2 June 2020

Lower back pain specialist in Canberra?

| Captain RAAF
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Hi Gang,

The missus is fighting some significant lower back pain, been a problem for her for about 3 years. Other than that, she is a fit and healthy specimen, maintaining a stunning appearance and physique.

She has visited a couple of doctors and both agreed with my diagnosis, weak core (stomach muscles) leaving the back to over-compensate and suffer accordingly.

She has tried exercise and it just leaves her in more pain. She has had scans and there is no inflammation present and no ‘smoking gun’, so she’s feeling very frustrated by the whole saga.

It’s playing havok with her morale which therefore impacts on mine, which of course affects my ability to provide the blanket of security that you all sleep under.

So, is there any lower back pain guru in Canberra I can take my cook to? She is at the end of her tether and I hate to see her suffer anymore and have to try every possible option.

Help me Obie-Wan, your’e my only hope!

If you’re also looking for an acupuncturist, check out our recently updated article on the best acupuncturists in Canberra.

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HandsOnMassage8:44 pm 30 Jul 13

As a professional remedial massage therapist, I and several of the multidisciplined professionals that I share clients with, have successfully treated and given home rehabilitation training to reduce pain and restore function to others such as your wife… A good therapist of any discipline who others keep going back to is worth finding…

I have found Bowen therapy worked well for me for a number of conditions. Andrew Earl at Canberra Bowen Therapy in Dickson is very good. His specialty is back pain (although he also works on horses!). You won’t find him in the phone book, but you can get details and an explanation from his website http://www.canberrabowentherapy.com.au. David Tow is a physiotherapist who also does Bowen and acupuncture. He is fantastic, but it is difficult to get an appointment as he is usually booked up.

mouldy said :

Evidence based practice would suggest otherwise. Muscle tension and tone is more often than not the symptom and not the cause. That doesn’t mean the muscle tension/tone/spasm needs to be addressed – it does.

Anyway, I’m out. Not sure if it was on this site but:

“Never argue with an idiot. Bystanders won’t be able to tell the difference.”

nowhere did I mention the spinal cord, I said column, this includes the vertabrae and muscle attachment points. So….look at all the muscles that connect into the spinal column:
http://injuryfix.com/archives/ezine_images/iliopsoas.jpg

If you are suggesting that muscle tightness that pulls on the spinal column causing pain in discs is a myth, then you are part of the problem as why so many people are not getting relief. More often than not the area of pain (in the spine) is the not the source of the problem.

That should have read “That doesn’t mean the muscle tension/tone/spasm DOESN’ Tneed to be addressed – it does.

Evidence based practice would suggest otherwise. Muscle tension and tone is more often than not the symptom and not the cause. That doesn’t mean the muscle tension/tone/spasm needs to be addressed – it does.

Anyway, I’m out. Not sure if it was on this site but:

“Never argue with an idiot. Bystanders won’t be able to tell the difference.”

nowhere did I mention the spinal cord, I said column, this includes the vertabrae and muscle attachment points. So….look at all the muscles that connect into the spinal column:
http://injuryfix.com/archives/ezine_images/iliopsoas.jpg

If you are suggesting that muscle tightness that pulls on the spinal column causing pain in discs is a myth, then you are part of the problem as why so many people are not getting relief. More often than not the area of pain (in the spine) is the not the source of the problem.

mouldy said :

” I am well experienced in these issues and a large majority of lower back pain isn’t spinal related its because of muscular dysfunction impinging on the spinal column”

If you’re talking about the spinal cord then this comment is anatomically, phsyiologically, and biomechanically impossible.

Regarding the OP – sometimes we forget that we don’t treat the scan, we treat the patient. Often it comes down to re-teaching someone how to move correctly – particularly if there is no hard evidence of damage on imaging.

nowhere did I mention the spinal cord, I said column, this includes the vertabrae and muscle attachment points. So….look at all the muscles that connect into the spinal column:
http://injuryfix.com/archives/ezine_images/iliopsoas.jpg

If you are suggesting that muscle tightness that pulls on the spinal column causing pain in discs is a myth, then you are part of the problem as why so many people are not getting relief. More often than not the area of pain (in the spine) is the not the source of the problem.

dtc said :

While we are on this issue, can anyone recommend a good physical ‘assessor’ ie someone who can look at your gait, your stretch abilities, your flexibility, mobility strength etc etc and come up with a list of what actually is wrong. For example, tight hip flexor or tight hamstrings or bad kyphosis

(hunch) etc.

This seems to be very common in the USA, there are lots of articles on conducting physical assessments and then using that to determine future action (exercise or stretching or as needed).

But I’ve tried in Canberra with limited results. This has included physios, sports doctors and trainers. Most of them find one or two faults with a short assessment and then recommend a cure that happens to be a cure in their profession. So physios suggest massages, doctors try anti inflmmatories, trainers an exercise program. None of them seem to understand when I say I want everything assessed and none of them (apart from one doctor) recommend anything outside their actual field. (the doctor suggested strength training for a particular muscle that wasnt working properly)

So any suggestions gratefully received

And to the OP – its not just the stomach muscles. One muscle that is really affected by sitting/our lifestyle and also by back injury is the glutes (as the above doctor informed me). It should be protecting your spine, but it often ‘shuts down’ when there is back injury and you have to consciously work to get it to ‘turn on’ again. If you dont, what happens is that your back muscles take the strain and they arent strong enough – causing back pain and potential spinal injury. (google ‘Bret Contreras’ for his website – some of it is bodybuilding stuff but there is a lot of rehab stuff on it as well).

try clinic88

rbw said :

(excellent post snipped).

This stuff is spot-on, unfortunately. My old L4/5 sciatic issues were fixed in the 80s by a physio who was right across all this. I still have my tennis balls! But haven’t used them in a while to release those nerve trigger points for stretching.

Now new sitting-induced back issues, lower (but not L4/5) and upper back, the lower is proving quite hard to shift. Had physio which relieved it, but the physio didn’t have any ideas for preventing it coming back, and come back it did.

They’ve invented foam rollers since the 80s and have been meaning to investigate them, I imagine they’re like that agonising deep tissue massage, ugh.

Need to find a good “back” physio who can do more than just release the vertebrae and muscles temporarily.

” I am well experienced in these issues and a large majority of lower back pain isn’t spinal related its because of muscular dysfunction impinging on the spinal column”

If you’re talking about the spinal cord then this comment is anatomically, phsyiologically, and biomechanically impossible.

Regarding the OP – sometimes we forget that we don’t treat the scan, we treat the patient. Often it comes down to re-teaching someone how to move correctly – particularly if there is no hard evidence of damage on imaging.

While we are on this issue, can anyone recommend a good physical ‘assessor’ ie someone who can look at your gait, your stretch abilities, your flexibility, mobility strength etc etc and come up with a list of what actually is wrong. For example, tight hip flexor or tight hamstrings or bad kyphosis (hunch) etc.

This seems to be very common in the USA, there are lots of articles on conducting physical assessments and then using that to determine future action (exercise or stretching or as needed).

But I’ve tried in Canberra with limited results. This has included physios, sports doctors and trainers. Most of them find one or two faults with a short assessment and then recommend a cure that happens to be a cure in their profession. So physios suggest massages, doctors try anti inflmmatories, trainers an exercise program. None of them seem to understand when I say I want everything assessed and none of them (apart from one doctor) recommend anything outside their actual field. (the doctor suggested strength training for a particular muscle that wasnt working properly)

So any suggestions gratefully received

And to the OP – its not just the stomach muscles. One muscle that is really affected by sitting/our lifestyle and also by back injury is the glutes (as the above doctor informed me). It should be protecting your spine, but it often ‘shuts down’ when there is back injury and you have to consciously work to get it to ‘turn on’ again. If you dont, what happens is that your back muscles take the strain and they arent strong enough – causing back pain and potential spinal injury. (google ‘Bret Contreras’ for his website – some of it is bodybuilding stuff but there is a lot of rehab stuff on it as well).

Madam Cholet12:19 pm 14 May 13

I’m with you on the tennis ball rbw – having a dog has some upsides! And this sounds really odd I know, but a rolling pin (old fashioned implement once used by ‘housewives’ to roll pastry for delicious pies), also is a good implement as you can lie it down one side of the spine in a similar fashion to a technique I have seen some physios use – although you are right, they use a bodgied up bit of wood which is far less sophisticated than my antique rolling pin.

Getting through the pain to a point where you feel able to start the restorative exercise is the thing though.

Girt_Hindrance12:14 pm 14 May 13

Tooks said :

Physio, core strengthening, dry needling – I recommend at least trying a good physio before anything else.

This worked for me- did my back in and ended up with one leg shorter than the other, I had two bulging discs between L4&5, and L5&S1.
Three different people recommended I go to “Move Happy Health Care” in Wanniassa, and three sessions later at under $80 each, I haven’t needed to go back and it’s been several months. I got an assessment, some massage, dry needling (quite an experience), and ongoing exercises to complete at home. Walking tall again now.
Also, lots of walking and as JB said, swimming is more than highly recommended.

Give Bud Chapple a call – he worked wonders with my fiance and I.
http://budchapplepilates.com/

Bud uses an active treatment approach. This involves a combination of manual hands-on work to release areas of joint and muscle tightness and exercises to strengthen and improve body awareness. Exercises involve floor work, weights, Swiss balls and specialised Pilates equipment including a trapeze table and reformer.

These exercises are designed to help people understand their condition and work with their body to improve everyday life.

I can guarantee right now that most of these recommendations will barely work and will continue to prolong the misery. I am well experienced in these issues and a large majority of lower back pain isn’t spinal related its because of muscular dysfunction impinging on the spinal column.

The majority of lower back pain being caused today due to poor posture and excessive sitting is placing pressure on the piriformis, glutes, psoas, illiacus and quadratus lumborum among others. Most people with chronic lower back pain tend to have significant issues in all these muscle groups of the hip and surrounding area.

Chiropractic and acupuncture temporarily work because these muscles can be relaxed or forced back into better positions, only to eventually pull back to the original state they have been long conditioned to hold. Generally there are excessive Trigger Points holding such alignments.

A good way to test for these muscles playing a strong part in back pain is if you roll around on a tennis ball through your buttock and side hip muscles. If you know where to look and push finger pressure along abdominals just near the edge of your hip bone. If these areas hurt quite badly this is likely what is causing the back pain bigger problems. Almost all people have issues in these muscles because of how much sitting we do, and also how poorly we do it. Although I have seen people with perfect sitting posture suffer the same problems because it is simply a matter of dysfunction from too much sitting and too little movement. Standing around for long periods also causing issues, and in my experience is more prevalent than sitting in causing these issues as well.

The only real solution I’ve come across is a series of extreme deep tissue work on these affected areas and sometimes it will take months of constant work on those areas to loosen them up and more importantly get the muscles to chronically relax rather than chronically tighten. You cna get one or two massages and get relief but you need to retrain the muscles. And extreme massage is required because some of these knots in those hip muscles are savagely tight and light massage won’t cut it IF you are looking for complete resolution.

ONLY when you get the knots out will retraining posture through pilates and other forms of physiotherapy will then get to the top of keeping you from causing the same problems again.

Ultimately this can get extremely expensive, so if someone wants full resolution of such issues, it involves educating yourself on the anatomy of all these muscle groups, knowing where in your body are the tight points that hurt and how to release them safely yourself. Some good tools are tennis ball, foam roller and a thera-cane. Work with a professional as well, find trigger point experts and active release chiropractors to assist to educate you and do release work and get to work with a physio/pilates expert to correct other dysfunction. Eventually you will get to the point where you know how to treat yourself effectively to maintain pain-free or close to pain-free.

And trust me I have walked the path of over 10 years chronic pain, the number one solution is educating yourself especially on anatomy and to watch closely how massage therapists, chiropractors and physios treat you. LEARN along the way.

But the cheapest and easiest solution is to roll on a tennis ball in the hips and glutes on any sore spots —on the sorest hold on the spot from 30-120 seconds at a time. if too painful work around the edges of the sorest point, wait for muscle to relax and imprortantly keep at it regularly. also get someone to work knots out of the more difficult places such as the piriformis, hip rotators, illacus, psoas and quadratus and this can get 10x relief very quickly.

guy said :

Speaking as someone who has suffered chronic lower back and neck pain, and tried all the conventional and alternative medicine therapies, it’s probable that stretching calves and hamstrings effectively is likely to be the simple, yet overlooked solution to chronic lower back pain. Kit Laughlin’s Stretch Therapy at ANU will probably change her (and your) life: http://www.pandf.com.au

You raise a good point.. Most of my LBP is attributed the to fact I have really tight quads and lose hamstrings which puts my hips out of alignment.

Nothing has worked for me long term, but I swore by acupuncture for shin pain, aqua therapy was amazing for my back pain, but it quickly returned when I was unable to keep up the sessions. (AIS pool have some really good sessions). And Roy Daniel at Belconnen physio practice gave me the freedom to move properly again with a shoulder injury. A few months with him vs a different physio for years and I felt fantastic.

What works for one.. May not work for the next person.

Trial and error….

I had lower back pain for years when I was a triathlete. The constant training took it’s toll. I was advised that the most important thing was to keep mobile, and my doctor was of the view that if anti-inflammatories kept me mobile, it was perfectly ok to use them. They worked, so I used them. I also used to sometimes visit an osteopath for the very intense massage he did, and that helped too.

Chiropractors, acupuncturists – they’re woo, and as noted above, don’t prove their efficacy in properly controlled studies. Don’t waste your money.

Chiropractors are a sham in my opinion, and I used to swear by them for years. I’d always leave feeling much better, but in reality, they were doing more damage to an already ruptured disc. Physio, core strengthening, dry needling – I recommend at least trying a good physio before anything else.

Madam Cholet8:23 am 14 May 13

johnboy said :

When my back was bung six weeks of lap swimming did wonders.

That’s some stamina – 6 weeks! Your skin must have been really wrinkly when you got out.

As you can see from the other posts, LBP is very common. Doctors to great work, so do physios, chiros, osteos and so on. But no one has all the answers to everyone’s problems and finding the specialist with the right solution for your wife’s condition is, sadly, a matter of experiment. Anyone you ask will swear by who or whatever ‘did the trick’ for them last time.

The condition is chronic (ongoing) because the cause is elusive – and pain can be a symptom of a problem elsewhere. So if the scans are clear of structural issues and the exercises she’s done didn’t produce much improvement, I suspect a postural issue. Causes: childbirth, MVA’s, sporty mishaps, poor form of the gym, any combination of the above . . and other things . . .

Consider booking your wife in to see a Remedial Massage Therapist for a postural assessment, treatment and homework. I recommend Griffith Massage Centre (6295 6733). Ask for Ben.

Cheers

Speaking as someone who has suffered chronic lower back and neck pain, and tried all the conventional and alternative medicine therapies, it’s probable that stretching calves and hamstrings effectively is likely to be the simple, yet overlooked solution to chronic lower back pain. Kit Laughlin’s Stretch Therapy at ANU will probably change her (and your) life: http://www.pandf.com.au

When my back was bung six weeks of lap swimming did wonders.

justsomeaussie9:12 pm 13 May 13

If you want to stick to just the science, there is no evidence that acupuncture and chiropractors work.

Controversial in the public eyes, yes, but both don’t stand up to peer reviewed double blinded studies.

A lot of people can confuse dry needling with acupuncture but don’t be fooled by the hocus pocus of acupuncture.

As someone who’s suffered severe back pack from a military injury I learnt the hard way the reason why the military doesn’t use acupuncture and chiropractors, it doesn’t work.

Stick to physios.

I had similar issues and appealed to facebook for a Pilates teacher. I’m going to Bud Chapple in Garran. Things are a lot better now. I can put shoes on! not just slippers. However I am doing a serious amount of exercises every day. Highly recommended.

Madam Cholet5:38 pm 13 May 13

Crikey! your post freaked me out. I thought it was Monsieur Cholet writing about my predicament this very day! I have just returned from an osteopath who has worked on my lower back issues that have plagued me for years. And yes, unfortunately it is the sedentary lifestyle to blame. We feel busy, but we are not actually using our muscles to do any of it. I was at the point where this week getting up and down was just excruciating….and sitting on a chair, well don’t even think about it!

However, the road to recovery is to start with gentle exercise. Just walking. It doesn’t fix it overnight and it might not fix it fully ever, but it blows the physical and mental cobwebs away. The other exercise she suggested that can be done anytime is to hold your arms out in front of you clasping your hands together and write large numbers in the air mr squiggle style. Odd suggestion, but it gets the hips wiggling again!

The osteo I just visited suggested that stress and lack of exercise can bring on the whole thing and that your brain remembers what it had to do once to try and help you recover from an injury you may have had once, so it just does it again, even though you are not injured, you’re just stressed. And then stuck in a cycle of stress because you can’t get better.

I don’t place all my faith in osteos or similar but I find that their therapy can be sometimes what is needed to kick start the healing.

If it’s any consolation, I know how she feels poor thing. I always think during these episodes that I would cry if I were not so worn out and tired from coping with the pain. I did look up a thread on RA myself to see if I could find a popular practitioner. The was one in monash that got a good rap….Maxwell Fravel or Favel in Kambah. Anyway, I couldn’t get into them, but instead did go to ACT Smart Osteo in Monash. Lee seems like a no nonsense kind of a person who just wants to help. No messing around! Not much sympathy for the sedentary!!!

Pilates and yoga are the best thing to strengthen the core.

There’s also a posture class at the ANU that I’ve heard rave reviews about.

Capt’n, I’d recommend Atlas Physio in Braddon, they’re not cheap but they are amazing. Secondly, get her to find the exercise that suits her that will include a lot of core exercises – for my $0.02 I’d also recommend finding a good Pilates class as it’s worked very well for my back.

The Woden Integrated Physio offer clinical pilates classes – I have found it really helps for building up the core muscles without causing lower back pain that occurs with other types of exercises.

Tetranitrate4:11 pm 13 May 13

Out of curiosity, when you say tried exercise, does that include actual weight training? ie: a balanced barbell routine incorporating Squats, Deadlifts, Rows and the like?
I used to have some back issues when I was much younger, but I’ve never had any problems since I started semi-seriously with the gym.

gentoopenguin4:02 pm 13 May 13

I have a slipped L4/5 and have been to a few physios about town. Suz Goodall at Powerhouse Physio is the best I’ve found…she works the back then gives you exercises to do at home to strengthen the core. I found this empowering cause it wasn’t only about treatment but also about what I could do to help myself out.

I’ve also been twice down the path of cortisone injections into the spine. It is about as unfun as it sounds. The second one worked a treat though and got rid of some very annoying sciatic pain down the leg. This could be an option for your wife depending on her level of desperation. She’d need a referral to a back specialist, who would then refer her on for the injection via MRI. All up it’s a few hundred bucks out of pocket and I’ve heard it usually takes two treatments to work.

Chronic lower back pain is the pits. the trick is to find the right mix of treatment and exercise for you. Personally, I couldn’t get by without physio, walking, my hot water bottle and the occasional course of anti-inflammatory meds.

Best of luck to your wife. I wouldn’t wish such pain on my worst enemy!

I suffered a lower back pain after a sport injury. The only thing worked for me was acupuncture. Has she tried acupuncture?

It sounds like she’d need both acupuncture and physiotherapy to completely shake it off. A weak core is one of the common cause of lower back pain especially if she sits front of computer all day.

I’ve seen a musculoskeletal specialist before and it helped 50% of the pain reduction. Then acupuncture for months and physiotherapy and on-going posture correction helped me.

For acupuncture, I recommend Charles Cai in Turner. http://www.chinesetreatmentcentre.com.au They have quite different doctors in that practice so please do try to see who achieves the best results. Charles Cai is the owner so you can discuss your concerns with him. He will recommend different treatments if necessary.

As for musculoskeletal specialist, the one I saw ages ago has moved away from Canberra. He was the best that I’ve come across. Sorry don’t have any recommendation here.

Good luck.

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