Back pain and injury is one of the most common injuries we see at REP Physio. Approximately 80-90% of us can expect to experience back pain at some point in our lives. You may be surprised to know that back pain is the leading cause of disability worldwide! As a result, back pain and sciatica (more on this in a moment) is one of the main reasons people seek out physical therapy and/or chiropractic care in Edmonton.
Fortunately, the majority of back pain episodes (even if severe) resolve within 6 weeks, with most resolving in just a few weeks! Read on to find out more about back pain and sciatica.
Back Pain and Sciatica
Sometimes, back injuries can also be associated with and/or cause sciatica. Sciatica is a general term used to describe pain and/or dysfunction stemming from the sciatic nerve. The sciatic nerve travels from the lumbar spine down the leg and into the foot. Below is a list of typical presentations for sciatica and back pain without sciatica.
Sciatica
- Pain in one (typically) or both legs (rarely) that extends past the knee
- Numbness, tingling, or a burning sensation in the leg
- Muscle weakness or heaviness in the affected leg
- Leg pain that increases when sitting down (typical of a herniated disc)
- Leg and/or back pain even at rest
- Healing timelines 3-6 months (or more)
Low Back Pain (aka benign mechanical low back pain) without sciatica
- Associated with a traumatic event (i.e. lifting something to heavy or awkwardly)
- Pain localized to the lower back and or buttock
- A dull achy pain
- Pain that does not radiate past the knee
- Pain that is movement/positional dependent
- No numbness or tingling, leg weakness
- Heal in 6 weeks or less
Injury to the sciatic nerve is typically due to a bulging (herniated) disc.
The sciatic nerve can also be pinched or compressed due to bony overgrowth in the spine or compression to the nerve along its course by adjacent structures. Sciatica can also be caused by severe trauma, such as a motor vehicle accident that causes significant injury to the lumbar spine.
Underlying conditions can also cause sciatica, such as some cancers. Again, as mentioned above a key difference between sciatica and an episode of low back pain is that sciatica usually presents with pain or dysfunction that extends below the knee.
Key points to remember when experiencing an acute episode of lower back pain or sciatica
- Imaging (X-Ray, ultrasound, MRI) is rarely needed, especially in the first 6 weeks of injury. In fact, images will rarely show the “cause” of the pain. Our expert physiotherapists at REP Physio will be able to determine if your injury is one of the rare cases where imaging is deemed appropriate for clinical management.
- Finding one particular cause or structure to blame for back pain is difficult, if not impossible. Other factors, including sleep quality, stress levels, beliefs about pain, previous history of injury etc., can all factor into your pain presentation.
- Back pain is not caused by something being “out” or “out of place”
- More back pain does not equate to more damage. Often, your back is just “sensitized” due to minor sprains and strains. Movement may be painful at first, but overtime the pain will decrease and your movement will improve.
- Bed rest is not helpful. Even if it hurts it is important to try to stay active. While you may need to avoid some movement for the first few days, taking a passive approach to your pain is not recommended and can lead to poorer outcomes.
- Back injuries, including sciatica, rarely require surgery. In most cases non-surgical management results in good outcomes.
- Back pain is rarely a medical emergency. However, if your episode of back pain is associated with changes to bowel and bladder habits (incontinence) or if you experience numbness and tingling into the groin area and/or sexual dysfunction, it is best to get checked out ASAP to ensure there is not too much pressure on the spinal cord (Cauda Equina Syndrome), a condition that typically requires surgical intervention. Additionally, if your sciatic pain or back pain is associated with unexplained weight loss also see your doctor to rule out cancers. Fortunately, this is rare.
Determining your treatment plan
Treating low back pain and sciatica at REP Physio in Edmonton begins with a thorough subjective history. Your physiotherapist will ask you questions about how the injury occurred and what your current symptoms are. We will also ask for a detailed medical history.
Most importantly, a subjective history allows us to get to know you. Once we understand your unique needs and circumstances, we will be better positioned to design an appropriate care plan. This is why at REP Physio we offer extended one on one treatment times. By taking the time required to get to know you, we can better understand how your injury is impacting your life, and design a care plan that best meets your needs.
The subjective history is followed next by the clinical exam. During the exam, you can expect your therapist to assess how your body moves. This can include testing your strength and reflexes, as well as performing a variety of orthopaedic and neurologic tests to help rule out medical red flags, and best determine the likely root causes of your pain.
Following your assessment for back pain and sciatica, your physiotherapist at REP Physio will ensure you have a thorough understanding of your clinical presentation. After all, if you don’t understand what is going on with your body, then you will not be empowered to get better. We will then discuss a variety of individualized treatment options to help you towards your rehabilitation goals.
Treatment options for back pain and sciatica
REP Physio is proud to offer multiple treatment options for back pain and sciatica. Following a clinical assessment, your physiotherapist will work with you to design a treatment plan that meets your unique needs and goals. Treatments for low back pain and sciatica at REP Physio in Edmonton may include any of the following:
- A therapeutic exercise plan (the foundation of your care)
- Leg and/or lower back stretches
- Manual therapy of the lumbar spine
- Intramuscular Stimulation and/or Dry Needling and/or Acupuncture
- Traction
- Massage Therapy
- Education about pain management
- Suggestions for modifications of your work station if appropriate
- Referral to other allied health providers if deemed medically appropriate (dietitian, physiatrist, pedorthist, physician etc.)
Don’t break your back for relief
At REP Physio in Edmonton, we make it easy for our clients to find relief from back pain and sciatica. With extended one on one treatment times and an experienced multi-disciplinary team, you can start feeling better today REP Physio!
Not sure where to start? Call us at 780-244-1095 or 780-395-9170. You can also reach out to our physiotherapists directly via email. A link to their bios can be found here.
