Physical therapy for low back pain
Description
Your doctor may refer you to a physical therapist to treat your low back pain. A physical therapist can teach you exercises and stretches that can make it possible for you to do the activities you want to do.
Physical therapy (PT) can help treat muscle strains and ligament sprains, sciatica, slipped disk, and arthritis. It may also help you prepare for spine surgery or recover after surgery.
The goal of PT is to help you function as well as possible with little or no pain. To do this, your physical therapist will:
- Help you strengthen and stretch the muscles that support your spine and legs.
- Teach you proper ways to move your spine when you do everyday tasks and sports activities.
Treatment and techniques
A lot of exercises, stretches, and other methods can help treat back pain. Your physical therapist will choose a set of exercises or treatments that are best for your back pain. Your primary care doctor or orthopedic surgeon will also help guide these treatments.
Before treating you, your physical therapist will check your body mechanics (how your body moves). To do this, your therapist may:
- Watch how your hips and legs move as you walk or do other activities
- Observe your spine and posture as you stand or sit
- Check the range of motion of your hip joint and spine
- Test your muscles for weakness or stiffness
- Check to see which movements cause pain or make your pain worse
- Check your balance and coordination of your muscles
After testing and checking you, your therapist will know which muscles are too weak or too tight. You will then start a program to stretch out your muscles and make them stronger. Most of the time, you will not need to use weights for these exercises.
The muscles in your abdomen, hips, and spine are some of the strongest muscles in your body. When all of these muscles are strong and working well together, they help stabilize your spine. When your spine is stable, there is less stress on any one part of your back when you are active. Building up these muscles is called "core strengthening." Having a strong core will help prevent back injury in the future. A lot of these exercises will focus on balance and symmetry between your sides.
Deep tissue work or massage
Your physical therapist may also do deep tissue work or deep tissue massage. This kind of massage is different from the kind of massage that can help you relax.
The goal of deep tissue massage is to break up tiny scars that can form in muscles, tendons, and other tissues. These scars can form in tissues that have been sore or tight for a long time, and they can cause pain or stiffness.
During deep tissue massage treatment:
- Your therapist will use thumbs, fingers, and even elbows to apply pressure to deep muscles and tissues. Your therapist will apply this pressure in long, slow strokes.
- The pressure will focus on the area of pain. Your therapist will slowly increase the amount of pressure, so the treatment should not be very painful.
- Make sure you tell your therapist if you have any changes in numbness or weakness in your legs during your massage.
Right afterward, you may have pain or stiffness in the muscles that your therapist worked on. Try using an ice pack on the sore or stiff area. Be sure to put a towel or cloth between the ice pack and your skin and to use the ice for only 20 minutes at a time. Don't fall asleep while using the ice pack, as you can get frostbite. Discomfort from massage should go way in 1 or 2 days.
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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