Managing Chronic Back Pain - The ABTP Way

Chronic Back Pain (CBP) refers to a wide range of persistent discomfort lasting beyond 3 to 6 months. This pain may range from a dull ache to sharp, shooting, and radiating pain, according to PubMed, Anna Citco et al. Biomed Res Int 2018, sedentary lifestyle exacerbates the recurrence of Lower Back Pain (LBP) by 3.5 times.  

Chronic Back Pain - AN OVERVIEW

Chronic Back pain is one of the most common health problems in our country. It can range from a dull, constant ache to a sudden, shooting, and sharp pain that may radiate down the leg. Sometimes it can come on suddenly because of an accident, a sudden fall, or lifting heavy objects, or it can develop due to conditions like PIVD. Treatment varies depending on the cause and symptoms, and often there are several contributing factors. However, timely physiotherapy interventions can reduce the chances of developing chronic back pain. 

Understanding the Anatomy of the Back

There are many different structures in the anatomy of the back that work together to support your body. Problems with any one of these structures can cause back pain.

There are five regions of the spine & the Parts of the spine and back include:

• Cervical spine.

• Thoracic spine.

• Lumbar spine.

• Sacrum.

• Coccyx.

• Vertebrae – The small bones stacked on top of one another, to protect the spinal cord.

• Spinal cord – This is the long bundle of nerves that run down the back through a canal in the vertebrae.

• Intervertebral discs – These are cushion-like pads between the vertebrae that act like shock absorbers and spacers for the spine.

• Ligaments – These are short bands of tough, flexible tissue that hold the vertebrae in place.

• Tendons – The cord of tissues that connect muscle to bone.

• Muscles – These are a bundle of dynamic fibers that support your spine and upper body.

Causes of Chronic Back Pain

Chronic Back pain can be caused by many different factors, which may all be present at the same time and interact to result in chronic low back pain. These could include mechanical problems with the spine, inflammatory conditions, and other medical conditions. 

Mechanical/Structural Problems

Chronic Back pain can happen due to mechanical problems associated with the  spine, discs, muscles, ligaments, or tendons in the back, or compression of a nerve.

• Sprain: When an injury occurs to the ligaments that support the spine (which connect the different bones together), often occurring from twisting or lifting improperly.

• Strain: This occurs when there is an injury to a muscle or tendon located near the spine.

• Degenerative disc disease: Usually, aging causes the discs between the vertebrae of the spine to wear down. It is associated with other degenerative changes in the spine, such as arthritis or spinal stenosis.

• Herniated or ruptured discs: It is an event that causes a disc to compress, further irritating nearby nerves. This often occurs at the lumbar level but can be present in the cervical spine as well.

• Spondylolisthesis:  When a vertebra in the spine slips out of place or gradually moves out of alignment, which can result in persisting pain.

• Spinal stenosis: When the spinal canal narrows down, it puts pressure on the spinal cord and nerves, resulting in constant pain.

• Fractured vertebrae

• Scoliosis or other congenital changes in the spine.

• Myofascial pain: tightness and pain of the muscles supporting the spine.

Inflammatory Conditions

Osteoporosis,  a disease that starts developing when the bone density and bone mass start decreasing. This can lead to painful fractures of the vertebrae. - definition instead - bone mass density reduces, leading to a fracture 

Fibromyalgia, a long-lasting condition that causes muscle pain and fatigue in the entire body.

Physiotherapy for Managing Chronic Back Pain (CBP)

Before discussing the protocols that are undertaken at ABTP, let's broadly discuss the benefits of physical therapy.

• Reduced Pain:

By addressing the underlying causes of pain, advanced physiotherapy like electrotherapy and Tecar therapy can lead to significant pain relief. 

• Improved Mobility and Function:

Techniques like manual therapy and exercises can improve functional ability. 

• Enhanced Muscle Strength and Stability:

Targeted exercises can strengthen back and core muscles, improving stability and reducing the risk of future injuries. 

• Enhanced Quality of Life:

By reducing pain and improving function, advanced physiotherapy can significantly improve the overall quality of life for individuals with chronic back pain. 

Advanced Physiotherapy Treatments or Management in CBP at ABTP

1. Myofascial Release (MFR)

Myofascial release (MFR) is a manual therapy technique aimed at alleviating pain and restoring movement by releasing tension in the fascia. Chronic pain is often linked to fascial restrictions that can lead to musculoskeletal dysfunction. Myofascial release focuses on the fascia, the connective tissue that surrounds muscles, organs, and nerves, facilitating a holistic approach to pain management.

2. IASTM (Instrument-assisted soft tissue manipulation)

   

Instrument-assisted soft tissue mobilization (IASTM) is a skilled myofascial intervention used for soft tissue treatment. It is based on the principles of James Cyriax cross-friction massage. 

What it does?

This enhances blood circulation in the affected area while also aiding the return of the fluid.

3. Cupping Therapy

   

Cupping therapy is an ancient form of alternative medicine where a therapist puts special cups on your skin for a few minutes to create suction. People get it for many reasons, such as pain and inflammation relief, relaxation and well-being, and as a type of deep-tissue massage.

What it does?

The air inside a plastic or glass cup is suctioned or vacuumed out by placing the cup on the skin.

4. Dry Needling Dry needling (DN) -  Thin needles are inserted into trigger points. What it does?  This manages pain, reduces muscle tension, and potentially improves healing, enhancing circulation to the muscle.

   

   
   

5. Electrotherapy In this, there is use of electric modalities like TENS, Ultrasound, Care therapy to relieve pain and inflammation. What it does? → Stimulates sensory nerves to modulate pain signals via the Gate Control Theory. → Enhances circulation and tissue healing, reducing muscle spasm, edema.
   

   

   
   

6. Mobility Training It is the restoration of joint movement through graded stretching and a guided flexibility regimen. What it does? → It improves the joint range of motion, reducing stiffness and restoring functional movement. → It also prevents adaptive shortening of soft tissues while maintaining alignment.
   

   

7. Strength Training These are the targeted exercises to strengthen spinal stabilizers like the multifidus, transversus abdominis, and core muscles.
   

   

   What it does? → Enhances spinal stability, reducing mechanical stress. → Builds muscle endurance to prevent fatigue-induced postural collapse and pain recurrence.

   
   

8. Postural Guidance & Ergonomics At ABTP, Experts ensure optimal body mechanics and impart education on workplace setup to help minimize spinal strain.

   What it does?

   → Reduces repetitive stress and static load on spinal structures during daily activities.

   → Promotes spinal alignment awareness, preventing recurrence of pain through self-management.