Low Back

We now understand how the low back gets hurt and injured and how it becomes degenerative. Shearing forces in the lumbar spine are created, thereby changing its stability. Through this knowledge, our evaluations are more thorough and treatment plans for low back pain and/or radiculitis are more specialized. Today, there is more awareness regarding how the psychological and social aspects along with bio mechanical issues impact pain. Biomechanical and fascial relationships have been well documented and proven; and they are part of our pain evaluation process.

A proper low back exam would include a complete assessment of biomechanics of the lower quadrant, as well as the assessment of the lumbar spine, pelvis, glutes and trunk. It is also necessary to understand the lower cross syndrome and its dynamics on low back pain due to biomechanical dysfunction. Most acute low back pain is generated by muscle spasms and/or sacroiliac joint dysfunction. There are usually precipitating incidences or factors. These issues are usually superimposed upon a biomechanically susceptible body with its muscular weaknesses and imbalances of the lower trunk, pelvis and legs.

Most incidences of low back pain are caused by muscle spasms related to muscle imbalance and biomechanical dysfunction. However, there could also be more significant radicular symptoms and MRI findings. Dallmeyer’s treatment plans address all these issues in a comprehensive fashion

However, there can also be underlying MRI and x-ray findings of the lumbar spine, such as degenerative disc disease, osteoarthritis, facet syndrome, spondylosis, spondylitis, and spondylolisthesis of varying degrees. These diagnoses are quite often symptomatic due to significant shearing forces in the lumbar spine secondary to pelvic weakness, lower extremity imbalances and daily biomechanical dysfunction. In these cases, surgery and/or anti-inflammatory injections may be needed. We often work with patients receiving anti-inflammatory injections or have undergone surgery. We work hand-in-hand with pain specialist to help patients restore movement, stability and strength.

The underlying philosophy of treatment that we incorporate here at Dallmeyer Physical Therapy is based on this biomechanical and dynamic research of Stuart McGill (http://www.backfitpro.com) and Dr. Chris Powers. However, we also combine this approach with proper movement function restoration from the teachings of Vladimir Janda, MD, DSC, whose emphasis is on movement retraining, movement patterning and overall proprioceptive facilitation.

For patients who present with radiculitis, we assess them via the Mackenzie Method (also MDT = Mechanical Diagnosis and Therapy), which also uses movement as treatment. Patients are taught a series of self-treatment strategies that have been demonstrated to give long lasting relief of back pain.

We also specialize in hands-on techniques for myofascial restoration and postural integration to help restore proper balance in the lower quadrant. This hands-on specialization comes from the teachings of Ida Rolfe and her emphasis on the pelvis as the keystone of the body and its relationship to the lower extremities and hips. World renowned clinician lecturer, and author Thomas Myers, has effectively demonstrated the great impact of the facial system on symptoms. Through his anatomical work he has provided another tool to extend the Rolfing approach.

Although, pain control via injections is being widely used in the field today, our rehabilitative approach can team up with other techniques for pain relief. Most people can resolve their low back pain and restore their function with careful physical rehabilitation, which can be very progressive and non-painful. Treatment plans mostly begin with myofascial release and postural integration. This approach is based on the mechanisms of pain and the ability to help the patient control their level of pain. After this, we move into restoring proper movement patterns and strengthening techniques.

At our clinic we often use our Med-x machine for back strengthening. This machine isolates and helps restore strength for the multifidus, and thoracic and lumbar longissimus muscle groups of the lumbar spine. These major muscle groups help stabilize the lumbar spine and thus decrease sheering forces.
Low back pain can be difficult and debilitating, but is treatable as described above. The pain from a degenerated lumbar spine and/or hip can be overwhelming, yet managed. The degenerative spine is a sign of increase sheering forces and physical stress. However, a treatment plan can be developed to change movement patterns and decrease the negative dynamics on the spine; ultimately promoting healing and decreasing pain.

Furthermore, by understanding how the low back is injured through destructive sheering forces and, pelvic/lumbar spine instabilities, we can also explain how to prevent future incidences. There are several areas to focus on, such as flexibility, muscle balance, functional movements, and proper lifting techniques. By addressing all of those through education, exercise, and hands-on work, we are able to give our patient the tools they need to restore their function and prevent further incidences from occurring. By understanding one’s individual movement patterns and how to maintain stability at the lumbar spine (through strength in the trunk, abdomen and glutes) one is able to help protect the lumbar spine and eliminate ongoing sheering forces and/or deterioration.

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Dallmeyer Physical Therapy Treats Low Back Pain