Low back pain can be caused by many different things. There can be nerves that are “pinched” by inflammation or bone spurs, muscles that are sore from an injury or overuse, pain after surgery, stenosis, disc problems and many other causes. Because of how the spine is organized in terms of muscles, bones, ligaments, nerves, etc; it can be very difficult to determine exactly what is causing the pain. Therefore, physical therapists now use “treatment-based classifications”. This means that we figure out which type of treatment is best for the individual patient based on his or her symptoms.
There are four general categories of low back pain, and based on a patient’s specific presentation, they are classified by one or more of these.
Using a machine or the therapist’s hands, the spine can be “distracted” or pulled on so that the spaces are opened up in the back and allowed to heal.
Based on how the person moves and which type of movement causes pain or gives relief, specific types of movement may be the best treatment to help with the pain. This generally refers to someone who feels better going in one direction, and worse in the other direction, such as bending forward to touch the toes hurting, and bending backward to look up at the ceiling feeling better.
Depending on the symptoms and how recent the pain is, the patient may benefit most from certain “hands-on” treatments by the therapist in which the joints and moved in a specific manor which may cause a “popping” noise (think chiropractic treatment). This treatment is always followed by exercise.
This type of treatment may be best when the person has had a surgery and the muscles aren’t doing their job to keep the spine strong and stable. However, almost always, a person will benefit from specific exercise prescribed by his or her physical therapist, no matter which category of treatment is best for them.
While the above classifications generally define some of the best treatments for low back pain (such as mobilization under the manual therapy umbrella and exercise), there are some other treatments that may be considered, based on the specific situation.
Heat and Cold
These treatments can help to relax you and loosen tight muscles.
Sound waves are used to provide a mild heat to stiff and sore parts of the body. (note that there is little research to support the use of this treatment method.)
infrared light (laser light) is used to help parts of cells heal. (note that there is little research to support the use of this treatment method.)
Low level electrical signals may help with pain and loosen tight muscles.
Therapeutic tape can be used to provide stability and relieve pain.
The therapist uses his or her hands to help provide healing. Examples are massage, stretching and joint mobilizations.
When it comes to low back pain, there is still much to be investigated and determined about which is the best course of treatment. However, physical therapists have developed a multitude of treatments that are based in research and tend to work well for patients. If you’re having low back pain, set up an appointment today!
Disclaimer: The information provided in this post or anywhere on richardsonpt.com is no substitute for an evaluation by a licensed healthcare provider. Always consult with your doctor before beginning any exercise or diet plan.
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