How Physical Therapy Helps Lower Back Pain

A common approach to treating lower back pain is to first prescribe a period of physical therapy (PT). In many cases, anti-inflammatory medications, rest and PT will resolve the painful condition. If unsuccessful, more invasive treatments may be considered including spinal injection and surgery. The effectiveness of a PT program requires an understanding of what it is trying to achieve. Learn what is included in a treatment program and how to help it be successful in relieving lower back pain.

The Goal of Physical Therapy

A program for treating lower back pain has three goals:

• decrease back pain
• increase movement
• educate the patient about maintenance to prevent future back issues

A patient who takes an active part in the first two goals and adopts a long-term maintenance program to prevent recurrence of back pain gains the most benefit from physical therapy. Those who don't are likely to return to their doctor with the same painful condition.

Two Elements of Physical Therapy to Relieve Lower Back Pain

Passive PT includes the application of heat to warm up the back muscles and cold to sooth them after an exercise session. It may also include electrical stimulation of the muscles to reduce tension.

Active PT consists of a series of exercises designed to gently stretch and strengthen muscles. The muscles around the spine support and stabilize the back. The abdominal muscles also provide critical support. These two sets of muscles, together, reduce the pressure on the bones and nerves that make up the spine. When these muscles fail, excessive pressure on the spinal joints produces pain.

Examples of Active Physical Therapy

Active PT strengthens muscle tissue in the lower back and abdomen to better support the spine. This is done through a series of gentle exercises that won't jar the muscles and increase back pain. Some of the exercises in a lower back pain program include:

• Exercise Ball Therapy - Lying back on a large exercise ball while rolling back and forth gently stretches muscles in the back.
• Sit ups, crunches and leg raises- These exercises strengthen the lower back and abdominal muscles.
• Abdominal machines - These are used to build up abdominal muscles.
• Low back hyperextension - Lying on the stomach and raising the chest off of the ground extends the spine and stretches the muscles that run along the sides of it.
• Forward bend - The person stands with feet and legs apart slightly, and bends forward until their upper body is parallel to the floor. This is used to strengthen lower back muscles.

Why Physical Therapy Doesn't Work

When physical therapy is not successful in eliminating lower back pain, the reasons often rest with the level of compliance of the patient with the program:

• The patient doesn't thoroughly understand the program
• The patient doesn't perform the exercises correctly
• The patient doesn't perform all of the prescribed exercises
• The patient doesn't continue the program on their own, long-term

This is why education is important -- to make sure the patient understands all aspects of the program. Supervision of the person when working out in the PT facility allows the therapist to correct mistakes in performing the exercises.

Continuing the program on their own is important for a person to maintain a healthy back and spine. If not enough time is invested in doing the exercises, not all of the exercises are performed, or they are performed incorrectly, there is a high risk that the person will return to their doctor with the same lower back pain complaints. 

For more information about the processes used to treat back pain, contact a clinic such as Cardinal Hill Rehabilitation Hospital.