Many people like you and me are affected by lower back pain. Why is that? Well, the reasons for that are:
Lack of mobility
Lack of flexibility
Muscle weaknesses
And our low physical activity lifestyle due to monotonic office jobs.
With Manual Therapy as a therapeutic approach, you can get rid of your lower back pain, especially when you combine it with exercises and, in some cases, Kinesiotape application (which is a flexible, elastic tape used to support muscles and joints, reduce pain, and improve blood circulation without restricting your movement).
What is Manual Therapy for Low Back Pain in Simple Terms?
Manual Therapy for lower back pain involves hands-on techniques to reduce your pain and improve your mobility. In this therapy approach, the focus is placed on soft tissue restrictions, joint dysfunctions, and muscle imbalances in your body. If applied correctly Manual Therapy leads to a significant reduction of pain and an improvement in your overall ability to move. (For more information about Manual Therapy in general, you can visit our related blog post here).
Which Techniques Are Used in Manual Therapy for Lower Back Pain?
Different techniques are used in Manual Therapy for lower back pain. In the following, I want to show you four of them:
1. Soft Tissue Release for Lower Back Pain Treatment
This technique focuses on breaking down adhesions, which are areas in your muscle fibers and fascia that become stuck and tight - do you feel a painful point when your palpate one of your muscle right now, does it feel tight? Yes? Well, then that's probably an adhesion!
If those adhesions are broken down, muscle and joint function are improved. Common methods for soft tissue release include:
Deep Transverse Massage: A deep, cross-fiber massage that targets the muscle to get rid of stiffness.
Instrument-Assisted Soft Tissue Mobilization (Hooking): This technique targets muscle attachments to join, muscles and tendons, helping relieve joint tension and prevent conditions like osteophytes (bone spurs) or osteoarthritis (a degenerative joint disease)
Visceral Mobilizations: These techniques address low back pain linked to pelvic or intestinal inflammation, often following surgeries like C-sections or gynecological procedures. Can be also because of gut disorder as lucky gut syndrom or dysbiosis. The manipulations used are external and painless manipulations and help to relieve adhesions and reduce inflammation.
2. Muscle Release Technics for Chronic Back Pain
Muscle release technics aims to relax your overstimulated or hyperactive muscles. This is done by targeting the nerve that is causing overstimulation of the muscle. By reducing the nerve signal, we allow the muscles to release and relax. Here are some of the techniques:
Strain-counterstrain or Jones technic: Here, the therapist (like me :-) ) moves the body into positionswhere the muscle tension is minimized. Puting a finger in a strategic location on the muscle, the therapist relieve pain and decreasing muscle tension.
Trigger points: These are specific spots in the muscles that are hyperactive or painful, and the therapist applies pressure or other techniques to release the tension.
Here is a quick self-experiment: Use the thumb of one hand, and press firmly into the fleshy area between the thumb and index finger of the opposite hand (the webbing between them). Keep pressing it for 20-30 seconds, yes it should be painful. After that release. Does it feel better?
And finally Fascial inhibition: Targets the fascia (the connective tissue surrounding muscles) to facilitate the sliding of muscle fibers between them and thus reduce restriction in movement.
Let's continue with another technique used in Manual Therapy:
3. Joint Manipulations for Lumbar and Pelvic Alignment
Joint manipulations for lumbar (the lower part of the back) and pelvic (the ring of bones between the hips) alignment involve hands-on techniques where a therapist like me uses controlled, precise movements to adjust and realign joints in the lower back (lumbar spine), pelvis (iliac bones), and sacroiliac joint (where the spine and pelvis meet).
The goal is to restore your joint positioning and movement. Misalignments in these areas can lead to pain, restricted mobility, and tension in surrounding muscles. By realigning the joints, pressure on nerves and surrounding tissues is reduced which leads to you experiencing less pain.
And finally:
4. Neurodynamics for Sciatica and Nerve Pain
Neurodynamic techniques help to mobilize trapped or irritated nerves, such as the sciatic nerve (the largest nerve in the human body!). Restoring nerve mobility can get rid of symptoms like sciatica - which is the pain, weakness, numbness, or tingling that you feel in your glutes and/or the back of your thigh.
Diaphragm and Pelvic Floor: Their Crucial Role in Low Back Pain
An imbalance between the diaphragm (major muscle of respiration) and pelvic floor muscles can be the reason for chronic back pain. Most often, the diaphragm becomes hyperactive, while the pelvic floor weakens. Manual therapy can help release the diaphragm and restore balance by teaching patients proper breathing techniques. Strengthening the pelvic floor with exercises like hypopressive abdominal techniques also supports lumbar stability. Hypopressive abdominal techniques are a type of exercise designed to strengthen the deep core muscles (transversalis muscle), and the pelvic floor muscles, by reducing intra-abdominal pressure. These exercises involve specific breathing patterns in combination with postural position to activate the core without traditional muscle contraction (like crunches or sit-ups).
There Are Also Some Complementary Therapies You Can do to Manual Therapy for Lower Back Pain Treatment:
Posture Correction
Improving posture through ergonomic adjustments at your workplace and in your daily activities can significantly reduce your back pain. For example:
Adjusting your desk setup
Using supportive chairs
Practicing proper lifting techniques (e.g., for groceries, children)
Strengthening Exercises for Lower Back Pain Relief
Targeted muscle strengthening should accompany manual therapy for low back pain management. Your main focus should be on:
Transverse abdominal muscles
Gluteal muscles
Postural muscles
Good examples of exercises are: Planks, bridge exercises, and stretches. Additionally, hanging from a pull-up bar can help decompress the spine and ease tension.
Heat and Cold Therapy for Inflammation
Alternating heat and cold applications can increase blood flow and reduce inflammation, which further supports your lower back pain treatment.
Lifestyle Adjustments for Your Long-Term Low Back Pain Management
Sleep and Hydration
The intervertebral discs regenerate and hydrate overnight, meaning quality sleep is essential for your back health! Also, ensure proper hydration to support the process.
Stress Management
High stress levels can lead to muscle spasms, causing by magnesium deficiency and elevated cortisol. Managing your stress can help reduce these muscle issues.
Anti-Inflammatory Diet
Incorporating an anti-inflammatory diet can help reduce the systemic inflammation that contributes to your chronic back pain.
So in summary: By incorporating manual therapy, targeted exercises, and lifestyle adjustments, you can effectively manage lower back pain and improve your overall mobility and function.
In the best-case scenario, you include posture correction, muscle strengthening, and stress management to provide lasting relief and prevent future back pain from happening in the first place!
If you experience back pain or pain in your body in general, feel free to get in touch with me!
PS: Here are some exercises for you that you can try at home to prevent back pain from happening:
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