Low Back pain.
My approach to low back pain has always been different. I am frustrated with patients being prescribed long courses core stability, pilates, yoga, massage, manipulation or chiropractic or osteopathic treatment with no clear measures of change, or indeed timeline.
We published an innovative paper in 2015 showing how strength training in a squat and deadlift can within 16 weeks improve pain, movement and sleep with a twice a week gym based program. I will ask you to lift weights, progressively heavier with good instruction to give you more capacity to do the things you want to do with clear goals in terms of strength gain, pain reduction and improved function. We are focused on fat infiltration of the back muscles, a sign that the muscle is not working at its capacity and we have shown that 30% of this is positively changed in 16 weeks of strength training and correlates well with reduction in pain and improvement with function.
Of course, getting the diagnosis is very important and an MRI of the spine allows us to reassure ourselves and you that there is no wedge fracture, pars fracture or other pathology, but disc bulges, facet joint osteoarthritis and modic changes are all common and we use these to help you understand your back, and confirm the things you can do rather than the things you cant.
A small proportion of patients flare up when starting the program and in those cases we will consider a CT guided nerve root injection to reduce pain, allowing you to progress with the training. You will work in a gym local to you with digital follow up, and we will set clear targets from our SSC Lab, so you will know the weights we want you to loft and how to get there. We will test your strength and power and use 3D imaging to look at how you perform tasks such as standing and lifting, to guide your individual program
Understanding how you lift weight, divide the load and carry out tasks such as sitting and standing and lifting, can help us understand how best to manage your rehabilitation program. It may need more rotation or extension, and we want to give you clear targets on % bodyweight we want you reach in your training.
Spine Lab lets us do just that – measure using 3D biomechanics, your body’s ability to cope with challenges, and give you clear objective data, to…you guessed it… train at the gym towards. This should reduce the cost of your rehabilitation, fewer sessions, and give you the confidence to train