Dr. Poornima

THE PHYSICAL TREATMENT OF BACK PAIN

Physiotherapy, osteopathy and chiropractic treatment can all help to relieve back pain. All of these techniques involve manipulating parts of the backbone and some can involve exercise, massage and ultrasound therapy.All must be carried out by a suitably qualified professional. 

By correcting any underlying mechanical disturbances in the musculoskeletal system, manipulation can effectively relieve the pain and distress of back pain and minimize the need for drug treatment and the risks associated with this. However,manipulation is not recommended in some people, including pregnant women and people with osteoarthritis of the neck or osteoporosis of the spine. If manipulation is inappropriate for you then your GP will let you know.

It is important that you choose a physiotherapist, osteopath or chiropractor who is suitably qualified. There are a number of regulatory bodies in place to help you do this. By choosing  a therapist who is registered ,you are automatically ensuring that you receive the best standard of care. 

The first time you visit a therapist they will take a full medical history and ask you about your general health, lifestyle, and emotional state and family history. This may take an hour or so. Subsequent consultations will usually last about half an hour.

PHYSIOTHERAPY

Physiotherapy uses physical means (such as massage,exercise, heat or electricity) to maintain and restore your physical and mental well-being. It is an active rather than a passive treatment and is usually concerned with keeping your joints and muscles moving. As well as relieving back pain, physiotherapy can also be used to treat a large number of other common ailments like muscle sprains, sports injuries, incontinence,osteoporosis, depression and asthma. 

Physiotherapy is heavily based on the basic principles of medical science, and is therefore generally regarded as a conventional rather than a complementary kind of therapy. 

Physiotherapist working in all areas of the , private healthcare, industry and education, and physiotherapy is the fourth largest healthcare profession in the country.

The back bone or spine is made of a series of bones extending all the way from the neck (cervical) to the tail (coccyx). These joints, like others, are prone to inflammation, sprain and strain, some more than the others. The coccyx in particular is highly prone to inflammation and can lead to localized pain, which is very typical, with the pain in the tailbone. This is known as coccydynia. Read on to know more about this common condition.

What is Coccydynia?

1. Literally, coccydynia translates to tailbone pain.
2. It is characterized by a sharp, localized pain between the buttocks in the tail bone.
3. It is often caused by injury to the pelvic area or the tail bone.
4. Sitting and/or leaning against the buttocks make it worse.
5. Pregnancy, when the additional hormones relax on the pelvic floor, also leads to increased pain of the tailbone.

Diagnosis: The pain can be easily confused with other conditions like sciatica, fractured tailbone, tailbone infections like shingles, etc. However, for a trained medical person, the symptoms of tenderness and pain are quite diagnostic. Pilonidal sinus, fistula, pudendal Neuralgia is also same as Coccydynia and show same symptoms. 

 Management:

1. If there is a rash or inflammation, it needs to be evaluated further for additional problems.
2. Where possible, rest completely for a short period of time till the acute phase of pain subsides.
3. In case of injury, ensure there is no repeat injury to the same area.
4. Pain medications are used to relieve pain, where it is severe and intolerable.
5. In severe cases, cortisone injection may be given in the doctor’s office. In addition to pain relief, it may even take care of the underlying problem per se.
6. Avoid sitting for prolonged periods where possible.
7. After the acute phase is over, when sitting for prolonged periods, sufficient padding is advised. This could be in the form of pillows or padded seats.
8. Sleeping on the sides is difficult, so sleep straight. If required, take a pillow in the middle.
9. Physiotherapy is also helpful in some people who have repeat attacks. This helps in pain management and controlling acute phases. There are specific tailbone stretches, which should be done under supervision.
10. Walking is one of the many effective ways to keep the tailbone “unlocked”, which helps in getting rid of the pain and avoiding spasms of the muscles around the tailbone.
11. Best internal manipulation and pain management can be done with Coccyx exercise.

The time taken for healing of the tailbone depends on whether it is a simple bruise or a severe one. The former would heal completely in about four weeks, while the latter will take about 12 weeks. If you wish to discuss about any specific problem, you can consult a physiotherapist.