So, my name's Jordan and I'm the Physiotherapy lead at Benenden Hospital. I look after a team of four Physiotherapists, who help manage the inpatient case load up on the ward and facilitate safe discharge home. And we manage an outpatient clinic downstairs where we treat all kinds of musculoskeletal problems. Probably the two most common problems that come into physiotherapy in outpatient settings would be shoulder pain and lower back pain; lower back pain being one of the most common. I'm sure everyone has experienced lower back pain at some point in their life. It's just some people's lower back pain is more persistent than others and that's when they would need to come in to see a Physiotherapist. We normally suggest if your pain lasts longer than two weeks, and you're unable to self manage it, or you feel like you're not coping very well, then that is a good time to come and see a Physiotherapist or speak to your GP.

Keeping active and exercising can help manage lower back pain for several reasons. I suppose the most important reason is keeping moving. Your skeletal system is supported by your muscles. So if your muscles remain strong, then your bones are well supported, and they will be able to perform your daily tasks. Your daily tasks could include sitting and standing from a chair, getting out of bed. Or it could include playing sports, like tennis, running or swimming. It's a friendly atmosphere, very welcoming members of staff. We have a multi disciplinary team here. So that will be like the Physiotherapists, the Consultants, the Nurses on the ward. So if any of us have any problems that we feel is slightly out of our scope, or we wanted further advice from a specialist, then we can liaise amongst each other to offer the best treatment.

So a patient would come into the Physiotherapy department, suffering with lower back pain. The session would be an hour long and that would give us an opportunity to find out what's been going on, work out what the potential cause of your pain is. So I'll be asking patients questions on when the pain started, how it started, potential triggers, activities or tasks that could aggravate your pain and potential things that could help ease the pain. I would also ask questions which we call red flag questions which basically rule out abnormalities that we wouldn't want to continue treatment or we would like to at least closely monitor. In scenarios like that, the Physiotherapist would make a clinical judgment as to whether they need to be referred on to a specialist, or if they need to be referred on to have a scan.

Assessing the lower back, that would include movement and strength. And if you suffer with any nerve symptoms, like pins and needles or numbness, to find out where the cause of those are coming from. If they're coming from the centre of your back, or if they're more the peripheral nerves that run throughout your body, normally down your legs. That were the ones that we look at most. Then we would also assess the joints above and below just to make sure that there's no symptoms referring from other structures, such as your hip, your sacroiliac joint or your upper back. And then end with the treatment. So that could be hands on treatment and it would always include a home exercise program and advice on how to manage your symptoms.

The other important factor that we would like to address are lifestyle changes. So stopping smoking, cutting down on alcohol intake, trying to increase your daily activities so that you're not living a sedentary lifestyle. This gets your heart rate going, gets your circulation improving and coping strategies for managing mental health. Because pain can be very draining and can cause low mood, especially if you've been suffering for a long time. To ensure physiotherapy is successful, and you get a positive outcome from the sessions. We always try to motivate our patients to complete the exercises given, regularly little but often and within their limits or if symptoms were worsening, then the Physiotherapist would refer you back to your GP or to the consultant specialist for further investigations - and this can include MRIs or X rays and blood tests. And these would rule out any underlying health conditions that would need further intervention from a consultant.