Patients suffering from lower back pain are often recommended lower back physical therapy for drug-free and nonsurgical treatment options before considering more aggressive treatments. Lower back physical therapy involves treatments that help you recover from a lower surgery you may have had or to help you prevent one and get back to your active lifestyle quickly. Physical therapy focuses on relieving pain, promote healing, and restoring function and movement but also addressing the cause of your back pain and not just the symptoms. It is carried out by professionally trained Doctors of Physical Therapy – educated specifically in the evaluation and conservative management of spine disorders.
The Lower Back Conditions Physical Therapists Treat:
Sciatica is pain in lower back caused due to irritation of the sciatic nerve. The sciatic nerve is the largest nerve in the body and originates from nerve roots in the lumbar spinal cord in the low back and extends through the buttock area, sending nerve endings down the lower limb. The pain occurs when the sciatic nerve is pinched, usually be a herniated disk in the spine or overall growth of bone.
Signs & Symptoms of Sciatica:
✔ Difficulty bending or sitting
✔ Numbness or tingling pain in the leg
✔ Pain with prolonged standing or walking
✔ Pain when swinging the golf club or sporting activities
✔ Difficulty sleeping
The human spine is made of several rubbery cushions or disks stacked up. A spinal disk is like a jelly-like structure with a softer center capsulated in a tougher exterior. A slipped, ruptured or herniated disk occurs when some of the softer jelly pushes out through a tear in the tougher exterior. A herniated disk irritates nearby nerves and gives rise to pain, numbness or weakness in an arm or leg. Spine physical therapy can be an excellent pain reliever and treatment for a herniated disc.
Signs & Symptoms of a Herniated & Bulging Disc
✔ Arm or leg pain – most commonly on one side of the body
✔ Numbness or tingling
✔ Unexplained muscle weakness
✔ Burning sensation in the affected area
Similar to the condition of a herniated disk, in bulging disc, a crack occurs in the outer layer of the disc. The difference is – a bulging disk bulges outside the space it usually occupies between vertebrae and doesn’t rupture out of the disc and affects a much larger part of the disc than a herniated one.
Spinal stenosis is a condition where spaces within the spine narrow down which put pressure on the nerves that travel through the spine. Spinal stenosis usually occurs in the lower back and the neck. Some patients with this condition can experience pain, tingling, numbness, and even muscle weakness. Symptoms can worsen over time.
Signs & Symptoms of Spinal Stenosis
✔ Numbness or tingling in a hand, arm, foot or leg
✔ Weakness in a hand, arm, foot or leg
✔ Problems with walking and balance
✔ Neck pain
✔ Bowel or bladder dysfunction (in severe cases)
Facet joints are located between the vertebrae of each segment of the spinal column. They are special bones that keep the vertebrae together and enable a range of motion in the spine. Facet arthrosis occurs when the protective cushion between facet joints worn down, become thinner or damaged through wear and tear.
Signs & Symptoms of Facet Arthrosis
✔ Pain when standing
✔ Pain with prolonged walking
✔ Pain with rotation of your spine
Postural Back Pain
One of the common reasons for back pain is poor posture. Improper standing, lifting, sitting for a longer duration can put abnormal stress on your spine that can lead to anatomical changes in this body part. This can constrict your blood vessels and nerves and provoke back pain. In addition, it can also cause problems with your discs, joints, and muscles.
Signs & Symptoms of Postural Back Pain
✔ Poor posture
✔ Sedentary lifestyle
✔ Muscle weakness
✔ Muscle tightness
✔ Poor core stability
Mechanical Lower Back Pain
Mechanical lower back pain arises inherently from the spine, intervertebral disks, or surrounding soft tissue. It is one of the most common health problems which usually stems from improper movement. For instance, many golfers may get lower back pain because their hips are tight. Instead of rotating at your hip joints, you compress the spine.
Signs & Symptoms of Mechanical Lower Back Pain
✔ Dull or achy Pain in low back
✔ Stinging, burning pain that moves from the low back to the backs of the thighs, in worst cases, into the lower legs or feet including numbness or tingling (sciatica)
✔ Muscle spasms and tightness in the low back, hips and pelvis
✔ Pain that worsens after prolonged sitting or standing
✔ Difficulty in standing up straight, walking, or going from standing to sitting
✔ Pain is usually worse with activity.
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What Can You Expect When You Get Lower Back Physical Therapy
The initial assessment for lower back physical therapy consists of knowing about various components of the patient’s history, which include age, weight loss, weakness, and sensory changes. The therapist will also ask you an array of questions such as what makes your back pain better or worse, how long you have had it, was there a mechanism of injury? Also, what your goals are.
All of this information tells your therapist about what is going on with your back pain and alerts him/her if there is a probable medical emergency. Some of these questions may not seem important to you, but they will be useful to your therapist in determining the source of your pain and treatment that will relieve your back pain. Below are just some of the more common questions your lower back physical therapist will ask you.
A. Understanding Your Back Pain
The human back has been designed to provide a great deal of strength, protect sensitive spinal cord and nerve roots along with providing flexibility and mobility in all directions. However, different parts of spine can be the reason for the back pain. Before your doctor signs up for a treatment, it is important to understand the underlying cause of your back pain.
B. What Makes Your Back Pain Better or Worse
What are the positions that make your back pain better or worse? Does it feel better -standing, sitting, or sleeping? Various factors, like your body posture, affects your back pain. Listing some of them:
- Age – Back pain gets more common as you get older, starting around age 30 or 40.
- Lack of exercise – Weak, unused muscles
- Excess weight – puts extra strain on your back.
- Diseases – Some types of arthritis and cancer can contribute to back pain.
- Psychological conditions – patients prone to depression and anxiety can have a greater risk of back pain.
- Improper lifting – Using your back instead of your legs can lead to back pain.
- Smoking – it reduces blood flow to the lower spine, which can prevent your body from delivering enough nutrients to the disks in your back. Smoking also slows healing.
C. How Long Have You Endured
Knowing how long a patient has had back pain is important for your physical therapist. If you’ve just suffered an injury it is considered acute. If you’ve had it for less than 12 weeks it’s considered sub-acute, and chronic if you’ve endured for longer than 12 weeks. This is important to your lower back physical therapist because they’ll need to adjust your treatments based on this.
D. What Treatments Have You Tried
Depending on the type of back pain, your doctor might recommend specific treatment to you. However, once you sign up for physical therapy, your therapist takes account of all the treatments you have tried, what worked, and what didn’t work.
Once your physical therapist had asked you an array of questions, the next step is to do a physical examination to see exactly what is going on with your lower back. The premise of the physical examination is to get an accurate diagnosis of what’s going on with your lower back and then to fix the cause of it. Below are just some of the tests and measure your lower back physical therapist will do:
1. Range Of Motion Testing
Range of motion testing is the measurement of movement around a specific joint or body part. In order to have a full range of motion, your joint or muscle must have good flexibility. This step may include the use of goniometer – an instrument that measures the angle of joints.
2. Muscle Strength
This process usually includes the use of muscle strength grading scale, which often allows your physical therapist to determine how a muscle or group of muscles is working.
3. Detecting the Cause of Your Injury
The course of physical therapy includes detecting the major cause of injury, which helps your therapist to plan the most suitable treatment.
4. Functional Testing
The major goal of a rehabilitation program is to help a patient function as quickly as possible. Functional testing includes various activities to provide a baseline for determining progress to compare performance.
Lower Back Physical Therapy Treatment:
● Spinal Traction
Spinal traction is a form of decompression therapy that aims to relieve pressure on spine. It can be performed mechanically or manually and is used to treat chronic back pain due to herniated discs, sciatica, pinched nerves, degenerative disc disease, and other back conditions.
● Lower Back Exercises
There is a wide range of lower back exercises which strengthens back, leg muscles, and stomach and help relieve back pain and support your spine. Sometimes all you need is a few lower back exercises to ease the pain and stiffness in your lower back. Depending on your condition, your physical therapist can provide the right exercises that you need to be performing.
● Patient Education
Around 80% of people accept having lower back pain at some point in their life. Unfortunately, very few of them receive the right treatment. Patients’ awareness regarding lower back pain is important for the prevention of this condition and healing optimally. For instance, patients will need to be educated on how to sit, bend, lift, and twist properly.
● Manual Therapy & Myofascial Release
Manual therapy provides instant as well as long-term relief to patients with chronic and acute back pain. It also helps to ease the joint problems, muscle strains, or a strained back. It also helps with a herniated and bulging disc. Usually the best lower back physical therapists know how to provide this type of treatment.
● Spinal Manipulation
Spinal manipulation is one of the best treatments for acute and sub-acute lower back pain that your lower back physical therapist that can provide. Spinal manipulation helps increase mobility but also reduces pain. Spinal manipulation can be used by chiropractors, physical therapists, and medical doctors to improve physical functioning and relieve lower back pain. The good news is that a physical therapist can do a spinal manipulation non-aggressively unlike what you see some chiropractors perform. This is a better and safer outcome for the patient.
How You Can Get Started With Lower Back Physical Therapy
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About Author: Dr. Scott Gray
Dr. Scott Gray is an internationally recognized and expert physical therapist specializing in sport, athletic, and back and neck injuries. He is the inventor of a revolutionary form of treatment called the GRAY METHOD. This type of treatment unlike others, addresses the CAUSE rather than just your SYMPTOMS with a full body approach. For more information on how to ease or overcome your injury, go to www.backinmotionsspt.com.