5 Stages of Spinal Breakdown: Understanding lower back pain

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January 23, 2018




Very few of us will escape the grips of lower back pain. Research has confirmed that more than 80% of us will be affected with lower back pain at some point in our lives. It can be a debilitating experience, which often leaves us feeling fearful, isolated and apprehensive about returning to our normal active lifestyle. The good news is that in most cases early intervention along with gentle movement will likely support a quick recovery. However, in some instances, persistent lower back pain results. In this scenario, the influence of psychological factors, such as stress, depression and/or anxiety, are important considerations.

Acclaimed physiotherapist Sarah Key, developed an approach to the treatment of spinal problems based on The 5 Stages of Spinal Breakdown.

The 5 Stages which she describes are;

1. Stiff Spinal Segment
2. Facet Joint Arthropathy
3. Acute Locked Back
4. The Prolapsed Intervertebral Disc (Disc bulge)
5. The Unstable Spinal Segment

A large component of her method is empowering clients to managed spinal pain through education and self -management exercises. She has written a number of comprehensive books, which document the stages of spinal breakdown and outlines the exercises that are most beneficial depending on the structures involved.

There are a number of different structures in your lower back and pelvis, which may be the primary cause of pain. Soft tissue, including muscle, fascia and ligaments, bone, spinal joints, intervertebral discs, neural tissue or nerves and organs within the abdominal cavity are the most likely structures to be causing your pain. Identifying which structure is the primary pain generator can be clinically challenging, but fundamentally important in order to establish the best course of treatment.

Secondary pain generators may be involved due to compensatory movement patterns and restrictions, which is why early intervention is crucial to the successful management of lower back pain. Imaging including x-ray, CT scan or MRI may also be useful in cases where clinical elements are not clear or neurological deficits are present.

Maintaining a healthy spine with regular gentle movements or stretches will assist in reducing the incidence of lower back pain and limit the likelihood of recurrences. Equally important is having an understanding of the basic mechanics of the spine and taking responsibility for your own recovery.

If you would like to learn more about the Sarah Key Method please visit www.sarahkey.com.au or if you would like to book an assessment and treatment with Michelle, who has completed Stage 1 of The Sarah Key masterclass please book online admin@nedlandsphysio.com.au