Low back pain

Living with low back pain is no joke.

The uncomfortable feeling of walking in a stiff manner, “like an old person.” Constantly worrying about the mattress in the hotel you are going to. Being afraid to sign up for BJJ training even though you want it so much.

After consulting orthopaedic doctors, you may learn that there are surgical options to address certain structural issues in your spine — such as a disc protrusion, spinal stenosis, or facet joint arthropathy. However, if you have researched enough, you may also know that MRI findings do not always correlate with pain, and surgery may require at least one year of rehabilitation. On top of that, your pain may not feel severe or acute enough to justify such an invasive solution.

Burning the nerves in your lower back to relieve pain may sound efficient, but you may still wonder: Why is the pain there? Is destroying the nerve really a reasonable solution?

Conventional physiotherapy — such as strengthening exercises, massage, dry needling, or cupping — can help, but often only to a certain point. After a few sessions, progress may plateau.

At that stage, it may feel as if everyone is too hesitant to admit that all options have been exhausted and that you simply have to accept living with pain forever.

But it does not have to be this way.

One possible reason recovery is limited is that you may not have received treatment targeting the fascial system. One of the characteristics of fascia is that it can become rigid in response to trauma or surgery. For example, an old appendectomy scar on the abdomen or a fall onto the tailbone in childhood can contribute to long-term fascial dysfunction.

To release densifications that may contribute to pain, weakness, numbness, or joint clicking, a specific and precise manual technique is required. The tissue must be properly warmed and treated with targeted, sometimes firm, pressure. This is why a regular massage often does not provide lasting results — it is usually too general and too gentle.

Another important reason persistent pain may remain is fear. Pain is generated by the brain, and it can occur not only due to actual tissue damage, but also due to perceived threat.

When pain persists over time, the affected area can become hypersensitive. You may lose the sense of control and awareness of what is happening in your lower back. This altered perception can itself contribute to ongoing pain.

To restore normal function, the nervous system needs repeated, safe feedback that the lower back is no longer in danger. This can be achieved through specific manual therapy combined with movement therapy — not random exercises, but interventions tailored to the individual needs of your nervous system.

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Physiotherapist for chronic pain in Jumeirah, Umm Suqeim 2, Dubai.