How to Help Low Back Pain Without Medication
Gaining relief from lower back pain with physiotherapy
Everyone experiences back pain from time to time. Research shows that about 80% of the population may suffer from lower back pain at least once in their lifetime [1]. Chronic lower back pain is a very common health problem globally and a major cause of reduced disability-affecting performance at work and even general well-being [1].
Chronic lower back pain (CLBP) causes disability which has increased by more than 50% since 1990 especially in low-middle income countries [2]. Sedentary lifestyle/occupation, smoking, obesity, and low economic status may be one of the leading causes of CLBP [3].
One of the most commonly used kinds of treatment adopted for gaining relief from lower back pain is physiotherapy. It may be used in combination with other management options like heat, traction, short wave diathermy, and the well-known massage. Physiotherapy may also be used alone.
The vertebrae, discs, ligaments, muscles, and facet joints are interlocking elements which make up the complex system called the human back.
Some of the physical therapy used for managing Chronic Lower Back Pain (CLBP) include:
- Walking- As simple as it looks, walking helps and may be as effective as other non-pharmacological methods in reducing pain and disability associated with lower back pain [4].
- Movement Controlled Exercises- This showed low to moderate evidence on disability caused by Chronic Lower Back Pain (CLBP). However, pain intensity significantly decreases at the end of treatment [5].
- Technology-Supported Exercise Therapy- Electromyography Feedback (EMG-FB) is an example of technological systems that provide Technology Supported Exercise Therapy (TSET). Patients with CLBP benefits immensely from this as pain, disability, and quality of life improve [6]. This treatment modality may be cost-prohibitive.
- Yoga- Yoga, a popular trend, may help in managing lower back pain. There is usually a slight reduction in pain. It is important to note however that in a few people, the pain increases with yoga [7].
5. Postural Guidelines- Physiotherapy helps with pain as the patient is guided on ways to ensure accurate posture to prevent lower back pain. The patient is also taught correct postural habits.
6. McKenzie Method of Mechanical Diagnosis and Therapy (MDT)- Here, the clinician prescribes specific exercises and advice regarding postures to adopt and postures to avoid based on the results obtained from the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) assessment [8]. Moderate to high-quality evidence has shown that MDT is superior to other rehabilitation interventions in reaching pain and disability seen with CLBP [8]. However, it may be quite expensive.
7. Mobilization and Manipulative Techniques in Physiotherapy- Mobilization of the specific part of the lower back affected is the goal while manipulative physiotherapy targets the specific point of pain. These techniques decrease pain and increases function. Studies show that though manipulation may be more effective, both are safe options [9].
8. Pilates- This exercise is centered on breathing, stretching, and controlled movement. It has been proven to have desirable clinical outcomes in CLBP management [10].
REFERENCES
1. Casiano VE, De Nk. Back pain. InstatPearls [Internet] 2019. StatPearls Publishing.
Link https://www.ncbi.nlm.nih.gov/books/NBK538173
2. Clark S, Horton R. Low back pain: a major challenge. Lancet. 2018;391(10137):2302. doi: 10.1016/S0140–6736(18)30725–6.
3. Hartvigsen J, Hancock MJ, Kongsted A. Lancet low back pain series working group. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137);2396–2367. doi: 10.1016/S0140–6736(18)30480-X.
4. Sitthipornvorakul E, Klinsophon T, Sihawong R, Janwantanakul P. The effects of walking intervention in patients with chronic lower back pain: a meta-analysis of randomised controlled trials. Musculoskeletal Science Pract. 2018;34:38–46. doi: 10.1016/j.msksp.2017.12.003.
5. Luomajoki HA, Bonet Beltran MB, Careddu S, Bauer CM. Effectiveness of movement controlled exercise in patients with non-specific low back pain and movement control impairment: a systematic review and meta-analysis. Musculoskeletal Science Pract. 2018;36:1–11. doi: 10.1016/j.mskp.2018.03.008.
6. Matheve T, Brumagne S, Timmermans AAA. The effectiveness of technology-supported exercise therapy for low back pain: a systematic review. Am J Phys Med Rehabil. 2017;96(5):347–356. doi: 10.1097/PHM.0000000000000615.
7. Wieland LS, Santesso N. A summary of Cochrane review: yoga treatment for chronic non-specific low back pain. Eur J Integr Med. 2017;11:39–40. doi: 10.1016/j.eujim.2017.03.003.
8. Lam OT, Strenger DM, Chan-Fee M, Pham PT. Effectiveness of the McKenzie method of mechanical diagnosis and therapy for treating low back pain: literature review with meta-analysis. J Orthop Sports Phys Ther. 2018;48(6):476–490. doi: 10.2519/jospt.2018.7562.
9. Coulter ID, Crawford C, Hurwitz EL, Vernon H. Manipulation and Mobilization for treating chronic low back pain: a systematic review and meta-analysis. Spine Journal. 2018;18(5):866–879. doi: 10.1016/j.spinee.2018.01.013.
10. Byrnes K, Wu PJ, Whillier S. Is Pilates an effective rehabilitation tool? A systematic review. J Bodyw Mov Ther. 2018;22(1):192–202. doi: 10.1016/j.jbmt.2017.04.008.
