One of the most disabling and common ailments in our society today is back pain. In fact according to a top researcher, lower back pain is as common as headaches in modern society. A recent study showed that if you see your GP with your back pain, if he then refers you to a specialist, who then sends you for X-rays and MRI scans, the accuracy of diagnosis is 15-20%. A frightening yet little known fact. Unfortunately the principles of modern medicine mean that the medical profession cannot treat an injury without an accurate diagnosis; is there any wonder why the incidence of back pain has doubled every 10 years for the last 30 years? As you can imagine, the problem is made even worse when you have had back pain for some time. The problem is that when you have had an injury for more than 6 weeks, another part of your body will start to compensate so you can have new pains as your condition deteriorates. So you can actually end up with more than one injury due to the mechanical compensations, which makes diagnosis even more difficult. We need to shift the paradigm and look at back pain differently.
Scientists, called Biomechanists, have been looking at back pain quite differently for some time. They look at the mechanical causes of back pain rather than focusing on the pain itself. They have found that they get better results by managing the biomechanical causes than many in the medical profession achieve by treating the symptoms. In fact independent research has shown that if you see at Physiotherapist over a 6 week period for your low grade back pain, your average improvement will be around 39% in functional capacity (the capacity of your back to perform work). If however you were to perform an exercise programme to manage the mechanical causes of your back pain, your average improvement would be around 141%. A profound difference and one that cannot be ignored.
This biomechanical approach is rapidly taking over from the medical approach in popularity as a much more effective method of treating back pain.
The most interesting thing about this method though, is that patients can be shown how to use it to look after themselves. This reduces the risk of them becoming reliant upon an individual therapist or doctor, and interestingly their compliance with their exercises programme is higher too.
Of course no single method can be the panacea of all ills, but what we are finding is that if the mechanical causes are addressed, the pain can subside without treatment on the 'injury', whatever it might be. Sometimes treatment is also required, however, but often people find that once they've committed to an exercise programme addressing the causes of their pain, they are then more able to manage the problem themselves. Then if local treatment is necessary, it is more likely to be successful, as the mechanical causes are no longer present.
Lets look at one of the most important tests called the 4-sign. If any of you have internet access you can ‘Google’ Patrick Fabre test and you will find more information about it there.
The Test:
Start:
Sit on a chair or stool and cross one leg over the other as shown in the diagram fig 1.
Sit on a chair or stool and cross one leg over the other as shown in the diagram fig 1.
Test:Relax your knee donw to a confrotable posoition. Look at the height of your knee from the imaginary line running throuhg your other knee, running parallel to the floor. Your knee should be only 2 – 3” higher than this line. Now try the the other leg and see if there is a difference in knee height from the imaginary line when you compare each side.
Results:
There should be symmetry, with the right side range of movement the same as the left. As a guide, the distance from the knee to the imaginary line should be no greater than 2 – 3”. If you have asymmetry where one knee is higher than the other there are some exercises that will help.
Meaning:
If one knee is higher it means that there is a muscle in your hip that is tight or in spasm. This can limit the movement in your pelvis and in turn can put more pressure on your back, causing pain. A simple exercise to reduce the spasm in your pelvis can help the pelvis to move again, thereby taking the pressure off your spine.
