One of the more frequent conditions we see at the clinic is Idiopathic Lower Back Pain. Idiopathic is just a fancy word for unknown.
Evidence Based Research conducted by the Massage and Myotherapy Association of Australia showed that there was a moderate level of success in the treatment of this condition with remedial massage.
So, what does that mean?
Lower back pain can occur without a real understanding sometimes of what exactly has happened.
One problem we see with just massage in treating lower back pain, is that the lower back is quite complicated, and one of the defense mechanisms of the body is muscles in the lower back going into spasm and in a sense protecting it from further damage. If you just massage the back in the acute or early stage, releasing those muscles you can get an issue with further spasms and pain as suddenly, the protection of those tight muscles is released, and the condition can worsen!
What do you do?
This is where it is important to have a skilled therapist who understands this predicament and can convey the need for not just massage alone to deal with the pain. Assessment is key, as well as liaising with other skilled healthcare practitioners if needed.
Firstly, we need to find out from the client what lead to the pain and evaluate movement or lack thereof. Have they taken medication, how have they helped themselves before they see you?
Treatment
In the acute phase, we treat the muscles surrounding the lower back like in the legs, middle of the back and the hips and sacrum.
Depending on the individual we would look at some myofascial release techniques to help the muscles directly involved or splinting – this is a slow sustained stretch, or the use of vacuum cupping is another alternative.
Depending on the circumstances we would check for Trigger Points in affected muscles – check the referral patterns and apply gentle stretching.
During the treatment we would need to be mindful of the position of the client as too long in a position, especially face down, and the back could lock up even more. Solution – we have a table that bends in the middle, so the client is comfortable and movement or stretches like gentle cat/cow or pelvic tilts.
Lastly, and probably most importantly, we would apply rock tape to the affected area. Why? Well, if you have just removed the body’s natural ‘bracing’ or splinting – it needs to be replaced with something to help hold it together until the inflammatory process can settle AND the client can do gentle strengthening exercises to rebuild the body’s support.
We would have a follow up treatment – usually 5 to 7 days after the first, evaluate and look more comprehensively at after care at home, or if no real change escalate to another healthcare practitioner.
Home Care
This really depends on the assessment and massage, but movement is key. To begin it is something as simple as short walks, then as the back starts to respond and inflammation decreases, we can look further into strengthening and stretching.
Please note this is a generalized and simplified plan. We look at each person individually as so many factors can influence the treatment and outcome. There is no blanket approach, this is just giving you an idea as to how we treat and how important it is to work with your massage therapist, massage alone is not the answer – we need YOU to be a part of your recovery.
