Lower back pain is the most common injury treated in our Bondi Junction Physiotherapy Centre. 95% of lower back pain is resolved within eight weeks using conservative non operative physiotherapy treatment in our clinic. In our Bondi Junction practice we focus on prescribing the appropriate core stabilisation (pilates) exercise program. We focus on ergonomic (sitting posture) retraining and advice on using the correct lumbar supports and chairs for the work station. Treatment is holistic utilising mobilisation and manipulative therapy techniques, deep tissue massage, acupuncture, traction and electrotherapy modalities. The physiotherapist works closely with allied health professionals to prescribe a peri radicular nerve injection or NSAIDS where indicated to assist with pain relief.

Clear parameters indicating lower back surgery:

• Six months of excruciating unabaiting leg pain, unresponsive to all conservative management.
• Bilateral pins and needles in both feet.
• Difficulty passing urine and saddle “numbness” or paraesthesia in the buttock region (neurological signs).
• Foot drop or complete muscle weakness in lower limb associated with ongoing excruciating leg pain.
• Grade 3 stress fracture (spondylolisthesis) in the vertebra (pars defect): usually at the L4/5 or L5/S1 intervertebral level. The 12mm forward slip is usually caused by trauma or degeneration to the vertebra.

Types of lower back spinal surgery:

• Discectomy: this involves removal of the herniated portion of the disc through keyhole surgery, to relieve pressure and irritation of a nerve root.
• Laminectomy: this procedure involves removal of the bone overlying the spinal canal to relieve nerve pressure usually related to “stenosis” (narrowing) of the spinal canal from the degenerative ageing process.
• Fusion: This procedure permanently connects two or more bones in your spine. This is usually done with instabilities or fractures of the spine, or with very severe degenerative changes.

The most important factor following all three surgical procedures is follow up core rehabilitation exercise programmes and ergonomic advice at our Bondi Junction Physiotherapy Centre.