What’s causing my back/leg pain (what’s my diagnosis)?
Back pain (+/- leg) is a symptom, not a diagnosis. There are number of causes of back pain. Sometimes a clear diagnosis is present where specific damage to a nerve indicates disc injury. However, much more commonly, back injury arises as a result of overloading/straining an intervertebral joint and/or surrounding muscle. There are a confusing array of terms, diagnostic labels and treatment options which often leads to confusion about managing your back pain.
The three main contributors to back pain are (1) structural (patho-anatomy) components , (2) movement-related factors and (3) psycho-social factors. Each person is different with varying structural, movement and environmental contributors combining to create back/leg pain.
The first part of diagnosis is to determine where the pain is coming from (the structural source of the pain) and then the second part is to determine why. Your Superspine clinician help explain what is happening to you, your likely ‘diagnosis’, and then navigate through the ‘why’ factors.
Do I need imaging of my back?
There are widely divergent points of view about the role of imaging. The current view is that imaging is only used when someone fails to improve with conservative treatment such as physiotherapy and exercise. Sometimes imaging is used sooner if there is a suspicion of something unusual or if nerve damage is present. Traditional XR imaging techniques provide only very basic detail and are now mostly used when a fracture is possibly present. Magnetic resonance imaging (MRI) is currently the best choice due to better definition of nerves, intervertebral discs, bony changes and even muscle, and with less radiation than a CT scan.
We manage back pain with short, medium and long term strategies in mind
Our approach to managing back pain consists of finding a working diagnosis, and navigating people towards recovery that is individualized and relevant. We start with a short term strategy, using exercise and manual therapy (“hands-on” type techniques) to reduce pain. However medium and longer term strategies based around restoring function, strength and fitness are often necessary to return people to full health and minimize recurrence. Medium and longer term strategies are required if your pain is persistent or re-occurring.
The first step is pain relief. Our clinicians have mentored training on the most effective manual therapy (‘hands-on’) techniques, such as mobilisation, massage, dry needling and manipulation. These techniques primarily aim to reduce pain and improve movement but are only the first step in developing a recovery strategy.
The second step is exercise-based and is designed around your personal preference. If your injury is short lasting with full recovery you may only need to resume normal activities. If your pain has not fully settled, has become recurrent or persistent, you are likely to benefit from of exercise (although the type of exercise will vary from person to person).
The third step is building an independent exercise program. This can be done either in the Superspine Gym, at a local gym/pool, in a physio-led exercise class or even at home.
Individualized Exercise strategies
Superpine uses a targeted exercise program to optimize function and prevent recurrence. However this is not a “one size fits all” concept. There are many different types of movement related issues that require different types of exercise. Some people need strengthening, some need relaxation, some people are too stiff, and a few are too mobile. The one thing that is true for most people with back pain is that they will benefit from some type of exercise. At Superspine we have a number of exercise strategies that include:
- Hydrotherapy and swim programs
- Pilates (reformer, trapeze and mat work)
- Specific exercise targeting mobility and/or strategic muscle groups
- DAVID strength assessment and training system (see more….)
- Cardio exercise