4 part series on low back pain – Part 4B: What to watch out for when seeking treatment

Read below for some hot tips, so you get the most out of your treatment.

1. Be careful of radiation exposure with what investigations you are told to get. 

  • As mentioned in the previous post, CT scans should only be done if absolutely necessary. They are cheaper for you than an MRI. However, CT scans are very high dose radiation. Be careful! 
  • MRI is a popular investigation of choice for the lumbar spine. This is because it provides lots of information on both soft and hard tissue structures. The good news is that there is no radiation exposure with MRI. However, you are typically out of pocket by about $300.
  • Xrays are helpful to show us the boney alignment of the spine. If your pain is in the lower back, then you only need an Xray of your lower back. Getting an Xray for the entire spine is usually unnecessary.
  • Most commonly, your referring practitioner will be able to get the most valuable information from getting you to have both an MRI and Xray.  

Left: An MRI of the lower back, showing the integrity of the lumbar discs.

Right: AN Xray of the lumbar spine. 

 

 

 

 

 

2. Your pain should improve with treatment!

  • You should not get an increase in pain after a session with your physio, chiro, acupuncturist or massage therapist. If your pain does increase, make sure you let your practitioner know.
  • If your pain is not improving after a few sessions, change practitioners or see your doctor (or Sports Physician). Either they are doing the wrong treatment for you or have not diagnosed you properly. Don’t keep going back just because!
  • As your pain improves, treatment should reduce. Don’t let any practitioner tell you that you need 3-4 treatments per week for 12 months. That is costly and unnecessary! Instead, your treatments may start at once (max twice) per week and as your symptoms improve, treatments should gradually reduce to once per 2-3 weeks. 
  • The most shocking warning I need to tell you is this… don’t be conned into making an upfront payment for 12 months worth of treatment, involving 3-4 sessions per week. Read the above dot point again.. treatment needs to be reducing as your symptoms improve not staying the same.

3. Be careful of some ‘out there’ wording that some practitioners use. 

  • No your spine cannot ‘be out of alignment’ and no it can’t be ‘popped back in’. Don’t let these terms scare you. 
  • And nor can your spine change position on X-ray after a few treatments.
    • Don’t let a practitioner take an Xray of your spine, do some treatments and repeat the Xray claiming that they have ‘straightened’ your spine. We have normal curvatures of our spines that are there for a reason (see the picture below).
    • Research shows that the position of a joint (measured using an Xray) does not change before and after a joint manipulation (i.e. crack).  
    • Instead, to improve the posture of your spine, be sure to keep working on your strength, flexibility and posture. For more information on how to do this, get along to a Physiotonic class today. Visit www.physiotonic.com.au to register. 

 

Above: the normal curvatures of the spine. 

 

There is one final blog past on this 4 part series to low back pain. Keep reading for more information on the ultimate answer for managing low back pain. 

About Physiotonic

Physiotonic are expert Sports Physiotherapists who run group exercise classes. We focus specifically on buttock muscle strengthening, deep core activation and flexibility. This will help you improve your posture. We specialise in helping runners to improve their running technique and running efficiency. The Physiotonic blog has posts on all sorts of health and fitness tips to help get you on your way!

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