Back Injuries & Pain
About 1 in 6 Australians live with back problems, and 84% of people will deal with back pain in their lives. While it can be debilitating, with the right strategies and support we can help you first understand it, so you can master it and get back to the good stuff.
Low Back Pain
Low back pain is a common issue that can be acute (short-term) or chronic (ongoing). Along with the pain it can also cause a huge amount of psychological distress and might in some cases feel like it is never-ending.
The important thing to remember with back pain, both acute and chronic, is that it is very often “multifactorial”, meaning there are often a lot of things contributing to it and these factors all need to be considered to give you the best chance of recovering.
That being said, when you come in for your first appointment our initial assessment aims to ascertain what the most dominant cause of your pain is. The questions we ask, and the tests we do are all there to determine whether it is primary something.
We will categorise some of the common, more specific conditions below, however for back pain especially we would recommend not using this as a diagnostic tool as it can rather reductive!
Injuries of the bones, joints and muscles.
Sprains and Strains
In more acute injuries we may see sprains, which are injuries to the joints or ligaments of the spine, or strains which are pulls or overstretching / overloading of muscles or tendons around the spine.
These are quite often the ones described as “my back just went” after bending over to pick up a shoe or to do a seemingly simple task. They can also be caused by more obvious events or sports injuries.
Depending on the severity, both are generally managed by a period of de-loading and protecting the area to create an environment which allows the body to heal naturally, and then gradually rebuilding the strength and health of the muscles, ligaments or tendons through targeted exercises which encourage adaptation and strengthening of the tissue.
During the treatment of these injuries we will also make sure that we find ways for you to still continue to live your life or find ways to move so you are not completely set back by your injury.
Bone and Joint Injuries
This category covers a range of conditions affecting the bony structures and joints of the spine, including stress fractures, spondylosis, arthritis, and spondylolisthesis.
Stress fractures are small cracks that develop in the vertebrae, usually from repetitive loading over time rather than a single traumatic event. They're commonly seen in athletes involved in repeated extension or rotation, such as gymnasts, cricket fast bowlers, or dancers. These are managed quite closely and will generally involve quite strict time off certain movements so they do not develop into a full fracture.
Spondylosis refers to the general wear and tear of the spinal joints that occurs with age, similar to how other joints in the body can develop osteoarthritis. It's a very common finding, and importantly, having spondylosis on a scan doesn't always correlate with pain or dysfunction.
Arthritis in the spine, most often osteoarthritis of the small facet joints, can lead to stiffness, localised pain, and reduced range of motion, particularly noticeable first thing in the morning or after periods of inactivity.
Spondylolisthesis occurs when one vertebra slips forward over the one below it, which can happen due to a stress fracture, degenerative changes, or sometimes be present from a younger age without ever causing issues.
These conditions are generally managed differently to acute soft tissue injuries, with more focus on load management, like reducing movements and amount of training that are aggravating things, and building capacity, control, and confidence in the spine over time to help support the joints. This usually involves a graded strengthening programme targeting the muscles that support the spine, along with education around load management and movement patterns that keep symptoms settled.
As with all our treatment plans, we work with you to make sure you can keep doing the things that matter to you, adapting activity where needed rather than avoiding it altogether, while we build up the strength and resilience of your spine over the longer term
Disc and Nerve Injuries
Intervertebral discs are strong, fibro-cartilaginous joints of your spine that allow movement and act as shock absorbers. Disc issues can arise through degenerative changes, where the disc gradually loses height between the joints, or through disc prolapses and herniations. A prolapse is when the inner contents of the disc bulge outwards but are still contained within the tough outer layer (the annulus), while a herniation is when that material breaks through the annulus itself.
A common misconception is that a disc can "slip," which conjures up scary images of discs literally sliding out from between the vertebral bones and damaging the spinal cord or other structures. The good news is that this is highly improbable, barring severe traumatic incidents, as your discs are firmly attached to your spine.
A disc prolapse or herniation can compress a nearby nerve or the spinal cord, which may cause pain and/or loss of function, but the chances of serious long-term damage, or paraplegia/quadriplegia, are incredibly rare. We also know now that, similar to other joint injuries in the body, discs can heal on their own without routinely requiring surgery or invasive procedures.
Nerve pain often feels like a deep, dull, burning ache, similar to a toothache. Depending on which level of the spine is affected, this may extend down an arm or leg, and you may notice pins and needles, numbness, or a loss of strength. In these cases we'll first assess how serious the issue is, and decide whether to send you for a scan to assist with diagnosis or refer you on to a specialist.
If we think it's manageable conservatively (without surgery), we may treat you with things like posture advice, joint or nerve mobilisations, exercises, or taping. Pain relief management from a GP is often helpful with nerve injuries too, as the pain can be quite severe.
As with the other injuries we treat, our focus is on helping you keep moving and living your life as much as possible during recovery, rather than putting everything on hold while you heal.