Low Back Pain – Adam Mann
Mark: Hi, it's Mark from Top Local. I'm here with Adam Mann, Insync Physio in Vancouver consistently, currently rated one of the top physiotherapists clinics in Vancouver as voted by their customers, the people who count the most. And we're going to talk about that low back pain. Adam's going to talk about a client of his, that injured themselves. How they injured themself?
Adam: So came on kind of out of nowhere they were cycling, for about 50 kilometers on the weekend. And then they felt this sharp pain in their back the next morning. and it was pretty sharp, but the thing that was really bizarre about this pain is it actually caused a shooting pain down into the heel of her left side.
And so it was pretty short and it was different than other back pain that she's had in the past. And she's had back pain in the past, but this was something new where there was this kind of zinging, electrical feeling down into the foot. So, she was quite scared and she went to the doctor and the doctor referred her to physio.
Mark: So how did you go about assessing the injury?
Adam: So, yeah, we started with a thorough assessment. We basically, again, did a nice history where we talked about, what caused this. And so again, it kinda came out of nowhere, but we found out that she did have back pain in the past, but usually it was just in the lower back and never shot down in the past.
I found out that actually she was born genetically with an extra vertebrae in her back, meaning an extra spinal segment and that's different, but it's normal. It's considered just a normal thing. Isn't something that would have caused that pain necessarily.
What we found out is where the numbness and tingling, where that zinging pain in the leg was. That gives us a clue where that possible nerve could be compressed. So it gave us a bit of a homing signal where we should focus our assessment. Nerves if we think about them. So tingling and zinging pain is usually a sign of a nerve injury and so nerves perform three things. They do reflexes, muscle strength and they do sensation.
So we tested all three of these components and we just basically compared, the reflexes sensation and the muscle strength to the other side, to find out what was normal for her. The thing that we did differently in the way I approach back pain is I actually really want the spine to move.
So I look at the range of motion pretty carefully. And this is a, this is a different style of assessment. It's called The Mackenzie Method or MDT. And we use it for diagnosis and treatment. And basically it's a very safe method where we get people to perform some repeated spinal movements. So we find out if their spine has a preference to go in the direction of backwards or forwards, or if that increases or decreases some of the numbness or tingling sensation.
We look at if sitting is aggravating or if I'm walking is aggravated. So basically we find different ways how their spine likes to move, and doesn't like to move. And so with these repeated movements, we found out that actually this person, liked a flex spine. So we found a certain type of motion that her spine responded to.
And how did we find that their spine responded that way? It was basically, the pain stays relatively constant at first, but the location of the shooting pain moved closer to the spine. So it wasn't necessarily in this case that the pain or the shooting sensation went away entirely, but it was closer to the area where there was a problem. If that makes any sense.
Mark: So tell me some more about that. How does that work?
Adam: So basically if we can get the pain closer to where the spine is, that's called centralization in this McKenzie Method. And basically at that point, we can really focus in on the joints that might be dysfunctional or the muscle tone or the pelvis position, some of these other components and deal with it.
If we find emotion, alternatively, that makes the pain in the foot stronger or more intense then we can sort of get a clue that that is emotion, that the spine doesn't like, but that further aggravates pain. And the reason why we do this is at the end of the day, back pain, although we can get people pain-free and get them moving much, much better, it tends to come back. So if someone is doing something that's pretty explosive or snowboarding, and if they haven't done it in a long time, they haven't been keeping up with their exercises. It tends to come back. I'm not sure if that's just why they call it the back, but, this is a good way for us to find how each spine likes to be moved and what exercises we can give them so that they can self manage some of these problems on their own.
So basically when we found that this person liked to flex spine, we gave them some exercises that basically would get their spine into a more flexed position. And it would take away the pain. And so once the pain got under control and that shooting electrical pain was in the spine area, we actually could work on other things. Like joint mobilizations, how this position, like I just sort of talked about and of course, core strengthening.
Mark: That sounds really good. So any final points you want to make? How did this end up for the client?
Adam: So basically this person is back to full activity and we talked a little bit about return to full activity looked like, cause they really like cycling. So, if they're going to go for a longer cycle, they have a routine of exercises that they do basically right before it. They keep up with some strengthening components that we give them, you know, that they have to do at least once a week, maybe twice a week.
And if they do those things, their back pain is pretty well under control. They don't have any of that shooting, electrical sensation anymore. And they're able to return to full activity, which is snowboarding, cycling, and climbing. And they live a very active, happy life. So basically, the idea is that this Mackenzie Method is a fantastic way for addressing back pain because it gives the clients some self management tips. Like I mentioned before, and then they also have a bit of self awareness.
They know if they're going to do something in particular, like walk for a long distance or get their spine in a position where their spine doesn't like it, they can avoid it or they can prepare for it.
Mark: There you go. If you're looking for some relief for your back pain and especially, if you're willing to take some responsibility and maintain it, the guys who can really help you with a course that not only takes the pain away, but helps keep you pain free as much as is practically possible. Back pain is the number one problem that people have in terms of pain in their bodies.
Adam: It is Mark.
Mark: So this is really important and I'm sure lots of people who are watching this have encountered this in the past. I certainly have. Adam Mann, at Insync Physio, you can check him out at their website, insyncphysio.com. Give him a call in Vancouver, (604) 566-9716 to book or in Burnaby (604) 298-4878 to book. You can also book online right on their website. Thanks Adam.
Adam: Hey, have a good one.