Spinal pain can be from a number of different pathologies, injuries or impairments and should usually be triaged into three main categories:
- Serious pathology- fracture, malignancy, infection, etc.
- Nerve root pathology- radicular pain or radiculopathy
- Mechanical back pain- movement or lack thereof related spinal pain
The most common form of back pain is mechanical back pain that is seen in >90% of people. There are a number of treatment options and a combination of these favours a faster and more resilient outcome.
Spinal manipulation
Factors favouring: hypomobility during spring test, low FABQ scores (FABQW <19), hip internal rotation >35º.
Factors against: symptoms below the knee, symptoms that peripheralise with directional testing, increasing episodes of back pain, no pain on spring test.
Specific exercise or movement
Factors favouring: directional preference for extension or flexion, centralisation with motion testing, peripheralisation in direction opposite to centralisation movement.
Factors against: low back pain only, status quo with all movements.
Stabilisation
Factors favouring: hypermobility with spring testing, increasing episode frequency, three or more prior episodes.
At Sydney Muscle & Joint Clinic our approach is consistent, high quality and based on the best scientific knowledge. We deliver evidence-based physiotherapy, exercise physiology and chiropractic for a range of musculoskeletal conditions, which means you get an approach that is effective, safe, and efficient. Contact your local Penrith physio today.
