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Wisdom Physiotherapy
Whole-body treatment approach
Whole-body treatment approach


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Lower Back Pain Treatment
By Carin Penberthy, Physiotherapist

Lower back pain can be debilitating, not only from a pain point of view, but functionally can be very limiting and have a major effect on daily life and work activities.

Although some episodes of lower back pain can be self-limiting and resolve by themselves, physiotherapy can help achieve a faster recovery, with a reduction in pain and an increase in mobility and function, hopefully reducing the severity and length of the back pain episode. This will also assist in reducing the likelihood of future back pain episodes.

Physiotherapists are experts in the assessment of musculoskeletal injuries, especially spinal related pain. A thorough and detailed assessment will help to ascertain the structures responsible for your pain. At Wisdom Physiotherapy, your physiotherapist will help give you a better understanding of the structures that may be contributing to the pain and educating you why this has occurred, and what may be contributing to this episode. This will then assist in guiding you on management of this episode and further self- managing techniques to try to prevent future episodes.

Physiotherapy for lower back pain short-term goals are to reduce pain and inflammation, promote healing, restore range of motion and strength, and increase function. Long-term goals are to restore full function to your desired activities and get back to functioning safely. Education and an ongoing exercise program will help with trying to reduce the risk of recurrence.

Your physiotherapist will discuss the appropriate treatment plan and may involve:

- Joint mobilisation and manipulation
- Soft tissue massage
- Neural mobilisation
- Deloading taping techniques and postural supports
- Dry needling
- Stretching (both passive and active)
- Strengthening exercises
- Clinical Pilates

Advice on recommended positions and postures at home and during work
Optimising work station positions and manual handling techniques.
Stretching and specific strengthening exercises will speed up recovery from acute lower back pain by regaining the range of motion and strengthening the back and abdominal muscles. Exercise prescription must take into account the diagnosis and clinical presentation. Lower abdominal core strength programs facilitate important muscles that dynamically control and stabilise your lower back and pelvis. Depending on your muscle recruitment pattern, the physiotherapist will prescribe the best exercises for you. We find this is best done under our supervision in our Clinical Pilates studio.

Other treatment options with lower back pain may include:

- Over the counter (OTC) medication for pain relief such as panadol, aspirin and for inflammation such as nurofen, ibuprofen, are available. OTC medication may help with pain relief for muscle related pain. If it more related to disc problems or nerve compression may not respond to OTC medication.

- Prescription medication may be needed if OTC medication hasn’t helped. Non-steroidal anti-inflammatory medication (NSAID’s) may assist with reducing back inflammation and assisting in pain relief.

- Nerve pain such as sciatica from a bulging disc may also need corticosteroids and anaesthetic medication that may be injected to reduce inflammation. Corticosteroids may be injected intramuscularly, taken orally or under imaging.

So don’t put up with the pain, be proactive in your recovery and seek the expert advice from Wisdom Physiotherapy, we are here and can help!

To make an appointment with Carin, click here to book online today.
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Lower Back Pain – what is lower back pain and the likely causes?

By Carin Penberthy, Physiotherapist

The lower back is a complex structure made up of interconnecting bones, discs, joints,nerves, ligaments, discs and muscles working together to provide a base of support for the body. This complex structure is susceptible to injury and pain and needs to be stable, flexible and strong.

Lower back pain (lumbar pain) may present in a number of ways depending on the underlying cause. Symptoms of the pain may include a dull ache, shooting or piercing pain, or a burning sensation. Pain may be localised in the back or radiate into the buttock, groin, legs or feet. The individual may also experience pins and needles, numbness or paraesthesia in the buttock, legs or feet. The pain may also worsen by certain postures such as prolonged sitting or prolonged standing, or when moving such as walking, or from sit to stand.

Lower back pain is often categorised by type of onset and duration. Episodes of back pain may be classified as acute (0-6 weeks), subacute (6-12weeks), and if pain persists for more than 12 weeks is considered chronic.

Types of low back pain commonly classified into:

Mechanical back pain is primarily from muscles, ligaments, joints (facet joints) and is often associated with pain localised in the lower back, buttocks and groin.

Radicular pain (sciatica) involves nerve tissue that is either impinged or inflamed. This pain will often radiate into the buttock or down the leg. This pain is often described as a burning sensation, shooting pain and can be also be associated with pins and needles/numbness and sometime weakness in the leg.

Pain can also be classified as traumatic or sustained overload injuries. Traumatic may be when a person bends awkwardly to lift a heavy load, that tears or damages structures, or sustained overload injuries are more related to positional stress or postural fatigue that overloads the back structures over an extended period of time causing injury, dysfunction and resulting in lower back pain

The source of lower back pain is commonly:

- Muscle – muscle tissue pain may be a result of muscle strains, muscle spasm, and muscle imbalances
- Ligament sprains
- Joint pain is often a result of facet joint irritation, stiffness or dysfunction.
- Bulging discs, herniated discs or degenerate disc disease can all contribute commonly to radicular pain where nerve tissue is irritated or impinged. - - Discogenic pain can also cause muscle spasm and associated facet joint irritation.

Other sources of lower back pain may include lumbar spinal stenosis, osteoarthritis, infection, tumours, deformity/fractures, osteoporosis, inflammatory conditions such as ankylosing spondylitis or rheumatoid arthritis. Lower back pain may also be a secondary pain related to medical conditions in organs of the body such as kidney or pancreas.

Consulting with a Physiotherapist for a professional assessment and diagnosis, followed by early intervention, is the best way to recover from lower back pain. At Wisdom Physiotherapy Nedlands we treat the cause of your pain and also help to prevent recurrent episodes.
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Sshhh....sneaky photo of the team. I thought they all looked too happy not to share 😄
What makes five physios laugh?
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What are trigger points? Why are they so painful? Why do we feel the need to get rid of them?

A trigger point (a.k.a knots) located within the muscle tissue is a dense collection of sensitised muscle nerve fibres. They are usually found in tight muscles or the fascia surrounding it. There are two types of trigger points, active trigger points and latent trigger points.

An active trigger point is when the muscle nerve fibres gives out persistent, low grade dull aches. No wonder you are so dead set on getting rid of it! The sensitisation of these nerves is due to inflammation. Pain is the body’s way of asking us to pay attention to the area. Referred pain can also be caused by active trigger points. For example patients with low back pain, trigger points are most commonly found within the gluteal muscles (figure 1) or even quadratus lumborum (figure 2). Headaches can be referred from trigger points within the upper trapezius or levator scapulae (figure 3).

On the other hand, latent trigger points are only tender when pressure is applied. However both types of trigger points may cause movement restriction and weakness.

So, how does dry needling help? Click here to find out:
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From the French word “en-pointe” meaning the ballet dancer has to gracefully support their whole body weight over the tips of their second or middle toes while their feet are fully extended.

This action requires a high level of strength and control in the legs, feet, ankles, and core body.

As children progress through junior classes and begin to consider pre-professional studies, they reach a stage where teachers and parents will decide when they are ready to progress into pointe work. Before they do this, dancers should undergo a pre-pointe assessment to determine their suitability for this advanced technique. For young dancers, it can be fatal for their career if they are moved into pointe too early, as there is risk of injury. This includes Achilles Tendinopathies or stress fractures.

Our Physiotherapist Sandrine Vatinelle has experienced this trauma first-hand as a young ballet dancer in Paris. With her dancing background and fine-tuned Physiotherapy skills, she now provides thorough Pre-Pointe assessment for ballet dancers. She also creates specific strengthening programs using Clinical Pilates. Click on the link to find out more.
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Physiotherapist Sandrine Vatinelle in the studio today working on her core strength, stability and flexibility on the reformer. Find out more about Clinical Pilates here.
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Clinical Pilates at 37 weeks pregnancy. An excellent way to keep strong throughout your pregnancy.
#nedlands #hampdenrd #physio #nedlandsphysio #clinicalpilates #pregnancy #preggiepilates #trapeze #mindthebump #pregnancyexercise
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Which sports are best for your health?
Research reveals racquet ball games, swimming and aerobics are the most protective against death from cardiovascular causes. Why? Read more here...
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