; clinicians and patients should consider pharmacological treatment with non- steroidal anti-inflammatory drugs as first-line therapy. Or tramadol or duloxetine as second-line therapy. Clinicians should only consider opioids as an option in patients who have failed the aforementioned treatments; and only if the potential benefits outweigh the risks for individual patients and after a discussion of known risks and realistic benefits with patients.

How we can help

Coming from a Sports Therapy background (MSc. Sports Medicine, BSc. Sports Therapy) my approach to back pain is typically multi-discipline (focusing on the whole body and the root cause of the pain). Therefore I would recommending non-invasive, alternative approaches like acupuncture, massage, spinal and hip mobilisations, exercises, heat, ultrasound and Pilates. For a practical and manageable approach to tackle back pain. You may be referred to another medical professional or for MRI if pain is chronic and doesn’t respond well to these treatments.

If you would like more information regarding the treatments available or to discuss an injury or ailment please email us at: info@thelittlecityspa.co.uk.