The process of identifying and managing chronic lumbar spine instability has proven to be a challenge for chiropractors and manual physical therapists alike. As found in a recent participating publication, “Chronic lumbar instability is showcased as a term that can encompass two types of lumbar instability: mechanical (radiographic) and functional (clinical) instability (FLI). The components of mechanical and FLI are presented relative to the development of a physical therapy diagnosis and management” (NCBI). This weakening or degradation of the spine leads to lack of mobility, pain, stiffness, numbness, and a decrease in normal functionality.
Neck and back pain has long been a big problem for the Western world. Recently published figures show this continued increase over the last few decades and there seems to be no slowing down or reversal in sight. It is estimated that around 80% of people will suffer some form of pain, injury, or lack of movement due to back pain. This is still one of the leading reasons for lack of work performance, hospital visits, sick days, and job loss in the industrialized world. It is a very serious issue that still seems to be widely undiagnosed and misunderstood.
There have been a number of factors that are thought to predispose a person to being more likely to develop lower back pain and Lumbosacral Instability. These include jobs that require a lot of sitting, bending, or twisting; exposure to vibrations or jostling can increase risks, and a lack of overall health and fitness also seems to make some people more prone to Lumbosacral Instability. Those with well-maintained mid-sections (abdominal muscles) seem to be least affected. A definition and diagnosis for instability is the opposite of a stable joint- which is one that moves normally with the normal pull of muscles and one that can withstand normal weight pressure and tension. In most cases, the classification of normal is defined as what most people can do and still remain pain free. So, an unstable joint cannot bear the normal weight, tension, or movement without resulting in pain or discomfort. Instability can impact the joints, tendons, muscles, soft tissues, blood vessels, nerves, and bones of the affected area. Another term recently gaining popularity among chiropractors and the medical community is "Functional Instability". This diagnosis is rendered when the joints and surrounding tissues and structure appear normal but the range of motion is still reduced or there is still pain and discomfort associated with normal tasks. Both diagnoses require some level of treatment so the patient can return to normal activity levels quickly.
There are a variety of treatment methods used for other lumbar related conditions which can also be applied to help treat symptoms of lumbar instability. These treatment options include:
Strengthening the muscles to help control joint and vertebrae placement
Braces or corsets (used for short term treatment and are worn for 4-6 weeks at a time)
Teaching the patient a variety of self-help exercises
Homework exercises are also a common and effective treatment, as it can help encourage spinal stability and helps the patient have an active role in their own health and care. These are coupled with dynamic lumbar stabilization exercises that Dr. Hamilton may recommend and monitor to ensure maximum success with self-care and maintenance. For instances where the more conservative treatments have not provided enough relief, surgery may be needed, though this is the final option if all other treatments have not provided adequate relief; the most common form is a spinal fusion or some other immobilizing step that aims at relieving pain if mobility cannot be restored to normal. Only you and your health care provider can decide what is the best course of action for your unique situation and your individual needs. Contact our office and put Lumbosacral Instabilityon the shelf for good, let Dr. Hamilton help!