According to the Cleveland Clinic, 90% of people will experience spine symptoms at least once over the course of their lives. What’s worse is that back pain radiates to other regions of the body, and with each episode of injury or pain, the effects worsen, last longer, and spread farther from the point of origin. Physical therapy is essential in ending the cycle of pain. In fact, 95% of herniated disc patients would not need surgery if their symptoms were addressed earlier.
Lower back pain is one of the most common forms of back pain. According to Move Forward PT, “at any given time, about 25% of people in the United States report having low back pain within the past three months.” The pain can range from mildly discomforting to excruciating. All degrees of pain, though, can inhibit you from enjoying daily life. Fortunately, treatment isn’t difficult to obtain, and in most cases, physical therapists (PTs) can help. Before we launch into a discussion of physical therapy treatment plans, though, let’s examine the signs and symptoms of low back pain.
Signs and Symptoms
Low back pain symptoms vary. You may experience pain in a single area, or it might be more broadly spread—possibly into one or both legs. The pain sensation may be dull, throbbing, burning, or sharp, and it may cause spasms or stiffness.
There are three categories of pain:
- Acute (pain that has lasted for less than three months)
- Recurrent (acute pain that returns)
- Chronic (pain that lasts longer than three months)
Low back pain typically occurs as a result of overuse, strain, or injury. Poor posture or form during sitting, standing, moving, bending, lifting, or sleeping, as well as exercise and other strenuous activities, can be contributing factors. There are also certain conditions that can lead to low back pain, including:
- Degenerative disk disease
- Lumbar spinal stenosis
- Herniated disk
- Tumors of the spine
Note: If you experience loss of bowel or bladder control and/or numbness of the thigh or groin in addition to your low back pain, seek emergency medical attention immediately.
Physical Therapy Treatment
If you suffer an acute injury to your lower back, get rest, use ice, and apply compression. Avoid bending, lifting, stooping, or remaining in any position for a prolonged period of time. In a couple of days, you should be able to return to normal activity, but you should transition to that activity gently and cautiously. According to the New York Times, if pain persists for a couple of weeks (also known as the sub-acute stage of the injury), then it’s time to seek out physical therapy services. If you’ve had back surgery, your surgeon or doctor will advise you on when to start physical therapy.
Every state, along with the District of Columbia, has some form of direct access to physical therapy, which essentially means you don’t need a physician’s referral to see a PT. That being said, you may want to contact your insurance company to determine what your specific policy requires regarding physical therapy. In selecting a PT, you’ll want to choose one who specializes in orthopedics and/or back pain, specifically lumbar spinal pain. (For more tips on what to look for in a PT, check out this page.)
During your first appointment, your PT will conduct an initial evaluation, which will include strength, balance, and pain tests. This allows the PT to develop a treatment plan (or plan of care) specific to you, taking into account the type, severity, and location of injury as well as your health and your ability to recover. Understanding these factors also enables the therapist to determine the frequency and duration of your sessions. According to Move Forward PT, treatments may include:
- Improvement of joints and soft tissue through manual therapy, including spinal manipulation (or “back cracking”) and massage
- Strength and flexibility exercises as well as aerobics
- Health and wellness education
- Posture and form training as well as ergonomics consultation
- Applied ice, heat, or electrical stimulation
- Prescribed at-home exercises and stretches
- Use of assistive devices
To ensure you regain normal mobility and function and eliminate your low back pain, it’s essential that you attend all PT sessions and complete the plan of care, including any prescribed home exercises. Following treatment, your PT also may recommend performing maintenance or strengthening exercises, both of which may reduce your chances of reinjury.