In our last blog (Why Do I Get Back Pain) we discussed some common reasons as to why we get back pain. The good news is that with the right treatment, managing and often even curing, back pain is absolutely possible. Let's now focus on the available treatment methods.

Clinical Pilates and Real Time Ultrasound

Clinical Pilates helps to strengthen the lower back core muscles (muscles which support and stabilize the lower back). When these muscles are strong any load placed on the back when lifting, bending etc goes through these muscles rather than the back. Hence the back remains protected.

The only way to ensure that the core muscles are being activated correctly is to assess them using Real Time Ultrasound. This way both the physio and the patient will be able to see the core muscles in action on the ultrasound screen and the therapist will be able to educate the patient on how to ensure that these muscles are working properly.

Why is this so important? Because if this step is overlooked then it's easy to give the patient wrong exercises - ones that are either too much or not enough for that particular person. If the exercises are too high level for that person's core strength then the core muscles won't cope and the load will go through the back. The result - increased back pain. If, conversely, a person who has quite good core strength is given exercises which are too gentle then the core muscles won't be sufficiently challenged and consequently their strength will not increase. While the back pain might not increase as a result neither will it improve as well as it would if the core muscles are given an adequate exercise intensity.

Another big goal of Clinical Pilates is to help improve our posture. This is particularly important if the reason for the back pain is the "postural syndrome" - pain caused by incorrect posture.

McKenzie Method

The McKenzie method is a highly effective treatment method for disc and facet joint pathologies. It utilizes specific stretches in order to either stabilize the disc (for disc pathologies) or take the pressure off the facet joints (for facet joint irritation).

Clinical Pilates works very well together with the McKenzie method. The McKenzie method assists in reducing the pressure on the disc/taking the pressure off the facet joints; Clinical Pilates, consequently, helps to strengthen the core muscles which aids in reducing the likelihood of future recurrences of the back pain.

Electrotherapy

Here we use the term "electrotherapy" loosely to include the following modalities:

• interferential therapy
• ultrasound
• SCENAR therapy
• drug phoresis
• magnetotherapy

These treatment modalities are highly effective if the back pain is quite acute. Their primary mechanism of action is improving the local blood circulation which helps to bring in more oxygen to the affected area. This, in turn, helps to accelerate the healing process. They also have a very good analgesic and anti-inflammatory effect.

It's important to note, though, that exercise is always the long term treatment approach and is most effective when it comes to maintaining the treatment effect and reducing the likelihood of future flare ups. Electrotherapy, however, is can be very helpful in managing the symptoms to make it easier for the person to carry out the exercises. These two treatment avenues can often have a very good synergistic effect.

General Physiotherapy

Other treatment options can include:

• mobilizations
• traction
• soft tissue massage

These can also help to settle down the symptoms and are often used in combination with electrotherapy.