At Jamie Bell Physiotherapy the majority of patients we see suffer with lower back and neck problems. Low back pain is the most common cause of sickness in the workplace in the UK with up to 80% of the UK population experiencing back pain at some point in their lifetime. It affects approximately one third of the adult population each year with 20% of people consulting their GP. Neck pain is also extremely common, and can have a negative impact on an individual's daily life.
There are a number of different guidelines for both low back pain and neck pain, with those proposed by the National Institute for Health and Care Excellence (NICE) being most commonly used in the UK. These provide clinical guidance regarding the most appropriate treatment methods and assessment tools. At Jamie Bell Physiotherapy we follow such guidelines in order to provide evidence based treatments for back and neck pain.
The actually causes of neck back pain are poorly understood, however it is believed that symptoms develop due to multiple factors. Only 15% of cases are thought to have an identifiable cause, with the remains 85% of cases classed as non-specific.
Both neck and low back pain can be caused by genetics, a lack of fitness, muscle weakness, poor posture, muscle imbalance, damage to the vertebrae or intervertebral discs, repetitive movements, or medical conditions such as scoliosis.
An increase in sedentary lifestyles and static working conditions is thought by many to have increased the prevalence of neck and low back pain. This is often related to office based working conditions where the individual is sat in a static position with poor posture and ergonomics. Poor posture and ergonomics increase the risk of muscle imbalances developing, causing muscles to become overactive and painful. Lifting with an unstable lower back/trunk can also cause damage to the facet joints and intervertebral discs. If the vertebra or intervertebral discs are damaged (in the form of a disc prolapse) the muscles overlying the area will go into spasm causing pain and restricting the individual's mobility.
Low back and neck pain can also become evident when playing sport, usually as a result of a twisting or bending movement at the spine whilst the spine is loaded. Spondylolisthesis is a condition which mainly affects children and it is caused by a vertebrae slipping out of position. This can be as a result of sudden injury, particularly during sport, or as a birth defect. The physiotherapist will be able to determine if this condition is likely through a thorough assessment and they may feel it would be appropriate to refer the patient back to their GP for an X-Ray. It is also common for athletes to develop trigger points within the muscles around the lower back and neck region when playing sport. These can be treated successfully with trigger point release massage and stretching to allow the muscle to be restored to its previous function.
Due to the mechanism of road traffic accidents, some people develop what is known as a 'Whiplash Associated Disorder'. Whiplash associated disorders involve a sudden change in movement in the cervical spine, causing excessive extension and flexion, injuring the facet joints and ligaments at the spine. Symptoms can typically persist for longer than 6 months, however it is important to speak with a physiotherapist early for advice on how to treat the neck pain. If following the road traffic accident you suffer from prolonged dizziness, fainting or problems with your speech, swallow or vision, you need to speak to a doctor as soon as possible.
Physiotherapy is extremely beneficial for neck and low back pain with a large amount of research available which supports its effectiveness as a treatment method. There are a number of different treatment methods which can be used for low back pain which will depend on its presentation and severity. At Jamie Bell Physiotherapy the physiotherapist will complete a thorough assessment, ruling out any sinister cases through asking specific questions. Once the physiotherapist has completed a thorough assessment, they will then be able to provide hands on treatment which again, will depend on the severity of the patient's symptoms.
Treatment methods include soft tissue massage, acupuncture, exercise prescription, joint mobilisations, joint manipulations, stretching and trigger point release therapy. The physiotherapist's at Jamie Bell Physiotherapy use an evidence based approach and the above treatment methods have recommended in the NICE Guidelines for low back pain. We also have immediate access to MRI scans, if further investigation is deemed necessary. Further information can be found on the Musculoskeletal Scans and Diagnostic Imaging.
As well as providing treatment, the physiotherapist will be able to advise with your desk set up and lifting postures when at work. They may also be able to advise you with your activity levels at work, encouraging certain movements to reduce your pain levels. This may be as simple as standing to have a stretch every 10-20 minutes if you sit at a desk all day. This will reduce the strain your back is put under and allow the soft tissues to lengthen.
Red Flags is a term used by health care professionals to highlight signs and symptoms of a serious underlying pathology. If the individual is suffering with back pain and they experience any changes in their bladder or bowel symptoms, radiating pins and needles or numbness down their legs to the toes, or numbness around the groin region, they need to visit their local A+E department for an immediate MRI scan. If the individual is suffering with neck pain then they need to be aware of any dizziness, problems with swallowing or speaking, changes in their vision (double vision) and fainting episodes. If they do experience these symptoms then they need to seek medical attention.
If you would like to discuss your problem before booking an appointment please give our physiotherapy team a call, we will do our best to help.