For patients with impaired mobility and chronic pain, a physical therapy evaluation is warranted as part of the pain management treatment plan. This strategy helps improve function, relieve pain, and enhance quality of life. Back pain is the most common reasons patients are referred to a physical therapist.

How common is chronic back pain?

Back pain is one of the most common complaints among working-aged persons. According to statistics, back pain affects approximately 85% of people at one time or the other. Chronic back pain is one of the most common reasons people seek pain medication management.

What causes back pain?

The spine is composed of 24 irregular shaped bones called vertebrae. Between each of these bones is a cushioning disc. The structures that support the spinal cord are many muscles and ligaments. Any of these structures can affect stability and mobility of the spine, and this results in back pain. The most common cause of back pain is frequent forward bending, heavy lifting, and poor posture.

What conditions do physical therapists treat?

Physical therapy can improve the following treatments:

  • Chronic back pain
  • Fractures
  • Stroke
  • Spinal cord injury
  • Carpal tunnel syndrome
  • Amputation
  • Arthritis of joints
  • Spinal arthritis
  • Neck pain

What can I expect at the first physical therapy visit?

A visit to the physical therapist involves an initial evaluation and assessment. The therapist checks your range of motion by having you move through many positions. You need to wear loose fitting, comfortable clothes. Be sure to ask questions about your condition, report all your symptoms, and discuss your impairment of activities. The therapist uses this evaluation to devise a physical therapy treatment plan.

What happens during a physical therapy treatment?

Physical therapists use a variety of techniques to decrease stiffness and pain, improve mobility, and increase mobility and strength. Therapy involves the use of many physical agents to relieve pain, including ice, heat, electrical stimulation, and ultrasound. A major component of physical therapy is patient education about the illness, injury, or chronic condition.

What are the different types of treatments offered by the physical therapist?

The treatments chosen by the physical therapist depend on the extent of your condition, the doctor’s orders, and your ability to participate in the treatment plan. Options include:

 

  • Exercise – The physical therapy will device a detailed exercise program to help you strengthen muscles and reduce stress on the joints. Stability of the core helps improve hip and back strength, which decreases the risk for future injury.
  • Manual therapy – This treatment decreases pain, increases flexibility, and relax tense muscles. Also called bodywork, manual therapy involves slow movements used to pull, push, and twist joints and bones into normal position, which is called mobilization. Other techniques are massage and pressure by controlled force (manipulation).
  • Decongestive lymphatic drainage – This form of massage alleviated excessive lymphatic fluid that has built up, and relieves swelling.
  • Ultrasound therapy – A specialized device emits high-pitched sound waves that relax muscles and ease muscle spasms. This therapy alleviates inflammation, relieves pain, and promotes muscle healing.
  • Electrical stimulation – With this technique, the therapist uses mild electrical impulses to reduce muscle contractions and pain.
  • Hydrotherapy – Also called water therapy, this involves exercising in water for improved muscle strength and joint flexibility.

How effective is physical therapy?

The efficacy rate of physical therapy is around 60-70%, according to research studies. One research study showed physical therapy in combination with other treatment modalities to be superior to general care (medication and education).

Resources

Deyle GD, Henderson NE, Matekel RL et al. (2000). Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee: A randomized, controlled trial. Ann Int Medicine, 132(3).

Hoving JL, de Vet HC, Koes BW, et al. (2006). Manual therapy, physical therapy, or continued care by the general practitioner for patients with neck pain: long-term results from a pragmatic randomized clinical trial. Clin J Pain, 22(4): 370-377.