Endo Spine Clinic

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PHYSICAL THERAPY

Physical Therapy for Low Back Pain
Patients suffering from most types of low back pain are often referred for physical therapy for four weeks as an initial conservative (nonsurgical) treatment option before considering other more aggressive treatments, including back surgery. The goals of physical therapy are to decrease back pain, increase function, and teach the patient a maintenance program to prevent future back problems.

Common forms of physical therapy include:
1. Passive physical therapy (modalities), which includes things done to the patient, such as heat application, ice packs and electrical stimulation. For example, a heating pad may be applied to warm up the muscles prior to doing exercising and stretching, and an ice pack may be used afterward to sooth the muscles and soft tissues. Active physical therapy, which focuses on specific exercises and stretching. For most low back pain treatments, active exercise is the focus of the physical therapy program.
This article focuses on active physical therapy and exercise as a means to help recover from back problems and prevent or minimize future flare-ups of low back pain.

Manual Physical Therapy for Pain Relief
Many patients arrive at their first physical therapy appointment expecting to receive hot packs, ultrasound and instructions on how to complete a series of exercises. These modalities are warranted in many instances and most therapists would agree that exercise is needed to help restore muscle imbalances. However, many therapists now approach the restoration of function from a different perspective. These therapists are interested in why a muscle isn't functioning properly and view back exercise not as the driving mode of recovery but as a complement to manual therapy. They may, for instance, look to restore proper sacroiliac or lumbar joint function to treat piriformis syndrome rather then directly manipulate the piriformis muscle through exercise.
Manual physical therapy is a specialized form of physical therapy delivered with the hands as opposed to a device or machine. In manual therapy, practitioners use their hands to put pressure on muscle tissue and manipulate joints in an attempt to decrease back pain caused by muscle spasm, muscle tension, and joint dysfunction.

Physical Therapy: Passive PT (Modalities) for Back Pain
Multiple modalities are commonly employed to reduce low back pain. They are especially useful in alleviating acute low back pain (e.g. an intense, debilitating episode of low back pain) for the patient. Physical therapists or chiropractors usually use passive modalities. Heat and Cold Therapy Heat and/or ice are easily available and are the most commonly used type of modality. Each type of therapy helps reduce muscle spasm and inflammation.
Some patients find more pain relief with heat therapy using heat packs and others with cold therapy such as ice massage. The two may also be alternated. They are generally applied for 10-20 minutes once every two hours, and are more useful early on (the first few days) in the course of an episode of pain.

Myofascial Therapy for the Treatment of Acute and Chronic Pain
Myofascial therapy relieves soft tissue restrictions that cause pain. Some causes of chronic myofascial pain or low back pain are easier to diagnose than others: trauma (suchas a car accident or fall), cumulative posture misalignment or mechanical deficits, a compressed nerve from a herniated disc, or inflammatory conditions. When pain is caused by myofascial tightness within the fascial system (the web of connective tissue that spreads throughout the body and surrounds every muscle, bone, nerve blood vessel, and organ to the cellular level) the diagnosis is more difficult, as fascia restrictions do not show up on MRI scans or X-rays.

What is Myofascial Therapy
Exercise Ball Therapy for Lower Back Pain Relief