Lower back pain, particularly idiopathic lower back pain (ILBP), is a prevalent and frustrating issue. In Auckland and worldwide, the pain associated with ILBP has emerged as a significant concern. Pseudoradicular lower back pain is often categorised as ILBP as in many cases of it is impossible to find the underlying disease causing the pain. It is described as lower back pain that radiate distally into the legs. Pseudoradicular pain remains above the knee and is often linked to localised disorders without any direct impact on the nerves or their roots this is not to be confused with Radicular pain, a common type of lower back pain that journeys below the knee and is believed to be a result of issues related to nerve root compression. ILBP is difficult to manage creating a lot of grief and frustration for those suffering from ILBP.
However, innovative treatments like Shockwave Therapy offer new evidence-based treatment options for sufferers. So let's take a closer look at ILBP and understand how Auckland Shockwave Therapy, working alongside Movement Mechanics Osteopathy, is able to leverage the therapeutic benefits of Shockwave Therapy to combat ILPB.
Unravelling Idiopathic Lower Back Pain (ILBP)
ILBP is lower back pain without sciatica, stenosis, or pronounced spinal deformation and can afflict any age group. This non-specific pain is second only to the common cold as the most common affliction of mankind and is among the leading complaints bringing patients to clinics worldwide (Hoy et al., 2010).
The Vast Impact
The repercussions of ILBP are profound:
It's a primary reason for disability among individuals under 45 (Hoy et al., 2014).
Acute ILBP can span three to six weeks (Delitto et al., 2012).
The lifetime prevalence surpasses 70% in many developed countries (Hoy et al., 2012).
Active adults, even those not seeking medical intervention, witness a 10-15% annual incidence (Hoy et al., 2010).
Addressing ILBP: Challenges and Conventional Treatments
Treating ILBP presents unique challenges:
Identifiable causes are often elusive.
Systemic diseases as underlying factors are infrequent.
Many back pain incidents are unforeseen and unavoidable.
Proven treatments for ILBP are relatively few.
Historical treatments span bed rest, NSAIDs, acetaminophen, muscle relaxants, and, in specific scenarios, surgery (Chou et al., 2017). Management of patients with ILBP is challenging with many of the analgesic effects associated with conventional treatment choices for non-specific low back pain being small.
Auckland Shockwave Therapy: A Fresh Perspective
Shock wave therapy (SWT) is a non-invasive therapeutic modality that has been applied in various medical fields, from urology (to fragment kidney stones) to orthopedics and rehabilitation (to treat musculoskeletal conditions). In recent years, the application of Radial Shockwave Therapy (RSWT) for managing pain, especially idiopathic lower back pain, has gained increasing attention.
Working alongside Movement Mechanics Osteopathy, we've integrated a multimodal approach of shockwave therapy and osteopathic hands-on treatment for the treatment of lower back pain due to the minimal risks and promising outcomes seen in our clinic.
The Goals of Shockwave Therapy for ILBP
Decrease the pain
Restore mobility
Hasten recovery so the patient can resume normal daily activities as soon as possible
Prevent development of a chronic recurrent condition
Restore and preserve physical and financial independence and comfort
Side Effects & Considerations
Every treatment has its considerations. With RSWT:
There might be discomfort during or after the session.
Some may experience skin reddening or swelling.
Mild numbness over the treated area is possible.
However, these are typically temporary and dissipate swiftly (Gerdesmeyer et al., 2008).
How SWT influences the body to produce an analgesic effect on idiopathic lower back pain
Mechanical Stimulation:
The fundamental mechanism of shock wave therapy is the delivery of a series of acoustic waves to the target tissue. These waves create microtraumas or microdisruptions in the tissues.
Neurological Effect:
The microtrauma caused by SWT has been postulated to reduce pain by overstimulating the nerve fibers in the treated area, leading to a temporary reduction in local nerve transmission— a phenomenon described as "gate control theory." By interrupting the pain signals sent to the brain, the patient experiences pain relief.
Increased Blood Flow:
SWT promotes neovascularization, which means the formation of new blood vessels. With increased vascularization, there's improved blood flow to the affected area. Enhanced blood flow brings about faster oxygenation and removal of waste products, which facilitates healing and pain relief.
Reduction of Muscle Tone & Spasms:
Shock wave therapy has been shown to reduce muscle hypertonicity and spasticity. This reduction helps in relieving the musculoskeletal pain associated with muscle strains, which often accompany or exacerbate idiopathic lower back pain.
Cellular Level Effects:
SWT stimulates cellular activities, particularly among mast cells. Mast cells play a crucial role in the inflammatory process. Their activation can accelerate tissue regeneration and repair.
Dissolution of Calcified Fibroblasts:
Calcium build-up can be a result of microtears or minor injuries in tendons. SWT can disintegrate these calcified fibroblasts, thereby helping alleviate pain.
Release of Substance P:
Substance P is a neurotransmitter and modulator that is associated with inflammation and pain. SWT can lead to the release of Substance P from the treated tissues, which, over time and with repeated treatments, depletes the local concentration of this substance, leading to a decrease in pain.
Collagen Production:
Collagen is essential for repairing damaged structures. SWT stimulates collagen production, which aids in the repair process and in the strength and integrity of the tendons, ligaments, and other musculoskeletal structures.
Summary of Shockwave Therapy for Lower Back Pain
Through a combination of neurological, vascular, cellular, and mechanical mechanisms, shock wave therapy offers a multifaceted approach to treating idiopathic lower back pain. By promoting healing and interrupting pain signals, SWT provides both immediate and long-term analgesic effects.
It's worth noting that while many patients benefit from SWT, individual responses can vary, and it's essential to consult with healthcare professionals to determine if SWT is the right treatment for a specific individual. For Auckland residents grappling with ILBP, Movement Mechanics Osteopathy remains committed to pioneering treatments, including Shockwave Therapy. Those seeking relief should explore the transformative potential of this therapy in Auckland.
Jonathan Hall M.Ost, GradDipHeal, BAppSci (HB)
Jonathan Hall is the founder and principle Osteopath at Movement Mechanics Osteopathy, a fully qualified Osteopath and currently studying Western Medical Acupuncture out of AUT New Zealand.
Chou, R., Deyo, R., Friedly, J., Skelly, A., Hashimoto, R., Weimer, M., ... & Brodt, E. D. (2017). Nonpharmacologic therapies for low back pain: A systematic review for an American College of Physicians clinical practice guideline. Annals of internal medicine, 166(7), 493-505.
Delitto, A., George, S. Z., Van Dillen, L., Whitman, J. M., Sowa, G., Shekelle, P., ... & Godges, J. J. (2012). Low back pain. Journal of Orthopaedic & Sports Physical Therapy, 42(4), A1-A57.
Gerdesmeyer, L., Frey, C., Vester, J., Maier, M., Weil, L., Weil, L., ... & Muehlhofer, H. (2008). Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis. The American journal of sports medicine, 36(11), 2100-2109.
Hoy, D., Brooks, P., Blyth, F., & Buchbinder, R. (2010). The epidemiology of low back pain. Best practice & research Clinical rheumatology, 24(6), 769-781.
Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., ... & Buchbinder, R. (2014). The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases, 73(6), 968-974.
Hoy, D., Bain, C., Williams, G., March, L., Brooks, P., Blyth, F., ... & Buchbinder, R. (2012). A systematic review of the global prevalence of low back pain. Arthritis & Rheumatism, 64(6), 2028-2037.
Comments