Low back pain: A physical therapist’s perspective

Low back pain: A physical therapist's perspective

Low back pain: A physical therapist’s perspective

When patients who are suffering from low back pain come to physical therapy for the first time, the two most frequently asked questions are, “Why was I referred to physical therapy when my MRI shows joint or disc abnormalities?” and “Don’t I need an MRI so you know what is going on?”

Both questions are very reasonable. After an MRI reveals a disc bulge or protrusion, many patients feel that a referral to a physical therapist is the equivalent of having your mechanic tell you to continue to drive your car and see if your flat tire improves. Frankly, both scenarios can feel ridiculous.

Thankfully, the human body is not like a car. Multiple studies in the last few years have shown that the farther a disc extrudes or protrudes, the more likely your body is to reabsorb the disc with time.(1,2) In other words, disc healing is a very real and normal occurrence.

MRI and X-ray Abnormalities

As we age, we can develop abnormalities that can be seen on MRI and X-ray. For example, in studies of patients without low back or neck complaints, about 30 percent of patients in their 20’s have disc bulging and degeneration.

The percent of abnormalities increases with age and by the time an individual is in his or her 80’s the prevalence of these abnormalities is greater than 80 percent.(3) Remember, these abnormalities are in patients without pain.

While there are times when surgery is needed to address low back pain, outcomes are significantly improved when abnormalities in imaging correspond with the expected complaints of the patient and positive clinical findings.

Watch the video below to learn more about how physical therapists can often treat lower back pain without surgery.

Low Back Pain Treatment

When developing a treatment plan for low back pain, it is important to realize that a one-size-fits-all approach is not appropriate. In other words, some movements and treatments that help one patient may not be effective for treating your low back pain.

Research has shown that subgrouping patients based on their history and clinical findings improves outcomes.(4) We do this first by getting a good history of the patient’s symptoms, screening for potential red flags, assessing neurologic involvement (how is his or her sensation and strength), and then determining movement or directional preference.

Movement preference is part of a spine examination where you complete range-of-motion exercises in particular planes of movement to determine how these motions affect your pain sensitivity or symptom location. Once movement preference has been determined, evidence-based therapeutic exercise and manual therapy are used to reduce pain sensitivity and restore previous mobility.

After the first visit to physical therapy, you should have a better understanding of what movements or postures are affecting your pain and what you can do immediately to improve symptoms. In each subsequent visit, response to treatment is reassessed and joint mobilizations, manipulation, soft tissue mobilization, and other various manual techniques along with progressive therapeutic exercises are utilized to further decrease pain sensitivity and movement limitation.

While the time it takes for symptoms to resolve varies, most patients should be able to see a benefit in their pain with physical therapy after the first few visits.


Nelson Caudill

Nelson Caudill is a physical therapist with KentuckyOne Health.

  1. Zhong M, Liu JT, Jiang H, et al. Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis. Pain Physician. 2017;20(1):E45-E52.
  2. Chiu CC, Chuang TY, Chang KH, Wu CH, Lin PW, Hsu WY. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil. 2015;29(2):184-95.
  3. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol 2015;36:811–6
  4. Fritz JM, Cleland JA, Childs JD. Subgrouping patients with low back pain: evolution of a classification approach to physical therapy. J Orthop Sports Phys Ther. 2007;37(6):290-302.

KentuckyOne Health hosts upcoming health fairs

KentuckyOne Health News and Events

KentuckyOne Health News and Events

Jewish Hospital Shelbyville Hosts 18th Annual Men’s Health Fair on June 2

Shelbyville, Ky. (May 11, 2018) – Jewish Hospital Shelbyville, part of KentuckyOne Health, will hold its 18th annual Men’s Health Fair on Saturday, June 2, 2018.

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Saint Joseph London Hosts 17th Annual Maternity Fair

London, Ky. (May 17, 2018) — Saint Joseph London, part of KentuckyOne Health, will host its 17th annual Maternity Fair on Friday, June 1 from 5:30-8:30 p.m.

Read full article

 

Working your body for a better you

Working your body for a better you

Eat less. Move more. You might have heard this or seen this written at your doctor’s office. It does sound like a simple prescription for wellness, right? But we all know it’s easier said than done.

Busy lifestyles keep us from stopping at the gym, playing sports or even walking around the neighborhood. But research is telling us fitness activities are more important than ever for physical, mental and even emotional wellness. Making them a priority is possible with a little planning and thought.

Regular physical activity increases your chances of living a longer, healthier life. For children and adolescents, it improves muscular fitness, bone health and heart health. For adults it can help with sleep, lower the risk of heart disease, type 2 diabetes, and some types of cancer. Being active also helps with emotional and mental health, by helping to manage depression and anxiety.

Here are some ways you can make “moving more” a fun part of your life.

For families:

  • Consider making a charity 5K walk part of your family’s next holiday or summer plans before heading for the cookout or family meal. Everyone can participate at their own pace without pressure and get some steps in while having fun.
  • While your child plays soccer or basketball, don’t pick up that cell phone and scroll Facebook. Use that time for a mini-workout by walking the perimeter of the field or court during practices or games.
  • Explore the outdoors by visiting a state park or hiking area. Most offer trails of varying lengths and family-friendly options. To make it more fun for kids, let them participate in picking the location or trail.
  • Make it a new habit to go for a group bike ride or dog-walking after dinner.

Just for you:

  • Finding an exercise buddy increases your chances of showing up for regular exercise, whether it’s at the gym or walking in the park or your own neighborhood. Having someone to chat with while you walk or work out makes it a social outing as well.
  • You’re not too old to play sports. Dust off your racket and join a tennis league or sign up for a volleyball team. You don’t have to be good; just have fun moving your body.
  • Instead of meeting a friend for dinner or drinks, meet at the park for a catchup session. Dinner can wait for a bit.
  • Replace a coffee or lunch break with an outdoor walk or walk a few flights of stairs to get your heart pumping.
  • Swim at your local recreation center. Instead of just sunbathing or watching the kids play, walk the length of the pool in the shallow end back and forth a few times for a light resistance workout.

Ways to be active are only limited by your imagination. Health benefits abound for people of all ages, backgrounds and abilities, but be sure to consult your doctor if you haven’t been active in a while. Start slowly and build up.

A common mistake some people make is to take an all-or-none approach and fail by putting too much pressure on themselves. Don’t try to work out five days a week if you are just starting or getting back into physical activity; you’ll burn out or get injured. Remember, even a little activity is better than none.

With just little changes in your lifestyle and attitude, you can reap big health benefits from being active. If you think about it, you have nothing to lose, and everything to gain.

Looking for a great family-friendly event that gets you moving and also helps you give back to your local community? Sign up for the Yes, Mamm! 5K. Learn more about the race and then register today!

A few goals to help keep your weight loss on track

A few goals to help keep your weight loss on track

Are you considering or have you undergone weight loss surgery? If so, then it’s likely you’ve thought about personal milestones or goals you would like to achieve on your journey to living a healthier you.

During our bariatric support groups, we often talk about realistic goals and tips as we cheer each other on during this life changing experience. Below are a few goals that will have you thinking beyond the number on the scale and directly impact your health!

Eat Enough Protein

When it comes to your diet, Rule #1 is “eating enough protein.” Eating a diet rich in protein can help reduce hunger, improve your immune system and build strength. Your provider or dietitian can work with you to determine how much protein you should consume daily. Even if your bariatric surgery is long behind you, it’s a good idea to be aware of your protein intake to be sure you’re reaching your daily goal.

Drink More Fluids

Lose more weight, stay fuller and prevent dehydration fatigue and headaches by getting enough fluids. The goal for most adults is to drink at least 64 ounces of water, or rather fluids, each day. If you find yourself struggling to reach this goal, here are a few tips:

  • Create a visual reminder of how close you are to reaching your daily goal by filling up four, 16-ounce water bottles (or a 64-ounce pitcher) and make sure you finish them by the end of the day.
  • Get high-tech and set up a hydration reminder that syncs to your smartphone.
  • If plain water is too boring, try adding lemon or mint for a little flavor without the added sugar. Low-calorie flavored water, decaf tea and coffee can also be good choices when it comes to reaching your 64-ounces-a-day goal.

Find a Friend

Make it one of your goals to not go it alone. A friend can provide that extra encouragement and motivation that we all need some days. If one friend is good, more friends are better – the more the merrier when it comes to finding help and support with eating right, exercising and reducing stress.

Go to the Doctor

If you are considering weight loss surgery, it’s easy to see why going to a doctor is necessary. But you shouldn’t only be scheduling an appointment with your surgeon. Whether pre-op or post-op, seeing your primary care provider and any other of your regular doctors can help you get healthy and stay healthy. By routinely going to your doctor, you can actively monitor important health and wellness measures, like blood sugar and cholesterol levels. Together with your physician, you can also create action plans for any other conditions, such as knee pain or sleep apnea.

Take Your Vitamins

There is no substitute for a healthy diet, but a healthy diet is not always enough. If you’ve had weight loss surgery, a multivitamin may be part of your daily routine. Talk to your surgeon or doctor about any vitamins you should take and then be sure to take them as recommended to prevent nutritional deficiencies. Remember, staying nourished can also help you lose weight by keeping up your energy levels and metabolism.

Smile

And finally, make it a goal to smile more. Smile when you greet people. Smile when you say goodbye. Smile when you are talking and listening. Smile for no reason at all. Why? Because the very act of smiling can help convince your mind that you are happier. Plus, smiling at other people will make them more likely to be friendly to you, which in turn will make you happier. All that extra happiness can make it easier to do your daily duties, like eating right and working out!


Jessica Gies

Jessica is a registered dietitian with KentuckyOne Health Weight Loss & Surgery Associates.

Learn More About Irregular Heartbeat [Infographic]

Learn More About Irregular Heartbeat [Inforgraphic]

Learn More About Irregular Heartbeat [Inforgraphic]

Heart arrhythmias occur when there is a change to the normal sequence of electrical impulses that coordinate heartbeats. This can result in the heart beating too fast, too slow or irregularly, which can affect whether blood is being pumped effectively within the body.

Learn more about the symptoms and risk factors of heart arrhythmia below. If you begin experiencing these symptoms, it’s important to seek medical attention immediately.

Colon Cancer Risk Factors and Warning Signs

If you are experiencing an irregular heartbeat or palpitations, schedule an appointment with a health care provider or learn more about available health screenings