Lumbar Instability Lumbar instability occurs as a result of damage to one or more of the structures that make up the three columns of the spine. In some cases, this damage will lessen the ability of the stabilising structures to resist mechanical stress and potentially allow abnormal movement to occur at the intervertebral segment. With repeated trauma, mild low back pain may be replaced by severe episodes resulting in loss of function. Clinical instability of the lumbar spine associated with fracture/dislocation is well recognised and usually requires surgical intervention. Orthopaedic surgeons, medical practitioners and physiotherapists have long realised that a less severe form of instability exists which can cause debilitating symptoms, while not displaying the dramatic neurological implications that are associated with fracture/dislocation. Patients with lumbar spine clinical instability have a history of recurring episodes of low back pain with loss of mobility. These episodes may occur several times per year. Patients have often been treated successfully with manipulation initially but may find as the condition progresses that any relief is only short-term. In the acute phase, the pain is debilitating with the patient usually describing a severe catching pain in the lower lumbar spine. Generally all active movements are tentative and restricted by pain. Palpation of the affective segment will illicit pain if done quickly. If performed slowly and carefully, increased accessory movement may be detected. Role of physiotherapy Physiotherapists play a significant role in the treatment of instability of the lumbar spine. Physiotherapy treatment in the acute stage is aimed primarily at pain relief. However, recent research has shown that the long-term resolution of lumbar spine instability must involve regular and intensive training of the paraspinal and abdominal muscles. This training must be specific to particular muscle groups (multifidis, transverse and oblique abdominals) if the maximum stabilising effect is to be achieved without placing further stress on the lower lumbar spine. Also important in the management of lumbar instability are mobilising exercises to help restore the patient's movement. When the basic abdominal and paraspinal contractions are mastered, the patient is then progressed through a series of exercises designed to enable them to return to a normal lifestyle with confidence. Finding a physiotherapist Would you like the names of physiotherapists who have a special interest in Lumbar Instability?  Lumbar Instability falls under the category of musculoskeltal in our online search.   [Find a Physiotherapist online now!] © By courtesy of the Australian Physiotherapy Association