Lower Back

At Walker and Hall we know through personal experience how any condition affecting the lower back can have an enormous effect on every aspect of your life e.g., from caring for yourself and family, to work, to sports and leisure activities and even just on your concentration.

The most common types of lower back pain we treat are

Poor Posture
Stiff and Painful Lumbar Spine
Facet Joint Sprain
Lumbar Spine Slipped Disc
Sciatica
Spinal Stenosis
Spondylolysis
Spondylolisthesis
Sacroiliac Joint Dysfunction

If your condition is not listed above please contact us

We have extensive experience in treating these conditions and managing your recovery.

To see how Walker and Hall can help you please see below:

Poor Posture (also known as Postural Syndrome of the Lumbar Spine)

Postural syndrome of the lumbar spine is a condition where pain is felt in the lower back, but there is no significant damage or trauma to tissue, and you often only experience an ache or pain during the activities which place sustained stress on the normal tissue.

Anatomy

The mechanism of pain onset in postural syndrome can be demonstrated by gently bending your index finger backwards until you feel a stretch. At this point there is no tissue damage or pain, but if you maintain this position for long enough, your finger will gradually become painful and start to ache. Postural syndrome in the lower back occurs in a similar fashion and typically occurs due to sitting or standing in poor positions for prolonged periods of time.

When sitting in a slouched position your lower back goes into its maximal bend (similar to touching your toes). This places a considerable stretching force on the joints of your lower back and over a period of time will cause an ache or pain. Similarly, when standing in poor posture considerable stress is placed on the joints of your lower back and again this will gradually cause ache or pain if maintained for too long.

Signs and symptoms of postural syndrome of the lumbar spine

  • Pain – normally experienced as a dull ache in the lower back which may spread into the upper back and neck if the poor posture is maintained and often eases when the posture is changed or with gentle movement.

How can Walker and Hall help you?

A thorough musculoskeletal examination is required to determine which structure(s) in the lower back are causing the postural syndrome, although you may experience little or no pain once your posture is corrected.

This is essential if the optimum recovery is to be achieved and it is important that your posture is corrected during provocative activities in order to reduce the likelihood of recurrence.

Following the diagnosis a treatment plan is devised and discussed with you.

The types of physiotherapy treatment used at Walker and Hall for lumbar postural syndrome include

  • Postural education including the use of a lumbar roll for sitting – this is the most important part of the treatment plan, and as most people experience little or no pain once their posture is corrected, this may be all that is needed to fix your problem.
  • a home exercise programme to improve posture, flexibility, strength and exercise tolerance
  • joint mobilization techniques to improve the range of movements
  • joint manipulation techniques to improve the range of joint movements
  • soft tissue massage to reduce pain and muscle spasm
  • electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain and muscle spasm
  • the use of an appropriate pillow for sleeping
  • activity modification advice
  • anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist

Stiff and painful Lumbar spine (also known as Osteoarthritis of the Lumbar Spine, Lumbar Spondylosis, Spinal Degeneration, Degenerative Spine, Back Arthritis, Osteoarthritis of the Spine, Spinal Arthritis)

A stiff and painful lower back (often given the diagnosis of lumbar spondylosis) is basically ‘wear and tear’ of the bones and discs in the lower back. It is a normal part of ageing and does not cause symptoms in everybody.

At Walker and Hall we know through personal experience how painful and disabling this can be. If left untreated it can affect all aspects of your lifestyle from sleeping to work and your leisure and social activities.

Anatomy

The lower back (lumbar spine) comprises 5 bones (vertebrae) numbered 1 to five from the top down, it joins the mid back (thoracic spine) above to the pelvis (sacrum) below. Each vertebra is joined to the one above and below by two types of joints, a pair of joints at the back (facet joints) and a disc in the middle at the front (intervertebral disc). Ligaments and muscles pass between adjacent bones and over the lower back to provide support and movement. Behind the disc is the spinal cord. This is a large structure that is made of nerves which pass messages from your brain to the whole of the body. At each level between adjacent vertebrae a pair of nerves emerge and pass around the chest. These nerves send messages to the muscles to cause movement and provide sensation to the skin.

Causes of a stiff and painful Lumbar spine

In the case of lumbar spondylosis the symptoms are caused by age related “wear and tear” in the vertebrae and discs. This is nothing unusual and depending upon your life style, occupation and sporting activities, this “wear and tear” can begin to develop from the age of 30.

As we get older the edges of the vertebrae start to develop small rough areas called osteophytes and the intervertebral discs become thinner, this is called degeneration. As the degeneration progresses these rough areas of bone begin to press upon the ligaments, muscles and nerves in the lower back and you begin to experience pain and stiffness.

Signs and Symptoms of a stiff and painful Lumbar spine

  • Stiffness in the lower back – particularly on waking and often getting worse towards the end of the day
  • Pain – most commonly felt over the lower back but may also be referred into buttocks, thighs, calves, and feet. It may be one side of the back with the symptoms spreading into one side of the pelvis and lower limb or on both sides. It is often made worse with movement. It often “comes and goes”, sometimes being associated with a particular activity following which your lower back feels painful. In a few people the pain will become chronic (persistent).
  • Pins, needles and numbness in the lower back, buttocks, thighs, calves and feet, this can be caused by irritation of a nerve as it leaves the spine (click here for an explanation of sciatica)

How can Walker and Hall help you?

A thorough musculoskeletal examination is required to determine which structure(s) in the lower back is causing the stiffness and pain. This is essential if the optimum recovery is to be achieved and to reduce the likelihood of recurrence.

Following the diagnosis a treatment plan is devised and discussed with you.

The types of physiotherapy treatment used at Walker and Hall for a stiff and painful lower back include:

  • joint mobilization techniques to improve the range of movements
  • joint manipulation techniques to improve the range of joint movements
  • soft tissue massage to reduce pain and muscle spasm
  • electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain and muscle spasm
  • postural education including the use of a lumbar roll for sitting
  • the use of an appropriate pillow for sleeping
  • a home exercise programme to improve flexibility, strength and posture
  • activity modification advice
  • anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist

Facet Joint Sprain (Lumbar) (also known as Facet Joint Pain, Back Sprain, Zygapophyseal Joint Sprain, Sprained Facet Joint, Facet Joint Dysfunction, Apophyseal Joint Sprain)

At Walker and Hall we know through personal experience how painful and disabling a facet joint sprain of the lower back can be. It can affect all aspects of your life from sleeping, sitting, driving and working to leisure activities such as sport and gardening.

Fortunately facet joint pain of the lower back responds well to the appropriate physiotherapy treatment.

Anatomy

The lower back (lumbar spine) comprises 5 bones (vertebrae) numbered 1 to 5 from the top down and joins to the thoracic spine above and the sacrum below. Each vertebra is connected to the vertebrae above and below by 2 types of joints viz., the facet joints, located at the back of the vertebrae on either side and a joint between the vertebrae and the disc (intervertebral disc) at the front. These joints are designed to support body weight and enable spinal movement.

Each facet joint is made from smooth cartilage which lies between the bony joint surfaces cushioning the impact of one bone on another. Strong connective tissue also wraps around the bony ends providing support to the joint. During certain movements of the spine, stretching or compressive forces are placed on the facet joint. If these forces are excessive and beyond what the facet joint can withstand, injury to the facet joint may occur. This may involve damage to the cartilage or tearing to the connective tissue surrounding the joint. This condition is known as a facet joint sprain.

Causes of a facet joint sprain

  • Excessive bending, lifting and twisting movements such as gardening and house work
  • Trauma – a direct blow to the lumbar spine as seen in sports such as rugby and a heavy tackle
  • Repetitive and prolonged forces – this includes activities that involve the adoption of awkward postures such as prolonged sitting and leaning forwards e.g., ironing and mowing the grass.

Signs and symptoms of a facet joint sprain

  • Pain – sudden onset during the aggravating activity, although you may also experience pain and stiffness in the lower back after the aggravating activity, such as waking the following morning. The pain is often felt on one side of the spine and can be associated with muscle spasm in the same area. Occasionally it may be referred into the buttocks or lower limb on the affected side. The pain is made worse with activities that involve twisting, lifting, arching backwards, bending forwards or sideways or sitting for prolonged periods of time.
  • Loss of movement – due to the severity of the pain, often all lower back movements are restricted.
  • Muscle Spasm – this occurs in association with the pain and is located over the painful joint.

How can Walker and Hall can help you?

A thorough and accurate musculoskeletal examination is required to determine which facet joint(s) is causing the problem.

Following the diagnosis a treatment plan is devised and discussed with you.

The types of physiotherapy treatment for lumbar spine facet join pain include

  • joint mobilization and manipulation techniques to unlock the facet joint
  • soft tissue massage to reduce muscle spasm
  • electrotherapy (e.g. ultrasound & Interferential therapy) to reduce pain and muscle spasm
  • postural education including the use of a lumbar roll for sitting
  • the use of an appropriate pillow for sleeping
  • exercises to improve flexibility, strength and posture
  • activity modification advice
  • anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist

Lumbar Spine Slipped Disc (also known as Bulging Disc, Disc Prolapse, Slipped Disc, Prolapsed Disc, Herniated Disc, Intervertebral Disc Injury)

At Walker and Hall we know through personal experience how painful and disabling a low back slipped disc can be, affecting all aspects of your life from washing and bathing, to sitting and driving, to work to your leisure activities. Fortunately a lumbar spine slipped disc responds well to the appropriate physiotherapy treatment.

Anatomy

The lower back (lumbar spine) comprises 5 bones numbered 1 to 5 from the top down. Each bone is separated above and below by a disc which is made of layers of strong connective tissue (the annulus) wrapped around a soft jelly-like substance in the middle (the nucleus) and the nucleus is capable of changing shape. When the nucleus protrudes from the disc due to a tear in the connective tissue it is known as a slipped disc (lumbar spine disc bulge).

To understand the mechanism of a lumbar disc bulge, think of the disc as a “jammy doughnut” where the top and bottom of the doughnut attach to the vertebrae above and below, and the jam in the middle represents the jelly-like substance (the nucleus) of the disc. If you pinch the front of the doughnut, you can imagine the jam being squeezed towards the back and if this is done repeatedly, the back of the doughnut (the disc) will become weaker and eventually the doughnut will start to bulge. In the disc, the situation is the same,- repeatedly bending forward squeezes the front of the disc, pushing the jelly-like substance towards the back. Overtime or suddenly this may lead to a lumbar spine disc bulge.

Lumbar spine disc bulges occur most commonly in people aged 20 to 50 years of age. The lowest disc of the spine (L5/S1) is most commonly affected with the disc above (L4/L5) the second most common.

Causes of a lumbar spine disc bulge

There are three main activities in everyday life which typically cause lumbar spine disc bulges provided they are sufficiently forceful, repetitive or prolonged

  • bending forward
  • sitting down
  • lifting (especially in combination with twisting)

Occasionally, lumbar spine disc bulges may occur following a trivial movement involving bending forward such as picking up a small object or sneezing. In these instances, the disc has normally been subject to repetitive or prolonged bending, sitting or lifting forces leading up to the incident.

Signs and symptoms of a lumbar disc bulge

  • Pain – often sudden in onset and felt at the time of the incident or activity, but occasionally it may occur after the activity such as on waking the following morning. It is typically felt in the low back and may be located in the middle, on one side or on both sides of the spine. You may experience pain radiating down the leg into the buttocks, thigh, lower leg or foot – see sciatica

The pain is generally increased with activities involving lifting, bending forwards, prolonged sitting, or when moving from sitting to standing such as getting out of a car. Coughing, sneezing and twisting may also aggravate symptoms.

Often the pain is worse first thing in the morning.

  • Muscle spasm – often felt over the low back and may spread to the mid back
  • Pins, needles, numbness and or weakness – these symptoms tend to be present if the disc has bulged so far that it is putting pressure upon one or more of the spinal nerves as they emerge from the spine (click here for an explanation of sciatica)
  • Deformity – you may notice that you appear to be standing with your spine noticeably out of alignment, often leaning away from the side of pain

How can Walker and Hall help you

A thorough musculoskeletal examination is required to determine which level of the lumbar spine is causing the pain. This is essential if the optimum recovery is to be achieved and to reduce the likelihood of recurrence.

Following the diagnosis a treatment plan is devised and discussed with you.

The types of physiotherapy treatment used at Walker and Hall for a lumbar spine disc prolapse include

  • joint mobilization techniques to improve the range of movements
  • joint manipulation techniques to improve the range of joint movements
  • soft tissue massage to reduce pain and muscle spasm
  • electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain and muscle spasm
  • postural education including the use of a lumbar roll for sitting
  • the use of an appropriate pillow for sleeping
  • a home exercise programme to improve flexibility, strength and posture
  • activity modification advice
  • anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist

Sciatica (also known as Sciatic Pain, Trapped Nerve in the Back, Trapped Sciatic Nerve, Pinched Sciatic Nerve, Acute Nerve Root Compression)

At Walker and Hall we know through personal experience how painful and disabling a trapped nerve (sciatica) in the low back can be. It affects all aspects of your life from sleeping, bathing, shaving, sitting, driving and working to leisure activities such as sport and gardening.

Fortunately sciatica responds well to the appropriate physiotherapy treatment.

Anatomy

Sciatica is the term given to symptoms experienced from trapping (compressing) or rubbing (irritating) the sciatic nerve. The symptoms usually include one-sided low back pain which passes into the buttock, leg, foot and toes, muscle spasm, pins and needles, numbness and weakness. Although the symptoms typically affect only one side of the body they can on occasion affect both.

Whilst sciatica is a common complaint, the term itself is often misunderstood. It is important to realise that sciatica is not a diagnosis, but rather a description of the symptoms. There are a number of conditions which can cause compression or irritation to the sciatic nerve resulting in sciatic pain. This is important to understand as treatment for each of these conditions is different.

Causes of sciatica

Some of the more common conditions which may cause sciatica include

  • Lumbar Spine disc bulge – this frequently occurs following excessive sitting, bending and lifting activities and may be due to trauma and or due repetitive or prolonged forces – click here for an explanation of Lumbar Spine Disc Bulge
  • Spinal degeneration – more often found in older patients, the sciatic pain is caused by bony compression of the nerve root due to spinal degeneration and spinal stenosis. These conditions occur as a result of gradual wear and tear over a long period of time and are frequently associated with overuse – click here for an explanation of Spinal Degeneration
  • Spinal Stenosis – this is normally associated with ageing or osteoarthritis and is due to the gradual wear and tear of the bones, joints, and discs causing the spinal canal to become narrowed – click here for an explanation of Spinal stenosis
  • Spondylolisthesis – this tends to develop during childhood and is most commonly seen in children between the ages of 9 and 14. It may also occur due to stress fractures of the vertebra associated with sports that involve repeated hyperextension of the spine – click here for an explanation of Spondylolisthesis
  • Sacroiliac Joint Dysfunction – this tends to occur as part of the aging process as “wear and tear” and is also common in pregnancy – click here for an explanation of Sacroiliac joint dysfunction

Spinal Stenosis (also known as Spinal Canal Stenosis, Lumbar Stenosis, Foraminal Stenosis, Lumbar Spinal Stenosis, Vertebral Canal Stenosis)

At Walker and Hall we know through experience how painful and disabling spinal stenosis of the low back can be. It affects all aspects of your life from sleeping, bathing, shaving, sitting, driving and working to leisure activities such as sport and gardening.

Anatomy

The low back (lumbar spine) comprises 5 bones (vertebrae) numbered 1 to 5 from the top down and joins to the thoracic spine above and the sacrum below. Each vertebra is connected to the one above and below by 2 types of joints viz., facet joints which are located at the back of the vertebrae on either side or a joint between the vertebrae and the disc (intervertebral disc) at the front. Each vertebra consists of a large round structure at the front called the body (vertebral body) and a bony ring at the back which forms a hole. Because the vertebrae are stacked one on top of the other, these holes line up to form the spinal canal. This canal provides protection and space for the spinal cord and nerves to travel from the brain to the rest of the body.

Occasionally the spinal canal can begin to narrow. This is called spinal stenosis and as the condition progresses the narrowing may place pressure on the spinal cord resulting in a variety of symptoms.

Causes of Spinal Stenosis

Wear and tear – this is normally associated with ageing or osteoarthritis and is due to the gradual wear and tear of the bones, joints, and discs causing the spinal canal to become narrowed

Signs and symptoms of spinal canal stenosis

Spinal canal stenosis is usually seen in older patients who have degenerative changes to their spine. Patients with minor canal stenosis may experience little or no symptoms. As the condition progresses symptoms begin to appear viz.

  • Pain – most commonly felt over the lower back and may be referred into buttocks, thighs, calves, and feet. It tends to be aggravated by activities that repetitively or continuously straighten and extend the spine and activities that place weight on the spine such as lifting, prolonged standing, walking etc. It is often eased during activities that bend the spine such as sitting, and take weight off it such as lying
  • Stiffness – particularly on waking and associated with the aggravating activities
  • Pins, needles, weakness and numbness – these may be experienced in the low back, legs and feet and are often a sign that the condition has become more severe and is causing spinal cord compression or compression of the sciatica nerve as it emerges from the vertebral column – click here for an explanation of sciatica

How can Walker and Hall help you?

A thorough musculoskeletal examination is required to determine the extent of the spinal stenosis and which structure(s) in the low back are involved. This is essential if the optimum recovery is to be achieved and to reduce the likelihood of recurrence.

Following the diagnosis a treatment plan is devised and discussed with you.

Whilst physiotherapy treatment cannot treat the structural narrowing of the spinal cord it can provide pain relief, improve flexibility and strength.

The types of physiotherapy treatment used at Walker and Hall for spinal stenosis include

  • soft tissue massage to reduce pain and muscle spasm
  • electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain and muscle spasm
  • joint mobilization techniques to improve the range of movements
  • joint manipulation techniques to improve the range of joint movement
  • postural education including the use of a lumbar roll for sitting
  • the use of an appropriate pillow for sleeping
  • a home exercise programme to improve flexibility, strength and posture
  • activity modification advice
  • anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist

Spondylolysis (also known as Pars Defect, Lumbar Stress Fracture, Lumbar Spine Stress Fracture, Stress Fracture of the Pars Interarticularis)

Spondylolysis is the name given to a stress fracture of the lumbar spine and at Walker and Hall we know through personal experience how painful and disabling this can be. It can affect all aspects of your life from sleeping, sitting, driving and working to leisure activities such as sport and gardening.

Fortunately Spondylolysis of the low back responds well to the appropriate physiotherapy treatment.

Anatomy

The low back (lumbar spine) comprises 5 bones (vertebra) numbered 1to 5 from the top down and joins to the thoracic spine above and the sacrum below. Each vertebra is connected to the one above and below by 2 types of joints viz., facet joints which are located at the back of the vertebrae on either side or a joint between the vertebra and the disc (intervertebral disc) at the front. These joints are designed to support body weight and enable spinal movement.

During certain movements of the spine, compressive force is placed on the facet joint. This force is then transmitted through a bony region known as the ‘pars interarticularis’. If these forces are excessive and beyond what the bone can withstand, bony damage will occur. This initially results in a bony stress reaction, but with continued damage it may progress to a bony stress fracture of the pars interarticularis. This condition is known as a Spondylolysis.

A Spondylolysis typically occurs on one side of the spine, but occasionally both sides may be involved. This can result in one vertebra slipping forwards on another and is known as a Spondylolisthesis – click here for more information about Spondylolisthesis.

Causes of a Spondylolysis

Repetitive or forceful hyperextension activities – activities involving excessive backward bending of the spine especially if they are combined with rotation. Typically they are overuse injuries and are more common in the younger athletes whose bones are yet to reach skeletal maturity.

A Spondylolysis is most commonly seen in the following sports

  • cricket (especially fast bowlers)
  • gymnastics
  • tennis
  • dance
  • weight lifting
  • wrestling
  • pole vaulting
  • high jump
  • throwing sports, javelin etc.

Signs and symptoms of a Spondylolysis

Pain – often experienced on one side of the lower back, progressively increases with movements involving hyperextension and decreases with rest. It is usually felt on the opposite side of the body to the arm performing the repetitive movement e.g., left sided low back pain for a right arm bowler etc. It can usually be reproduced by firmly pressing on the affected area or by extending backwards whilst standing on the affected leg.

How can Walker and Hall help you?

A thorough musculoskeletal examination is required to determine the extent of the spondylolysis and which structure(s) in the low back are involved. This is essential if the optimum recovery is to be achieved and to reduce the likelihood of recurrence.

Following the diagnosis a treatment plan is devised and discussed with you.

The types of physiotherapy treatment used at Walker and Hall for Spondylolysis include:

  • soft tissue massage to reduce pain and muscle spasm
  • electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain and muscle spasm
  • joint mobilization techniques to improve the range of movements
  • joint manipulation techniques to improve the range of joint movements
  • postural education including the use of a lumbar roll for sitting
  • the use of an appropriate pillow for sleeping
  • a home exercise programme to improve flexibility, strength and posture
  • activity modification advice
  • anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist

Spondylolisthesis

Anatomy

The low back (lumbar spine) comprises 5 bones (vertebra) numbered 1 to 5 from the top down and joins to the thoracic spine above and the sacrum below. Each vertebra is connected to the one above and below by 2 types of joints viz., facet joints which are located at the back of the vertebrae on either side or a joint between the vertebra and the disc (intervertebral disc) at the front. These joints are designed to support body weight and enable spinal movement.

A Spondylolisthesis refers to the slipping of one vertebra forward on another and is graded according to the degree of slip of the vertebra relative to the vertebra below e.g., a Grade I slip indicates a slip of less than 25%, Grade II – 50%, Grade III – 75% and Grade IV > 75%.

Causes of Spondylolisthesis

  • Bony Defect – these tend to develop during childhood and are most commonly seen in children between the ages of 9 and 14. The defect is due to an absence of a section of bone on each side of the vertebral column which assists in holding the vertebra in alignment. This section of bone is known as the ‘pars interarticularis’
  • Stress Fracture – whilst not common a Spondylolisthesis may also occur due to stress fractures of one or both pars interarticularis. This may occur due to excessive athletic or sporting activity involving repetitive hyperextension of the spine.

Signs and symptoms of a Spondylolisthesis

With a Grade I Spondylolisthesis it is not uncommon to have no symptoms at all. It tends to be Grades II or higher that are symptomatic

  • Pain – usually experienced over the low back and may be referred into the buttocks, thighs, calves, and feet as sciatica – click here for an explanation of sciatica – it is often experienced during activities that straighten and extend the spine, especially if they are repetitive, excessive, or maintained for long periods of time. They tend to be eased by activities that bend the spine e.g., sitting
  • Stiffness – particularly on waking and associated with the aggravating activities
  • Pins, needles, weakness and numbness – these may be experienced in the low back, legs and feet and are often a sign that the condition has become more severe and is causing spinal cord compression or compression of the sciatica nerve as it emerges from the vertebral column – click here for an explanation of sciatica

How can Walker and Hall help you?

A thorough musculoskeletal examination is required to determine the extent of the Spondylolisthesis and which structure(s) in the low back are involved. This is essential if the optimum recovery is to be achieved and to reduce the likelihood of recurrence.

Following the diagnosis a treatment plan is devised and discussed with you.

Whilst physiotherapy treatment cannot treat the structural deformity of a Spondylolisthesis it can provide pain relief, improve flexibility and strength.

The types of physiotherapy treatment used at Walker and Hall for Spondylolisthesis include:

  • soft tissue massage to reduce pain and muscle spasm
  • electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain and muscle spasm
  • joint mobilization techniques to improve the range of movements
  • joint manipulation techniques to improve the range of joint movements
  • postural education including the use of a lumbar roll for sitting
  • the use of an appropriate pillow for sleeping
  • a home exercise programme to improve flexibility, strength and posture
  • activity modification advice – with a Grade III or IV Spondylolisthesis high speed and contact sports should be avoided altogether.
  • anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist

Sacroiliac Joint Dysfunction (also known as Sacroiliac Joint Pain, Sacroiliac Joint Sprain, SIJ Dysfunction, Sacroiliac Joint Inflammation, Sacroiliac Joint Injury, Sacroiliac Joint Disorder, Sacroiliitis)

At Walker and Hall we know through personal experience how painful and disabling a problem with the sacroiliac joint dysfunction can be. It can affect all aspects of your life from caring for your family, sleeping, sitting, driving and working to leisure activities such as sport and gardening.

Fortunately sacroiliac join dysfunction responds well to the appropriate physiotherapy treatment.

Anatomy

The sacroiliac joint is located in the lower part of the back and joins the tail bone (sacrum) to one of the pelvic bones (ilium). There are two sacroiliac joints – one on either side of the spine. The sacroiliac joints act to transfer weight from the spine to the pelvis and allow a small amount of movement to occur.

During certain movements of the spine and hips, stretching and compressive forces are placed on the sacroiliac joints and the surrounding ligaments. If these forces are excessive and beyond what the sacroiliac joint can withstand, injury to the sacroiliac joint may occur. This is known as sacroiliac joint dysfunction.

Causes of Sacroiliac Joint Dysfunction

Degeneration – as a weight bearing joint the sacroiliac joint can develop age related “wear and tear”

Pregnancy – during pregnancy hormones are released that allow the ligaments of the sacroiliac joints to relax, this allows for increased movement during childbirth. However this increased movement can cause increased stresses and abnormal wear of the joint leading up to childbirth. Also the additional weight and altered walking pattern (altered gait) associated with pregnancy may also place additional stress on the sacroiliac joints.

Excessive force – movements such as bending, sitting, lifting, arching and twisting of the spine can all affect the sacroiliac joint

Weight bearing forces – activities such as running and jumping

Trauma – Injury to the sacroiliac joint may occur traumatically or due to repetitive or prolonged forces over time.

Signs and symptoms of sacroiliac joint dysfunction

  • Pain – usually experienced on one side of the low back around the top of the buttock and may be associated with referral into the lower buttock, groin or thigh. In rare cases, pain may be felt on both sides of the lower back. It is generally increased with activities that involve lower back or hip movements and often you will experience pain on rolling over in bed, putting on or taking off your shoes and socks, walking up and down stairs and running
  • Asymmetry of the pelvis due to muscle tightness, joint stiffness, altered leg length and or joint laxity associated with pregnancy

How can Walker and Hall help you?

A thorough musculoskeletal examination is required to determine the extent of the sacroiliac joint dysfunction. This is essential if the optimum recovery is to be achieved and to reduce the likelihood of recurrence.

Following the diagnosis a treatment plan is devised and discussed with you.

The types of physiotherapy treatment used at Walker and Hall for sacroiliac joint dysfunction include:

  • joint mobilization techniques to improve the range of movements
  • soft tissue massage to reduce pain and muscle spasm
  • electrotherapy (e.g. Ultrasound, Interferential Therapy) to reduce pain and muscle spasm
  • postural education including the use of a lumbar roll for sitting
  • the use of an appropriate pillow for sleeping
  • the provision of sacroiliac joint braces / support
  • the correction of leg length discrepancy
  • a home exercise programme to improve flexibility, strength, core stability and posture
  • activity modification advice
  • anti-inflammatory advice. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist