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What To Expect At Physical Therapy For Lower Back Pain

Why Is Physical Therapy Beneficial For People With Sciatica

Back Pain Tips from a Physical Therapist

Because it can help reduce inflammation and pain, improve physical function, and prevent recurrence of sciatica symptoms. Plus, your physical therapy program may teach you how to improve your posture and often includes a home exercise program for long-term improved physical health.

Passive physical therapy may include therapeutic exercise movements to increase range of motion. Photo Source: 123RF.com.

How Passive Physical Therapy Reduces Sciatica

The goal of passive physical therapy is to gently relieve painful soft tissue tension by relaxing your body, thereby preparing your body for active therapies that promote strength, flexibility, and long-term pain prevention. Your individualized passive PT plan may include some of the treatments below.

Deep tissue massageDeep tissue massage targets specific spinal muscles and fascia in the lumbar spine , hips and buttocks that may be compressing the sciatic nerve and/or nerves that branch off from the sciatic nerve. The therapist uses direct pressure and friction to try to release the tension in your soft tissues .

Deep tissue massage may involve application of direct pressure to a muscle group to release tension and pain. Photo Source: 123RF.com.

Hot and cold therapiesUsing heat, the physical therapist seeks to get more blood to the target areamore blood flow brings more oxygen and nutrients to that area. For example, a heat pack placed on your piriformis muscle may help reduce muscle spasms that could be causing your sciatica. On the other hand, cold therapy slows circulation, helping reduce inflammation, muscle spasms, and pain. Your physical therapist will alternate between hot and cold therapies to get the greatest benefit from each.

Common Causes Of Lower Back Pain

Pain in your lower back can be a symptom of various issues, but sometimes it is a symptom of an underactive or overactive lifestyle. Many people have lower back pain from bad posture, lifting something too heavy, or being on their feet for long periods. If the pain is left untreated or continues without relief, it could signify a more serious underlying condition. One of the most common causes of back pain is strained muscles or tendons. Many soft tissues are connected throughout your back, and simple activities like sitting down too long or lifting heavy weights can strain the muscles or even cause them to tear.

Additionally, many joints and discs in the back often become worn down or moved over time, resulting in serious pain and mobility issues. The most common conditions are degenerative disc disease, facet joint dysfunction, spondylolisthesis, sacroiliac joint dysfunction, and a lumbar herniated disc. These conditions can result from overuse or underuse and can cause severe pain and difficulty moving even small amounts. Osteoarthritis is a huge contributor to many lower back problems. Because it is caused by everyday wear and tear on your spine and the joints, OA can begin at any time and often lead to slowly worsening pain as your cartilage, and bone composition continues to break down and lose stability.

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Setting Up A Treatment Plan

After your examination, your PT will have a pretty clear idea of a treatment plan to start working on decreasing your pain and improving your mobility. Your physical therapist should discuss with you the goals of treatment and the expected course of your rehab.

Your physical therapist may start treatment after your initial evaluation. They may use therapeutic modalities like ultrasound or electrical stimulation to help manage your pain and improve your muscle function.

Exercise is one of the staples of any rehab program. After your initial evaluation, your physical therapist should prescribe a list of exercises to do at home and provide you a detailed print-out to help keep you on track.

Your PT will also make recommendations about how frequently to return for treatments. Many rehab programs consist of twice or thrice weekly visits. Sometimes, sessions are done once a week. Your specific program will depend on variable factors including your pain level or current level of mobility.

When embarking on a treatment plan, ask the PT what improvements you can expect to achieve over a certain period of time. Be optimistic but have realistic goals.

Research suggests that the best results are achieved with a multidisciplinary team consisting of a healthcare provider, PT, and other specialists . The irregular or occasional use of PT tends to be less successful.

Types Of Back Pain Effectively Treated

Physical Therapy for Low Back Pain: Effective Treatment and Lower Costs ...

There are two types of back pain: chronic and acute. Physical therapy can treat both. Chronic pain comes on slowly and lasts longer than twelve weeks. It is caused by wear and tear, degeneration, and even habitual poor posture or overactivity with weak muscles. Acute pain typically occurs after an injury it feels sharp and instant. Types of lower back pain effectively treated with physical therapy are:

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Functional Core Strengthening Exercises

Balance – Single Leg Activities:

These exercises help to improve balance and coordination while also strengthening the deep stabilizing muscles of the spine.

  • Start by standing on one leg with your knee slightly bent.
  • If needed, hold onto a counter or chair for balance- be safe but also challenge yourself.
  • Hold your balance for 30+ seconds for 2 to 3 sets on each leg.
  • When you’re ready you can progress in a variety of ways- including leg lifts or standing on a softer surface .

Dynamic Reaching Activities:

These exercises also help to improve the coordination of deep stabilizing muscles with daily activities.

  • Start by standing tall with your feet hip-width apart.
  • Slowly reach one arm up overhead and to the opposite side.
  • Focus on moving gracefully and with a feeling of strength.
  • Repeat 10 to 15 times for 2 to 3 sets on each arm.
  • Progress by adding weights or reaching in a variety of other positions

Other Classic Strengthening Moves to Try:

  • Lunges

Other alternative treatment options with varying levels of evidence behind them include:

  • Medication: such as steroid injections or pain medications
  • Self-care: rest, exercise, modalities, etc.
  • Chiropractic care
  • Acupuncture
  • Massage therapy

These methods may provide short term relief but do not tend to provide long term answers to pain.

What Happens At Physical Therapy

The first thing the physical therapist will do is an evaluation. Your physical therapist will run diagnostic tests and a physical evaluation to determine the extent of your back pain. Theyll also screen you for more serious health issues that could be causing your pain.

Patients may have physical therapy for back pain two to three times a week for several months. While youre there, the therapist will work with you on stretching and strengthening exercises.

Here are some of the more common treatments:

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Find The Relief Youve Been Looking For With Physical Therapy

The World Health Organization estimates that in the United States, 149 million days of work are lost due to low back pain.

Many people suffer from lower back pain and have no idea how to find permanent relief. Dealing with this kind of pain impacts daily life and can take away the time you normally use to relax, work, and spend time with your family. Essentially, back pain can make it difficult to enjoy life as a whole. Not to mention that it can keep a person feeling highly irritable, depressed, and can contribute to a number of other health problems.

Lower back pain is the leading cause of activity limitation and work absence in most of the world, placing a high economic burden on people, households, communities, industry, and governments.

If youre struggling with this kind of discomfort, theres no doubt that you want help, and now you can have it! A licensed physical therapist will help direct you through the appropriate therapy treatments to get back to your everyday life without any discomfort. Please contact Walker Physical Therapy today to learn more!

Core Targeting Strengthening Exercises

Self Test For Low Back Pain | Elite Physical Therapy

Pelvic Tilts:

An excellent exercise for retraining some of the deep core muscles, such as the transverse abdominus and pelvic floor, that often become dysfunctional with the onset of low back pain.8

  • Start by lying on your back with your knees bent and feet flat on the ground.
  • As you exhale, tilt your pelvis so that your low back flattens against the ground.
  • Focus on tightening the lower abs and lifting the pelvic floor without bearing down or tensing the neck.
  • As you inhale, return to the starting position.
  • Repeat for 10 to 15 repetitions, being sure to move slowly and with control throughout.

Plank:

This advanced movement is great for the whole body and can be easily modified for whatever level you can currently tolerate.

  • Start in a push-up position with your hands under your shoulders and your feet hip-width apart.
  • Keep your abs tight and spine neutral and hold the position- either on your hands or elbows.
  • Breathe as you hold this position for 30-60 seconds.
  • If this is too difficult, drop down to your knees and hold the plank position from there.

Other Core Exercises to Try:

  • Dead bugs

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Stretching For Back Pain Exercises

Almost every individual who has suffered from low back pain should stretch their hamstring muscles once or twice daily. Simple hamstring stretching does not take much time, although it can be difficult to remember, especially if there is little or no pain. Therefore, hamstring stretching exercises are best done at the same time every day so it becomes part of a person’s daily routine. There are many more stretches that can be done to alleviate lower back pain.

Does Your Low Back Need Pt

If you found yourself scrolling through and reading this article, there’s a very good chance that you will benefit from physical therapy. Whether you have a new injury or are battling a chronic issue, a physical therapist can help you protect your spine while making measurable progress that gets you back to normal life.

Ready to get started and ditch the frustration that comes with low back pain? Book an appointment with a CityPT expert today. You can see them almost instantly and gain valuable insight asap.

This guide is intended for informational purposes only. We are not providing legal or medical advice and this guide does not create a provider-patient relationship. Do not rely upon this guide for medical information. Always seek the help of a qualified medical professional who has assessed you and understands your condition.

References

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Why Physical Therapy For Back Pain Is A Good Idea

The muscles of the back, along with the muscles of the side body and abdomen, make up your bodys core. This large group of muscles is responsible for almost all movement in some way or another. Back pain can cause even the most mundane tasks to become excruciating.

Suffering through back pain without seeking treatment means you wont be able to exercise effectively. Bending and reaching may be out of the question. And you may even find it painful to stand, sit, or lay down. Your quality of life will suffer as a result.

Physical therapy for back pain is a non-invasive alternative. Surgery is expensive and it involves days or even weeks of downtime. While youre recovering, youll lose range-of-motion and muscle mass which makes it even harder to get back on your feet. A physical therapy treatment plan can save you time and money while reducing or eliminating the need for powerful pain medication.

Do I Need Physical Therapy For My Back Pain

If You Have any of These 5 Symptoms, You May Need Physical Therapy ...

If you are in generally good physical health with a regular fitness routine and do not have pain that radiates into your legs, your low back pain is likely to resolve without treatment. Physical therapy is often advised for individuals who are at risk of developing chronic low back pain. Often, this is the patient with severe, unremitting pain or symptoms that radiate into the legs that may also have numbness and tingling.

Once we have ruled out serious conditions that may require immediate medical intervention, a physical therapist will design a treatment program that:

  • Improves structural impairments in your spine and pelvis.
  • Relieves pain or modifies your current pain experience.
  • Returns you to your normal activities as quickly as possible.

While it may seem better to stay in bed and wait for the pain to resolve, this has been shown to be counterproductive to the natural healing process. Instead, it is recommended to remain active, modifying or reducing your regular exercise routine as tolerated, with a gradual return to your normal activities.

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Stretch And Strengthen Your Lower Back

Stretching your back when experiencing pain has many benefits beyond pain relief. Stretches like a knee to chest stretch or a piriformis muscle stretch can help reduce pain and the strain on your lower back and any stiffness. Most stretches can be adapted and specified for a patients level of flexibility and mobility. Even stretching other parts of the body like the neck, shoulders, and hips can reduce stress on your back. Yoga can be a helpful tool for increasing your range of motion.

Still, it must be done carefully and with professional instruction to guarantee that you do not put additional strain on your back or risk further injuries. Beyond gaining the flexibility to reduce pain through stretching, exercising your back to gain strength can also help in multiple ways. Not only can strengthening your back minimize pain, but it can also help prevent the risk of reinjury in the future by providing dynamic stabilization of your spine.

How Can I Benefit From Pt Treatments

Active physical therapy is distinct from passive therapy, as it requires activities that the patient must do instead of treatments that the therapist performs on the patient. These exercises are typically used later in therapy, after the lower back pain has been reduced enough for you to perform exercises and stretches without feeling too much discomfort.

There are lots of exercises that your physical therapist can suggest. Many of them include targeted stretching, stability exercises, flexibility training, and strength training. Some of these exercises will boost your range of motion, and others will build up and restore muscles around affected areas to provide proper support for those parts of the body.

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How Can Your Physical Therapist Help

Before considering other more aggressive treatments for chronic lower back pain , physical therapy is utilized to decrease pain and increase function. A PT can help strengthen muscles and improve flexibility to help patients avoid another injury. Standard forms of physical therapy include:

  • Passive PT focuses on modalities like electrical, thermal, or mechanical applications
  • Active PT focuses on specific exercises and stretching techniques

Not all lower back pain is the same, so your PT will create a plan tailored to your specific symptoms and condition. They might suggest a combination of treatment options to offset your pain.

What To Expect During Your Physical Therapy Appointment

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Upon your first visit to our clinic, your physical therapist will ask you many health related questions about your medical history and lower back pain. Allowing them to have this information will help your therapist provide you with the best treatment plan so that you experience long-lasting results.

Your therapist will also conduct a thorough examination of your body. Depending on your symptoms, your physical therapist might assess your flexibility, strength, balance, posture, coordination, blood pressure, and heart and respiration rates. They might use their hands to touch and evaluate your back and surrounding areas to check for tightness. They will also visually assess your mobility.

During your treatment, your physical therapist will provide you with special exercises to perform at home so that you can minimize pain, avoid re-injury, lessen strain, and speed up your recovery time. They may also recommend certain technology or equipment that can aid you in recovery, and spend time educating you about where your source of pain is coming from, as well as pain management strategies.

If youre ready to alleviate your pain, contact Hands-On Physical Therapy to learn more about how physical therapy can help you live a pain-free life.

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Exercises For Low Back Pain

While many believe that bed rest is the best solution for relieving lower back pain, it can actually slow down your recovery. Inactivity can make your muscles tighten up, causing more pain. Movement is the best medicine. Your PT will suggest you stay gently active, helping you get back on your feet much sooner. You can also try out these exercises for low back pain to target the affected areas:

  • Lower back stretches bridges, cat and cow pose, knee to chest, press up back extensions, and side twists
  • Core strengthening exercises partial crunches, pelvic tilts, wall sits, and hip stretches

Other options your PT might add to your treatment plan include:

  • Spinal manipulations

What To Expect During Physical Therapy For Lower Back Pain

Most Americans experience lower back pain at some time in their lives. This frustrating and painful condition leads to more work absenteeism and lost productivity than any other physical cause and is one of the most common reasons that people seek medical treatment. Although doctors often suggest over-the-counter medications or prescription drugs to ease back pain, these medications all carry risks. A less invasive alternative is physical therapy .

The American College of Physicians is the largest medical-specialty society in the world. The organizations 2017 guidelines advocate a non-invasive, non-pharmacologic approach for the treatment of acute, subacute, and chronic low back pain as first-line options.

The ACP recommends therapies administered by professionally trained physical therapists, including spinal manipulation, exercise, massage, and superficial heat, prior to resorting to pain-relieving drugs.

Heres what to expect if you choose physical therapy for your lower back pain.

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