There are so many different causes of low back pain that a paragraph or two does not do the subject any justice at all. No two people presenting with back pain are alike, but the cause of their symptoms may be similar. It is the responsibility of the physiotherapist to determine the specific nature of the pain–ie: its source, the reason for the injury (if not obvious), and other factors that might be contributing to the pain. For instance a truck driver who sits for 8 hrs straight, then starts to unload a flatbed is at risk of giving herself a disc injury. The cause of the pain is an injury or sprain to the disc, which may have been initiated by the prolonged sitting, and finally sprained after using a poor lifting technique.
The most common low back injuries are to the discs, facet joints, nerves, and muscles. Understanding the ‘what’ is only part of the solution. Knowing the ‘what’ and ‘how’ to the injury guides the type of treatment chosen by the physiotherapist.
This diagnosis refers to pain that is originating from irritated nerves, and is a subgroup of conditions that effect the spine. Usually it describes an irritation o f the part of the nerve as it exits the spine. If it occurs to one of the nerves in the low back, it is called sciatica. If in the neck, it is referred to as a cervical radiculopathy. The exact cause of a radiculopathy can vary, but the end result is pain and numbness/tingling that radiates into the arm or leg in a specific pattern. Special tests can usually determine the spinal level of the nerve irritation.
Neck conditions are also varied. Mechanical neck pain is really just an indication of the region of the painful symptoms. The causes of neck pain are multiple, and could be postural, occupational, genetic, degenerative, and so on. Treatment is also dependant on the history and clinical findings.
Shoulder Tendonitis, Bursitis and Impingement – These conditions are the most common causes of local shoulder pain. The causes are many, including faulty biomechanics related to posture, overuse, sudden strain or a fall, and degeneration. The treatment will depend on the cause(s) identified on the exam.
The sacroiliac joint(s) are part of the pelvis. There is one on each side where the sacrum forms a joint with its respective iliac bone. Anatomically they are located under the two dimples that can sometimes be seen just above the buttocks. These joints should always be considered as a possible source of pain when the low back is involved, even though they cause pain much less frequently than the lumbar spine. Commonly they become painful during or after pregnancy and require some form of stabilization with a combination of exercise and external support.
Tennis Elbow – This common problem is often (but not always) related to the neck. It is associated with repetitive activity and is considered to be a repetitive strain injury or RSI.
Ankle Sprain – As with knee injuries, ankle sprains are almost always related to trauma. The nature of the sprain depends on the direction/magnitude of the force vector.
Plantar Fascitis – This painful heel condition is usually characterized by increased pain when taking your first couple of steps in the morning. The tissue known as the plantar fascia starts to break down. The cause is not always obvious, and usually a thorough physical examination and consideration of all biomechanical factors is required. After this is done, a reasonable approach to management is implemented.
TMJ – Temporomandibular Joint Dysfunction
What are the signs and symptoms of TMJ dysfunction? Pain is the most common symptom of TMJ problems, although not everyone gets pain.
Symptoms can include:
- Pain in the jaw joints and facial muscles
- Clicking, grinding or locking of the jaw
- Headaches & Dizziness
- Difficulty opening or closing the mouth comfortably
- Pain on talking, chewing (especially hard food) & yawning
- Ear pain, ringing in the ears (tinnitus) & hearing loss
There are many musculoskeletal conditions that are too numerous to mention on this web page. If you have a problem that may or may not be helped with physiotherapy, ask your physician or call our hotline. If we still can’t tell whether or not you would derive benefit with treatment, we would advise booking for an assessment of your physical complaint at which point your therapist will tell you whether this is a problem that would be helped with physiotherapy.