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What Causes Back Pain?

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Back Pain Treatment

Back pain – or lumbar spine pain – can be the result of a single event or trauma, or the result of a combination of factors including poor posture, declining physical fitness, and/or repetitive activities, including faulty lifting, bending, or twisting. Previous injury and family history may also be a contributing factor.

Lower back pain is usually non-serious and resolves within 2-6 weeks. Sometimes, back pain is accompanied by upper back pain, buttock pain, or pain down the leg. Physical therapists at Saunders Therapy Centers can get to the root cause of your pain, and provide immediate treatment to lessen the intensity and duration of your pain. In some cases, you only need one or two clinic treatments. Common causes of back pain include:

Muscle Strain: Sleeping without proper support, over-working during exercise, or bending or twisting the “wrong way” can cause a temporary but very painful strain. You may not be able to rotate, flex, or extend your back fully. It may hurt more to move around or change positions.

Lumbar Osteoarthritis: This is a wear-and-tear condition, also called lumbar arthritis. As we age, the space between vertebrae in the back decreases, and excessive friction can cause pain. Even though structural changes are inevitable with age, pain is not! Improving posture and strengthening the stabilizing muscles (the abdominal core and hips) is key to help with this condition.

Lumbar Degenerative Disc Disease: Though scary-sounding, this condition is closely related to osteoarthritis, in that it is a wear-and-tear condition. Disc degeneration typically causes a low-level chronic back pain with occasional episodes of more severe pain. Treatment is similar to osteoarthritis and involves postural training, core strengthening, and manual therapy.

Facet Joint Syndrome: The joints between each vertebra can become slightly misaligned or inflamed, causing pain. Manual therapy techniques can restore normal motion and decrease inflammation.

Lumbar Disc Herniation: Between each vertebra is a structure called the “disc”, which can bulge or herniate, placing pressure on nearby structures including the nerves. More severe disc herniations can cause leg, foot, and toe pain and weakness. Lumbar traction and manual therapy techniques can be helpful. Surgery is not always necessary, so physical therapy should usually be tried first.

manual therapy for back pain

How Can We Help?

Saunders Therapy Centers therapists are highly skilled at evaluation, and will know the specific techniques to use depending on the source of your symptoms. When your pain improves (often rapidly!), almost all lower back pain patients benefit from postural restoration and exercise to restore normal muscle length and strength to prevent a future episode.

 

When is Back Pain Serious?

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Saunders Physical Therapist

Back pain is usually non-serious and resolves within 2-6 weeks. Rarely, back pain should be considered an emergency, or needs further treatment before seeing a physical therapist. Here are some situations where you should seek immediate medical attention:

Trauma or Accident: If your back pain was caused by a slip or fall, or significant trauma such as a motor vehicle accident, you should have a medical evaluation to make sure there is not a fracture or instability before seeing a physical therapist.

Numbness in the Feet or Toes: Leg, foot, or toe numbness may be a sign that a nerve is pinched. Physical therapy can help with this, but if numbness is severe or progressing, you should see your physician.

Sudden or Progressive Weakness of Your Leg: Nerves in the lower back supply the muscles of your legs. Sudden or increasing weakness of the knees, ankles, or toes may be a sign that a nerve is pinched, and further medical evaluation is needed.

Loss of Bowel or Bladder Control: Sudden changes in bowel or bladder control can be a sign that there is pressure on the spinal cord, and is considered an emergency condition. See a physician right away if you experience these symptoms.

 

Saunders Physical Therapist

 

When is Neck Pain Serious?

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Herniated Disc Treatment

Neck pain is usually non-serious and resolves within 2-6 weeks. Rarely, neck pain should be considered an emergency, or needs further treatment before seeing a physical therapist. Here are some situations where you should seek immediate medical attention:

Trauma or Accident: If your neck pain was caused by a slip or fall, bumping your head, or a motor vehicle accident, you should have a medical evaluation to make sure there is not a fracture or instability before seeing a physical therapist.

Numbness in the Hands or Fingers: Hand or finger numbness may be a sign that a nerve is pinched. Physical therapy can help with this, but if numbness is severe or progressing, you should see your physician.

Sudden or Progressive Weakness of Your Arm: Nerves in the neck supply the muscles of your arm, hand, and fingers. Sudden or increasing weakness of the arm may be a sign that your nerve is pinched, and further medical evaluation is needed.

Loss of Bowel or Bladder Control: Sudden changes in bowel or bladder control can be a sign that there is pressure on the spinal cord, and is considered an emergency condition. See a physician right away if you experience these symptoms.

 

Photo of Plastic Spine Model

 

What Causes Neck Pain?

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physical therapist using manual therapy, Treating a patient with neck pain

Cervical spine pain can be the result of a single event or trauma, or the result of a combination of factors including poor posture, declining physical fitness, and/or repetitive activities, including faulty lifting, bending, or twisting. Previous injury and family history may also be a contributing factor.

Neck pain is usually non-serious and resolves within 2-6 weeks. Sometimes, neck pain is accompanied by headache or pain between the shoulder blades or down the arm. Physical therapists at Saunders Therapy Centers can get to the root cause of your pain, and provide immediate treatment to lessen the intensity and duration of your pain. In some cases, you only need one or two clinic treatments. Common causes of neck pain include:

Muscle Strain: Sleeping without proper support, over-working during exercise, or turning your neck the “wrong way” can cause a temporary but very painful strain. You may not be able to rotate, flex, or extend your neck fully. Pain can be in the neck or between the shoulder blades.

Cervical Osteoarthritis: This is a wear-and-tear condition, also called neck arthritis. As we age, the space between vertebrae in the neck decreases, and excessive friction can cause pain. Even though structural changes are inevitable with age, pain is not! Improving posture and strengthening the stabilizing muscles is key to help with this condition.

Cervical Degenerative Disc Disease: Though scary-sounding, this condition is closely related to osteoarthritis, in that it is a wear-and-tear condition. Disc degeneration typically causes a low-level chronic neck pain with occasional episodes of more severe pain. Treatment is similar to osteoarthritis and involves postural training, strengthening, and manual therapy.

Facet Joint Syndrome: The joints between each vertebra can become slightly misaligned or inflamed, causing pain. Manual therapy techniques can restore normal motion and decrease inflammation.

Cervical Disc Herniation: Between each vertebra is a structure called the “disc”, which can bulge or herniate, placing pressure on nearby structures including the nerves. More severe disc herniations can cause arm and hand pain and weakness. Cervical traction and manual therapy techniques can be helpful. Surgery is not always necessary, so physical therapy should usually be tried first.

How Can We Help?

Saunders Therapy Centers therapists are highly skilled at evaluation, and will know the specific techniques to use depending on the source of your symptoms. When your pain improves (often rapidly!), almost all neck pain patients benefit from postural restoration and exercise to restore normal muscle length and strength to prevent a future episode.

 

Therapy For Neck Pain

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physical therapist performs Neck Pain Treatment Technique

Neck pain can be debilitating, and it’s tempting to rush to an orthopedic doctor to get help. But wait – physical therapists are skilled at evaluating and treating most neck pain problems. What’s more, they are trained to assess whether your condition requires more diagnostic evaluation. Seeing a physical therapist first saves valuable time and expense for the majority of neck pain conditions. At Saunders, our approach entails:

Musculoskeletal Evaluation: A thorough evaluation will be performed on your initial visit to assess for possible muscle imbalances, myofascial restrictions, joint dysfunction, and nerve involvement that may be contributing to your symptoms.

Manual Therapy: Our therapists all have advanced training in manual therapy which is a hands-on approach that addresses restrictions in the soft tissue, myofascial system, and/or the spinal joints to facilitate proper alignment and healing.

Spinal Stabilization and Exercise: Studies have shown that deep muscles which control spinal movement are inhibited with your first episode of neck problems. These muscles do not automatically return to proper function when the pain subsides, leaving you vulnerable to further injury. You will be shown specific exercises to activate these muscles properly, decreasing the likelihood of future neck pain episodes.

Postural Education and Body Mechanics: Our physical therapists will teach you body awareness and you will learn mechanics and postures that decrease load and stress on the spine, relieving your neck pain.

Neck Pain Treatment Technique

Physical Therapy Neck Pain Techniques

Physical therapists can immediately decrease neck pain with manual therapy, myofascial techniques, postural training, and restoring muscular length and strength through specific exercise.

 

How Often Do I Attend Work Hardening? How Long is Each Session?

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work hardening client using wrench to tighten unistrut

The goal of Work Hardening is to simulate the intensity of real work. Therefore, your program will usually increase from a minimum of 2 hours per session, up to a maximum of 8 hours per session. We often increase to 5 days per week in the last week of the program. Sometimes, full days aren’t needed, especially if your work doesn’t require constant physical activity, or if you are supplementing Work Hardening with part-time work. Your Work Hardening Team will plan your program WITH you to design the right combination of hours and days per week.

How Long is a Typical Work Hardening Program?

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work hardening client squatting to lift bread crates for job simulation

Your Work Hardening team works with YOU to identify goals and barriers and develop a comprehensive plan to help get you back to work. In some cases, a short 2-3 week Work Hardening program is enough to put the “finishing touches” on your physical rehabilitation. The goal of this shorter program is to improve strength, endurance, and confidence so that you’re physically and mentally ready to jump back into the job. If you’ve been off work for a long time, have a complicated injury, or have been experiencing chronic pain, the program can be as long as 6-10+ weeks. We will plan your program together to make sure it works for you.

Work Hardening – What Exactly Will I Do?

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work hardening client sorting medium sized boxes

Most people who are referred for Work Hardening have physical barriers that prevent them from reaching their work goals. Examples of these are stiffness, weakness, poor balance, or poor endurance. We stress general fitness, endurance, and work simulation, as well as specific muscle and joint work as needed. The exact combination of these physical restoration elements is customized for each client. Work simulation is one of the most important elements of your rehabilitation, and is something you may not have experienced in your previous physical therapy sessions.

In addition, many clients who have been off work for a long period of time are struggling with non-physical issues such as ongoing pain limiting their function, fear, anxiety, and even anger. If you are experiencing these challenges, we can help. In addition to all the same physical conditioning and job simulation activities, we use an evidence-based, neuroscience approach that involves pain neuroscience education (PNE) and progressive exposure to activities identified as painful/problematic. Our staff is specifically trained to distinguish between “hurt” and “harm” and we will help you know when it’s safe to work through symptoms, and how to use your body more effectively. We find that this approach of gradual exposure to painful activities has great success with long-lasting pain syndromes or fear of return to function. Most clients experience a significant increase in ability to work, even if their symptoms don’t completely go away.

What is the Work Hardening Evaluation?

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occupational therapist chatting with smiling client carrying box

Before beginning the program, each client participates in a 2-hour evaluation. We obtain a thorough injury history, work history, psychosocial screening and baseline functional assessment covering lifting, pushing, pulling, carrying, upper extremity function, and body position capabilities. During this comprehensive evaluation, we get to know your job-related goals, and we will help you identify barriers to successful return to work.  We work together with you, your physician, and others as needed (e.g., QRC or disability case manager) to develop a custom program. Saunders Work Hardening teams customize the length of the program based on the results of your evaluation, availability of light or modified duty, and program goals. If you are currently working, but with restrictions, we structure the program to supplement what you do on the job.

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