Physical Therapy Guide to Low Back Pain
If you have low back pain, you are not alone. At any given time, about 25% of people in the United States report having low back pain within the past 3 months. In most cases, low back pain is mild and disappears on its own. For some people, back pain can return or hang on, leading to a decrease in quality of life or even to disability. Physical therapists help people with low back pain improve or restore mobility and reduce their pain.
Signs and Symptoms
Most people who have an episode of acute pain will have at least 1 recurrence. While the actual cause of low back pain isn't often known, symptoms usually resolve on their own. Psychosocial factors, such as self-confidence and a perceived ability to cope with disability, have been shown to be predictors of who might not recover from low back pain as expected. We used to believe the cause of low back pain was related directly to the tissues of our body, but are now understanding the condition to be more complex. Although low back pain is rarely serious or life threatening, there are several conditions that may be related to your low back pain, such as:
Degenerative disk disease
Lumbar spinal stenosis
Tumors of the spine
How Is It Diagnosed?
Your physical therapist will perform a thorough evaluation that includes:
A review of your health history.
Questions about your specific symptoms.
A thorough examination that includes assessing the quality and quantity of your movements, and any movement behaviors that might put you at risk for delayed recovery.
Tests to identify signs or symptoms that could indicate a serious health problem, such as broken bones or cancer.
Assessment of how you use your body at work, at home, during sports, and at leisure.
For most cases of low back pain imaging tests, such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) are not helpful for recovery. For example, in a recently published article comparing patients who received an MRI first vs physical therapy first for low back pain, the patients who received an MRI first spent on average $4,793 more (with similar outcomes in each group). If your physical therapist suspects that your low back pain might be caused by a serious health condition, the therapist will refer you to other health care professionals for further evaluation.
How Can a Physical Therapist Help?
Not all low back pain is the same, so your treatment should be tailored to for your specific symptoms and condition. Once the examination is complete, your physical therapist will evaluate the results, identify the factors that have contributed to your specific back problem, and design an individualized treatment plan for your specific back problem. Treatments may include:
Manual therapy, including spinal manipulation, to improve the mobility of joints and soft tissues
Specific strengthening and flexibility exercises
Education about how you can take better care of your back
Training for proper lifting, bending, and sitting; for doing chores both at work and in the home; and for proper sleeping positions
Assistance in creating a safe and effective physical activity program to improve your overall health
Use of ice or heat treatments or electrical stimulation to help relieve pain
Can This Injury or Condition Be Prevented?
Physical therapists can teach you how to use the following strategies to prevent back pain:
Use good body positioning at work, home, or during leisure activities.
Keep the load close to your body during lifting.
Ask for help before lifting heavy objects.
Maintain a regular physical fitness regimen—staying active can help to prevent injuries.
There is evolving evidence suggesting that the best strategy in preventing disability and care-seeking for low back pain is simply understanding what we are learning about the topic of pain.
What Kind of Physical Therapist Do I Need?
A physical therapist who is experienced in treating people with orthopedic or musculoskeletal problems.
A physical therapist who is a board-certified clinical specialist, or who completed a residency or fellowship in orthopedic physical therapy. This therapist has advanced knowledge, experience, and skills that may apply to your condition.
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