BETTER BACK PROGRAM
MOBILITY AND STABILITY with OSTEOPATHY AND PHYSIOTHERAPY
…working together to achieve better outcomes in the treatment of back and spinal pain
The Goals
- Prevent reoccurrences of pain and disability in individuals with episodic back pain
- Improve outcomes in individuals who suffer from chronic low back pain by decreasing pain, increasing function and minimizing long term disability.
The Challenge
- Two thirds of the population experience back pain at some time in their lives. (Anderssen,1999)
- Although back pain is episodic and 90% of patients recover at 6 weeks post onset many people have frequent reoccurences
- Forty percent of all back pain sufferers have reoccurrences within six months and up to sixty percent within one year. (Frymoyer, Pope, Costanza, Rosen Goggin and Wilder, 1980).
Who will Benefit?
- Current symptoms of spinal pain
- Postural dysfunction
- Chronic inflammatory disease
- Degenerative spinal conditions e.g. Osteoarthritis of facet joints, degenerative disc disease
- Pre and post back surgery with permission of MD
- Adolescent spinal pain and scoliosis
- Pelvic girdle pain / post abdominal surgery
Better Back Plan
Our program combines osteopathic and physiotherapy manual therapy, core stability exercises, postural and self management education.
Assessment
Initial assessments are completed by both an Osteopath and a Physiotherapist. Each assessment is one hour long, with treatments lasting 45 minutes.
All treatments are one on one with the therapist. One treatment per week for a minimum of 6 weeks is a standard plan for clients.
Outcome measures- the following are used pre treatment and at 6 week intervals.
· RMDI (Roland Morris Disability Index)
· Numeric pain rating
Treatment
Osteopathy
The goal of osteopathy is to restore mobility to all structures and systems of the body thus improving posture and spinal alignment. The spine as a mobile structure is prone to areas of hypo and hypermobility. Restricted or excessive joint mobility can increase the mechanical and compressive load on the spine.
During an osteopathic treatment we treat the entire spine and lower extremities to maximize postural alignment. Treatment also ensures mobility throughout the fascial and muscular systems. Research shows that osteopathy is effective in decreasing spinal pain, improving function, decreasing disability and medication use. (Andersson, Lucente, Davis, Kappler, Lipton & Leurgans (1999), Shaw (2006)
Physiotherapy
Physiotherapy treatment will consist of manual therapy, modalities, exercise therapy and postural, ergonomic and self management education. Exercises will focus on retraining of faulty movement and motor patterns, correction of muscular imbalances, and improving core stability and strength. Research has demonstrated evidence supporting muscle dysfunction and the benefit of retraining core stability. (Hides,1996, 2001)
PhysioPilates
PhysioPilates is an assessment based exercise approach to injury prevention and rehabilitation that focuses on motor control training to correct and treat movement and stability dysfunction. Individual and group exercise sessions will consist of exercises to improve posture, balance, core stability and strength. PhysioPilates is taught by our physiotherapists, who are also certified Stott Pilates Instructors.
REFERENCES
Andersson, G.B.J, (1999). Epidemiological features of chronic low back pain. Lancet, 345, 581-588.
Andersson, G.B.J, Lucente, T., Davis, A., Kappler, R., Lipton, J. & Leurgans, S, (1999). A
comparison of osteopathic spinal manipulation with standard care for patients with low back
pain. The New England Journal of Medicine, 341, 1426-1431.
Frymoyer, J, W., Pope, M.M., Costanza, M.C., Rosen, J.C., Goggin, J.E, Wilder, D.G. (1980).
Epidemiologic studies of low back pain. Spine, 5(5), 419-423.
Hides JA, Richardson CA and Jull GA 1996. Multifidus recovery is not automatic after resolution of acute, first-episode low back pain. Spine 21(23), 2763-2769.
Hides JA, Jull GA and Richardson CA 2001. Long-term effect of specific stabilizing exercises for first-episode low back pain. Spine 26(11), 243-248.
Licciardone, J. C. (2004). The unique role of osteopathic physicians in treating patients with low back pain. J Am Osteopath Assoc, 104(11 Suppl 8), S13-18).
Licciardone, J.C., Stoll, S.T., Fulda, K., Russon, D.P., Sim, J., Winn, W., et al. (2003). Osteopathic manipulative treatment for chronic low back pain a randomized clinical trial. Spine, 28(13), 1355-1362.
Lipton, J., Meneses, P., Martin, J., Mizera, A., Kappler, R., Brooks, J. & Parr, C. (2002). Improved pain score outcomes achieved through the cooperative and cost-effective use of physical (osteopathic manipulative) medicine in the treatment of outpatient musculoskeletal complaints. The AAO Journal, 26-32.
Moseley, G.L. (2002). Combined physiotherapy and education is efficacious for chronic
low back pain.
Australian Journal of Physiotherapy, 48, 297-302..
Shaw, S.A. (2006) The Effect of Global Osteopathic Treatment on Chronic Low
Back Pain. Unpublished Thesis. Canadian College of Osteopathy. Toronto. On.
van Tulder, M.W., Koes, B.W., Metsemakers, J.F.M.& Bouter, L.M. (1998). Chronic low back pain in primary care: A prospective study on the management and course. Family Practice, 15(2), 126-132.
Williams, N. H., Wilkinson, C., Russell, I., Edwards, R.T., Hibbs, R., Linck, P., et al.
(2003). Randomized osteopathic manipulation study (ROMANS): pragmatic trial for
spinal pain in primary care. Fam Pract, 20(6), 662-669.
