- Name – Kristy M
- Occupation – physiotherapist
- For how many years have you been treating back pain and related health issues?
- What is the most common type of back pain you see?
- Discogenic lower back pain is by far the most common
- Sacroiliac joint pain (mainly women)
- Occasional facet joint problems
- What treatments/advice do you most commonly prescribe/give to lower back pain sufferers? (please list or describe the top five)
- Usually (but not always) these people have forgotten how to stand and move properly and so we correct their compensations and weakness so that they know how to stand and move properly
- Transverse abdominus and pelvic floor activation (core stability) starting very basic!
- Don’t spend too much time in one position whether that be sitting or standing
- Do not lift and if you have to, engage your core muscles
- Stretch your calves, pecs and very gently you hip flexors and hamstrings (if there is no neurogenic pain)
- In your experience, how long (days, weeks, months, years, if ever) does it usually take for lower back pain to settle?
Very hard question as it so dependant on the individual and the individual problem. Acute can be days, but if its discogenic it is a chronic problem that needs future consideration in most situations. Can settle acute disc pain in 2wks but it will always be a pathology
- Do you give advice on how to prevent a recurrence of lower back pain, and if so, what does this advice generally consist of?
- Stay as fit and strong as possible- usually I will advise the type of exercise that suits there pathology and their bodies response to certain movements, pilates is always good
- Make sure you exercise and stretch at least 1x per day
- Stay away from aggravating factors i.e. lifting or vacuuming
- What sorts of aids do you most commonly suggest lower back pain sufferers purchase (back supports, different desk chair, massager, etc)?
- Different desk chair for sure
- Have also tried to get companies to make standing desks available
- I don’t find back supports are helpful as a huge part of rehab is getting the patients muscles to function properly again and not to rely on ligaments or supports
- In your experience, do none/some/most/all of the lower back pain sufferers you treat find alternating standing with sitting is one solution to help ease their pain, speed their recovery/return to work?
Yes most definitely all of the above. I highly recommend this as one of the most important pieces of advice and often patients will re-present with flared lower back pain due to prolonged sitting (driving to airport) or prolonged standing (in a line at the polling booth)
- If standing does help, what ratio of sitting to standing do you advise; and how do your clients achieve this (electric sit stand desk, laptop on the filing cabinet, other). Please give as much information as you can.
I believe that a 60-40 or 70-30 ratio of standing to sitting is preferable. It will lean further towards the standing once they have also dealt with the tightness issues around the hip. i.e. initially their hip flexors may be so tight that when they stand their pelvis is continually thrown into an anteriorly rotated position and this can flare up their back. Alternatively they may flatten their lordosis as a way of reducing their pain but this will irritate discs and they will end up in more pain. Eventually when these compensations, tightnesses and weaknesses are addressed, standing is more preferable. Some patients have been able to find standing desks but this is rare, the way they have been dealing with it is to move every ½ hr.
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