Knowing the type of back pain you have can be crucial when determining a treatment plan. Here are three types of back pain that may benefit from physical therapy.
Most lower back conditions, unless considered a medical emergency, may benefit from some form of physical therapy and exercise. The underlying cause of back pain dictates the foundation of the physical therapy program and the types of exercises that need to be included.
Axial back pain
Back pain that is not attributable to a known, recognizable cause is called axial or nonspecific back pain. This condition typically results from a group of contributing factors, such as using unsupported posture and/or being overweight.
Physical therapy is usually recommended for chronic axial back pain that has lasted for over 3 months and focuses on stretching and strengthening the lower back while also trying to eliminate lifestyle factors that may be contributing to the pain.
While not a medical diagnosis, sciatica is a set of symptoms caused by an underlying condition that may irritate or compress a spinal nerve in the lower back, causing lower back pain and/or leg pain.
Physical therapy and exercise for sciatica typically include extension and flexion (forward and backward bending) exercises, lumbar strengthening exercises, and nerve and joint mobilization methods, among others.
Post-surgical pain and healing
Following spine surgery, physical therapy and exercise can help eliminate fatigue, return to normal day-to-day activities, and avoid re-injury. Being involved in a consistent, guided exercise program can be critical in helping the body heal from the surgical procedure and in minimizing future episodes of back pain.
Physical therapists typically recommend abdominal, back, and leg strengthening exercises with some aerobic exercise to start the post-surgical exercise program.
Physical therapy is not recommended when back pain is caused by serious medical conditions, such as cauda equina syndrome, infection, or spinal tumors, where immediate medical or surgical intervention is warranted.
Duration of a Physical Therapy Program for Low Back Pain
The total length of an exercise program depends on the severity and duration of the low back symptoms.
- For chronic low back pain, physical therapy typically starts with an 8-week program performed under the guidance of a physical therapist.
- A longer-term maintenance or rehabilitation therapy is prescribed after the guided phase, which can be done at home.
The duration of the guided program may increase or decrease based on the outcome of the treatment.
Physical therapy may be combined with other nonsurgical treatments for the lower back to improve the overall pain outcome. Hands-on alternative treatments, such as massage therapy, manual therapy, and acupuncture may be beneficial when performed in combination with a physical therapy regimen. A combination of physical therapy and lumbar epidural steroid injections may also be recommended by a patient’s physician for some types of back pain. Physicians may also prescribe pain-relieving medication. Physical therapists may prescribe self-treatments, such as heat and cold therapy, to decrease pain and inflammation and improve tissue healing.