Back Pain

Ryan LaCorte Treatments

Back Pain is one of the leading causes of disability in the Unites States.  It is estimated that 80% of today’s population will experience low back pain at some point during their lifetime.  Most cases resolve within a few months, while others tend to linger, and become chronic.  There are many mechanisms for low back pain ranging from muscular strains, arthritic changes, congenital abnormalities, sacroiliac dysfunctions or disc related injuries. Unfortunately, Low Back Pain is commonly reoccurring and will affect individuals multiple times throughout their lifetime.   Below we will highlight common mechanisms for low back pain.

Herniated or Bulging Discs

The lumbar spine is comprised of five lumbar vertebrae separated by discs, and culminating at the Sacrum.  The discs of the lumbar spine tend to be very pliable, allowing for motion between vertebral segments and acting as a shock absorber.  A disc is comprised of two parts; the Annulus Fibrosis and the Nucleus Pulposus.  The Annulus Fibrosis is the outer portion of the disc.  It is comprised primarily of collagen fibers, and creates a tough circular exterior of the disc.  The Nucleus Pulposus is the inner portion of the disc and is loose network of fibers contained in a gel like substance.  At birth, the disc is comprised of 80% of water, however this reduces throughout your life time due to stresses placed upon the disc.

In a bulging or herniated disc, the Nucleus Pulposus (Central Portion of the Disc) begins to press into the Annulus Fibrosis causing the disc to bulge, crack or tear.  As this injury occurs, the body responds through an inflammatory process in hopes of helping the disc heal.  Unfortunately this greater irritates the situation, and can create pressure on a nerve root and possibly result in pain down the leg (sciatica.)  Fortunately, the body is very good at controlling the inflammatory response from bulging discs.  90% of sciatic symptoms will reduce within 6 weeks regardless of intervention.  However, Physical Therapy can help to shorten the effects of a herniated or bulging disc through extension based exercise and/or treatments to control muscular responses and restore mobility.

As stated earlier, most individuals with low back pain will experience multiple episodes throughout their lives.  Through physical therapy, we are able to reduce the frequency and duration of such symptoms through core stabilization exercises in conjunction with targeted stretching and patient education.  All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

***For more information, please see the article titled “The McKenzie Method in the Treatment of Low Back Pain” written by Kyle Kaye in our publications.

Degenerative Disc Disease

Another common cause of low back pain is Degenerative Disc Disease.  As stated earlier, at birth the discs are comprised of approximately 80% water.  Through wear and tear as well as a life time of loading and compression on the discs, this percentage drops as we age.  The discs will have a tendency to become more fibrotic and less pliable over time.  While we are unable to “pump” the discs back up, through Physical Therapy we are able to help the body adapt to the structural changes that have occurred over time.  Through postural training including core stabilization as well as exercises to maintain muscle and joint flexibility, we are able to help restore prior levels of function while controlling pain.  Your physical therapist will perform a thorough evaluation to devise a treatment plan to best address your symptoms.  All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

Spinal Stenosis

As Degenerative Disc Disease sets in, there will be less spacing between vertebrae creating a smaller space for nerve roots to exit the spinal canal, resulting in Spinal Stenosis.  Most commonly, spinal stenosis refers to the narrowing of the intervertebral foramina (space where nerve root exits the spine.)  However, some cases of spinal stenosis can create a narrowing of the central canal surrounding the spinal cord.  This will generally be referred to as central canal stenosis.  This can be secondary to congenital defects (ankylosing spondylitis) or thickening of spinal ligaments encroaching upon the spinal cord.  Through physical therapy, we can help to restore proper postural alignment through core stabilization exercises as well as reduce any restrictions related to limited flexibility or joint motion.  Your physical therapist will perform a thorough evaluation to assess your condition, and devise a treatment plan to best address your symptoms.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

***For more information, please see the article titled “What is Spinal Stenosis” written by Joseph Scrudato in our publications.

Spondylosis or Facet Joint Arthritis

The change in structural alignment secondary to the reduction in disc height can also create irritation, and breakdown of the facet joints (joints linking one vertebrae to the next.)  The breakdown of the joint is referred to as Spondylitis or facet joint arthritis.  Spondylitis is a breakdown of the cartilage in the facet joints of the spine.  Through physical therapy we can greatly affect these conditions by reducing the inflammatory response, and restoring joint motion. As noted earlier, arthritic conditions will generally go through inflammatory phases.  In physical therapy we are able to help control and reduce inflammatory responses while restoring health to the joints.   Your physical therapist will perform a thorough evaluation to assess your condition, and devise a treatment plan to best address your symptoms.   All of our facilities are equipped with state of the art modalities, and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

 Low Back Strain or Sprain

Acute low back pain frequently involves a muscle strain, or sprain of supporting structures of the lumbar spine.  Twisting, bending and lifting can frequently over burden the muscles and support structures of the low back, and create tissue damage.  Through physical therapy, we are able to reduce acute low back pain through soft tissue mobilization, stretching, and joint mobilization techniques along with the modalities and topical analgesics.  These interventions can expedite recovery and return you to your prior level of activity.  Your physical therapist will perform a thorough evaluation to assess your condition, and devise a treatment plan to best address your symptoms.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs. Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

Osteoporosis/Osteopenia

Osteoporosis, and Osteopenia are conditions characterized by a loss of bone density, decreasing bone strength, and increasing the risk of facture.  The most common population affected by osteoporosis, and osteopenia are post-menopausal women.  Due to changes in estrogen production, the body fails to produce the necessary amount of new bone mass required to maintain strong, and healthy bones.  Many risk factors are uncontrollable, including age, family history, race (more common in Asian, and Caucasian population), and body frame size.  Other risk factors within our control include tobacco use, excessive alcohol consumption, diet lacking calcium, and sedentary lifestyle.   The most commonly areas affected by Osteoporosis and Osteopenia are the spine, wrist, and hip.  Fortunately, there are now many interventions to help slow the progress of Osteopenia and Osteoporosis, and over time reverse bone density loss.  Medications, along with an appropriately designed exercise program can have a significant effect on the progression of Osteopenia and Osteoporosis.  Through physical therapy, we are able to target the structures most commonly involved with Osteopenia and Osteoporosis, and load these structures to stimulate the growth of new bone.  The human body is an amazing organism that will respond to most stresses placed upon it.  By safely increasing the stresses on structures affected by Osteopenia and Osteoporosis through well designed exercises we are able to not only slow bone density loss, but at times, reverse it.  All of our facilities are equipped with state of the art modalities, and equipment to meet your needs. Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

***For more information, please see the article “Fighting Osteoporosis through Physical Therapy” written by Michael Yorke in our publications.

*** For more details on treatment of Osteoporosis and Osteopenia, see our Specialty Treatments.

Compression Fracture of the Spine

Compression fractures of the spine occur most commonly in individuals with Osteoporosis and Osteopenia due to low bone density.  As an excessive load is placed on a weakened bone, the result is the bone cracking or collapsing.  In the majority of cases this occurs in the vertebral body of the thoracic and lumbar spine.  Most compression fractures are stable, however result in severe pain and possibly structural changes of the spine creating postural abnormalities.  Physical therapy plays a great role in not only the treatment of compression fractures but also the prevention of compression fractures. Initially, the goal is to control pain levels following a compression fracture through soft tissue mobilization as well as pain relieving modalities.  Through patient education we can help patients avoid high risk positions and motions leading to compression fracture.  We can additionally help to elongate tissue to control postural abnormalities and reduce compression forces on the spine.  Finally, we will design an exercise program to help to safely load bone tissue to stimulate new bone growth. Your physical therapist will perform a thorough evaluation to assess your condition and devise a treatment plan to best address your symptoms.  All of our facilities are equipped with state of the art modalities and equipment to meet your needs. Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

***For more information, please see the article “Fighting Osteoporosis through Physical Therapy” written by Michael Yorke in our publications.

***For more details on treatment of Compression Fractures, please see our Specialty Treatments.

 Post-Surgical Care

Many conditions involving the low back are appropriate for surgical intervention.  Whether you underwent a Fusion, Laminectomy, Disc Replacement, Spacer, Discectomy, Vertebroplasty, Kyphoplasty or minimally invasive or micro procedure, your therapist will work hand in hand with your surgeon to expedite recovery and reduce pain levels.  Effective post-operative care following low back surgery is essential to maximize surgical results.  Your therapist will help the body to heal as well as prevent future injury from occurring.  Your physical therapist will perform a thorough evaluation to assess your condition and devise a treatment plan to best address your symptoms based upon the surgeon’s post-operative orders.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

Sciatica/Radiculopathy

Sciatica, or Radiculopathy is a term used to describe pain that radiates down the leg or arm due to nerve irritation, compression, traction, or injury.  There are many injuries that result in sciatic pain.  Common injuries include a herniated or bulging disc, arthritic conditions of the spine, nerve traction injuries, sacroiliac dysfunction or piriformis syndrome.   Through a thorough evaluation your therapist will uncover the mechanism behind your radiculopathy or sciatica and devise an effective treatment approach to reduce you symptoms and restore your prior level of activity.    All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

***For more information, please see the article on Sciatica written by Paul Eberle in our publications.

Sacroiliac Joint Dysfunction (SI Joint)

The Sacroiliac joint is the point where the base of your spine, the sacrum, meets the pelvis.  This is a common site for pain to originate due to the excessive stresses placed on these joints.  Symptoms associated with Sacroiliac Joint Dysfunction can include low back pain, point specific tenderness along SI Joint and/or pain radiating into the lower extremity.  Some individuals can present with inflammation and irritation along the SI joint due to either excessive or limited joint motion.  Through a thorough physical therapy evaluation, we will assess any abnormalities or obliquities in SI Joint positioning as well as assess muscular attachments.  Your therapist will develop a treatment plan to either stabilize or realign the SI joint through exercises and manual interventions.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

***For more information, please see the article “Low Back Pain?  Or Could it be Your Sacroiliac Joint?” written by Christina Gilson in our Publications.

Piriformis Syndrome

The piriformis is a muscle that externally rotates the hip (rotates the leg away from the body.)  It plays a significant role in hip stabilization as well motion.  In the majority of the population, the Sciatic never will run just below the piriformis muscle.  However, in approximately 10% of the population, it is believed that the sciatic nerve will run directly through the piriformis.  In these individuals, it is believed that the piriformis muscle, when injured, can constrict the sciatic nerve and create radicular pain down the lower extremity.  The piriformis muscle is a common site for muscle strain and injury.  When irritated, the piriformis can create buttock pain and at times tingling or numbness down the leg.  These symptoms can be controlled through physical therapy.  You physical therapist will utilize soft tissue mobilization techniques to control muscle spasm as well as gentle stretching exercises.  As symptoms resolve it is essential to ensure proper flexibility and strength in the piriformis muscle.  An exercise program will be designed to prevent future injury and restore prior level of activity.  Your physical therapist will perform a thorough evaluation to assess your condition and devise a treatment plan to best address your symptoms.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

***For more information, please see the article “Core and Back Pain” written by Katie Groome in our publications.

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