By Poonam McAllister, Vestibular Physical Therapist, Central Illinois Institute of Balance
Many people have back pain and many people have problems with balance. People may not realize that the two seemingly different concerns are often connected.
Nine out of ten individuals will suffer from back pain at least once. Back pain is one of the top five complaints that people visit their doctor for and is the most common reason for missed work.
Balance problems manifest as difficulty walking, climbing stairs, or just simply being able to stand to do basic activities of daily living like getting dressed or brushing teeth. These limitations can occur due to basic balance problems caused by neurological conditions like peripheral neuropathy or stroke. However, people often ignore the simple back pain and its effects on the spinal nerves which can lead to similar balance challenges. Let’s discuss some of the effects of physical impairments caused by chronic back pain and how they relate to balance problems.
The spine is a complex interconnecting network of nerves, joints, muscles, tendons, and ligaments, and all are capable of producing pain. Large nerves that originate in the spine and go to the legs and arms can make pain radiate to the extremities. Back pain can be acute or chronic; can arise from the neck, upper back, lower back, and pelvic/tail bone area; can be constant or intermittent; and may radiate to arms and legs. Back pain may be an aching, sharp, or burning type pain and may include symptoms other than pain including weakness, numbness, or tingling.
Damage to the nerves due to pressure from bone spurs, herniated disc material, or, in severe cases, pressure on the spinal cord itself can lead to significant muscle weakness. Muscle weakness that goes unchecked can lead to dropped foot which can affect the ability to walk, clear thresholds or stairs, and ultimately increase the risk of falling. Pressure on the spinal nerves can also lead to radiculopathy or neuropathy, which can cause tingling and numbness in feet. This abnormal sensation or in some cases loss of touch or joint awareness can also lead to problems with balance. Sacroiliac joint dysfunction can cause pain with standing and other weight-bearing activities. People often discount their pain due to aging or injury and only report the difficulty with walking, stair climbing, and balance. However, chronic back pain can cause balance problems due to its effect on the somatosensory system.
Balance problems can be evaluated and treated by assessing the visual, somatosensory (feeling from the joints and skin) and vestibular systems (inner ear). A thorough interview and a comprehensive evaluation of various systems that control equilibrium can help identify the root problem. Simple treatments like following proper body mechanics, posture correction exercises, micro-stretches, and core stabilization exercises can successfully treat a new back injury and keep it from becoming a chronic problem, which in turn may help correct or avoid problems with balance.
Don’t let your back problem become chronic. Talk to your medical provider and ask for a referral to a physical therapist. Since the structures involved can vary from case to case, an individualized personal exercise program prescribed by a physical therapist is usually more effective than group or wellness-based programs.
For more information, you may contact Poonam McAllister, physical therapist, at Central Illinois Institute of Balance, 309-663-4900, www.dizzyil.com. They are located at 211 Landmark Dr., Suite E-3, in Normal and specialize in treating balance and dizzy disorders.
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