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Back Pain

At Active Physiotherapy Jerusalem, David Fidler offers new hope for sufferers of back pain. His evidence based approach incorporates the latest research for physiotherapy treatment.  This entails taking a whole person approach to back pain. Research has shown that there is very poor correlation between Xray findings and back pain. This may help to explain the poor results when treatment is aimed at just muscles, discs, and other specific findings as seen on Xray.


Back pain arises from an interplay of mechanisms coming from biological, psychological, and social domains. They do not exist as separate entities in people, so a whole person approach is important. At Active Physiotherapy we explain how these factors contribute to your present episode of back pain. We offer proven treatments and management strategies to treat your present episode, show you how to stop it developing into a chronic condition and recommend strategies to prevent reoccurrence.


Why should I make an appointment?

Low back pain is very common, with many people experiencing ongoing pain.  Back problems may also contribute to hip and knee pain and cause tingling, numbness, and pain down the leg.


You should consider making an appointment if you regularly suffer from any of the following symptoms:


  • Low back pain during prolonged standing

  • Low back pain when getting up from sitting or getting out of bed in the morning

  • Fear of bending or feel that it is not safe to pick things up things from the floor

  • Concerns about causing further damage or re-injury.

  • Restricted range of back movements or feeling of tightness in the back or behind your legs

  • Feel that you have tried everything and nothing has helped

  • If you have been told the only treatment that can help is surgery.


Successful treatment for back pain is possible with a modern understanding of causes of back pain and a willingness to actively participate in your treatment. David will support and guide you through this process, so that you will have confidence to return to your activity.


What can I expect at my initial treatment?

Prior to treatment a detailed history and physical examination is undertaken. At this stage, it is important to exclude the possibility of more serious pathology, that may not be appropriate for physiotherapy. This may need specific specialist referral.  Only a very small percentage of back pain fits into this category.


Most commonly, low back pain is non-specific and may have started without any traumatic incident.  Degenerative changes to the disc or arthritic changes to the vertebral joints are now considered part of normal ageing and may contribute only minimally to your back pain.


What happened to my back?

The latest understanding of back pain, points to a more complex and diverse range of contributing factors than what is seen by looking at a back X-ray.  Into this mix must be included psychological factors such as fear, beliefs and meaning of back pain, social factors such as previous pain episodes and how your pain was explained, your body’s individual and instinctive physiological reaction to stresses, genetic factors, lifestyle and many others. Your back-pain experience is specific for you and an understanding of this, is important for successful treatment outcome.


Why should I choose David Fidler at Active Physiotherapy?

At Active Physiotherapy, David’s expertise is in analysing these factors and understanding how they contribute to your back pain.  He will explain and discuss these with you, so that you can actively participate in your recovery.


The initial focus is to reduce pain.  In acute back pain, this may be achieved by hands on, mobilising techniques together with pain relieving measures such as analgesics, heat, taping.  This may be all that is needed to achieve back pain relief and return you to normal activity.


Why does back pain sometimes persist?

The nervous system and brain are part of the hardware that allows us to feel pain.  These neural networks are active in all pain.  Biological mechanisms produce “danger messages” in our nervous system when there is tissue damage. Your brain transforms these messages into a very unpleasant feeling of pain, that alerts us to take some action, for example seeing a doctor. This is very useful and necessary if our body is damaged. 


Sometimes signals within the nervous system are amplified and the brain can cause severe pain, despite only minimal or no damage in the tissues and therefore minimal danger to us. In this case, we cannot rely on what we feel as a true report of damage to our body. An example of this might be when back pain continues long after an injury and after tissue damage has healed, yet we still feel pain and have restricted movement.


Assessment of back pain by an experienced therapist, knowing when it is safe to stress the body and return to activity, is vital for successful treatment.


A modern and scientific approach to pain and injury can give hope to sufferers of back pain who previously understood their pain only in terms of tissue damage.


Can I return to normal activities?


Once the level of pain is stabilised, exercises and graded activity can again be added into your management.  This will restore your back to a state of fitness and allow you to safely return to your activities.


David is happy to answer any queries you may have about back pain and discuss with you how he can help you.


Contact David Fidler at Active Physiotherapy 

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