LOW BACK PAIN BEYOND the STRUCTURE BASED DIAGNOSIS

According to statistics, Low Back Pain has a lifetime prevalence of 65% to 80% . With a prevalence so high, there is a good chance you will experience low back pain at some point in your life. Perhaps you have in the past, or you have some low back pain right now. When it comes to the proper treatment, how do you know what is right for you? Chances are, you’ve probably seen a physician, possibly received some medications, maybe even an x ray and MRI, and perhaps your physician has recommended you try a course of Physical Therapy. At North Jersey Physical Therapy, we have a unique approach to the treatment of your low back pain.

According to statistics, Low Back Pain has a lifetime prevalence of 65% to 80% . With a prevalence so high, there is a good chance you will experience low back pain at some point in your life. Perhaps you have in the past, or you have some low back pain right now. When it comes to the proper treatment, how do you know what is right for you? Chances are, you’ve probably seen a physician, possibly received some medications, maybe even an x ray and MRI, and perhaps your physician has recommended you try a course of Physical Therapy. At North Jersey Physical Therapy, we have a unique approach to the treatment of your low back pain.

Now that it is understood that your MRI findings might not even be showing the true root cause of your pain, you may be asking yourself, what is causing my low back pain? At North Jersey Physical Therapy we look at how your body moves, we look for compensatory patterns that may have become long term strategies due to muscle inhibition elsewhere, leading to wear and tear in certain areas which eventually leads to pain. Often, the site of the pain is not the same as the cause of the pain. For example, your pain may be in your low back, but the reason it hurts at that segment is because your body is moving too much from that same segment because something else isn’t moving well enough, or certain muscles have become inhibited, or you are overusing muscles that aren’t designed to be used in such a way. You are beating up that one section of your back because something, somewhere else, isn’t doing its job.

Now that it is understood that your MRI findings might not even be showing the true root cause of your pain, you may be asking yourself, what is causing my low back pain? At North Jersey Physical Therapy we look at how your body moves, we look for compensatory patterns that may have become long term strategies due to muscle inhibition elsewhere, leading to wear and tear in certain areas which eventually leads to pain. Often, the site of the pain is not the same as the cause of the pain. For example, your pain may be in your low back, but the reason it hurts at that segment is because your body is moving too much from that same segment because something else isn’t moving well enough, or certain muscles have become inhibited, or you are overusing muscles that aren’t designed to be used in such a way. You are beating up that one section of your back because something, somewhere else, isn’t doing its job.

The physical therapists at North Jersey Physical Therapy will give you a comprehensive initial evaluation, go over their findings and share with you their physical therapy diagnosis, assessment, and treatment plan to address the root cause of your low back pain. They will design a home program to reinforce new movement strategies that will help improve carryover between treatment sessions and promote progress. Call today to improve the way you move!


1 Laxmaiah Manchikanti, MD  “Epidemiology of Low Back Pain” ;Pain Physician Vol. 3, No. 2, 2000

2 Boden SD et al.  “Abnoral magnetic resonance scans of the lumbar spine in asymptomatic subjects.  A prospective investigation.” J Bone Joint Surg. Am.  1990 Mar; 72(3):403-8.

Pain and Injury from Improper Breathing

By John Vicchio, PT, CCTT

Breathing is unquestionably a key function of the human body. It sustains life by providing oxygen needed for metabolism and removing the by-product of these reactions, carbon dioxide. Breathing has other functions that affect motor control, postural stability and roles in maintaining homeostasis function (maintain internal stability such as balance and equilibrium) in the autonomic nervous system and circulatory system. When breathing becomes dysfunctional it affects people’s lives, challenging homeostasis, creating symptoms that most patients do not associate with their pain and compromising health.

The primary muscles of breathing are the diaphragm, intercostals (muscles running between the ribs) and abdominals, which allow the average person to take over 21,000 breaths per day. These muscles are located in the chest wall compromised of the rib cage/thorax and the abdomen, creating an effective respiratory pump. The respiratory pump can become dysfunctional due to many factors, which are altered and paradoxical motion between rib cage and abdomen called paradoxical breathing, thus increasing use of upper body muscles such as the scalenes, upper trapezius and sternocleidomastoids. Abdominal weakness and rib cage stiffness are common dysfunctions that we see at North Jersey Physical Therapy Associates (NJPTA).

At our clinic we evaluate and treat on how breathing affects postural stability and motor control. Muscles such as the diaphragm, transverse abdominals and pelvic floor muscles are important for motor control and postural support as well as for breathing. If their function is compromised there is an increased susceptibility to low back pain and injury.

At NJPTA, we take a unique approach in treatment, which includes an extensive assessment and treatment using manual therapy interventions, neuromuscular exercises (90/90 Diaphragm breathing, Buteyko breathing) and dry needling. These are all helpful tools in restoring and maintaining motor control/postural stability.

Below is an illustration of optimal breathing from Integrative Core Dynamics:

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