Physical Therapy Treatments for Back Pain
Physical Therapy Treatments for Back Pain
By Brennan Howe
Physical therapy uses different techniques, such as ultrasound,
electrical stimulation, cryotherapy, massage, exercise, and heat in
order to relieve muscle spasms, increase flexibility, strengthen
muscles, relieve pain, and accelerate the healing process. A
study in The New England Journal of Medicine found that the
effectiveness of physical therapy for low was about the
same as that of chiropractic treatment and better than no treatment
Physical therapists must graduate from an accredited physical
therapy program, many of which offer master’s and doctoral degrees
along with bachelor’s degrees. Most schools require two to
four years of pre-physical therapy coursework before admittance.
Like other physical treatment programs, physical therapists spend
time in both the classroom and medical settings before graduation.
After graduation, they must take exams to become licensed, and some
states require continuing education to maintain that license.
After it is determined by a doctor or back specialist that you are a
candidate for physical therapy—some time between two to six weeks
after the onset of low or sooner if the pain is severe or
recurs frequently—you will meet with the therapist to determine the
best plan of treatment for you. You will be asked how your
back pain developed, how long you’ve had it, whether or not it’s
recurring, what actions make the pain better or worse, and any
relevant medical history you have. The therapist will also
give you a physical exam of your spine movement, muscular
flexibility, sitting and standing posture, muscle strength,
reflexes, respiration, motor function, and repetitive movements.
From there, he or she will determine which treatments will be best
for you. There is some trial and error involved, so if one
treatment doesn’t work to alleviate pain, the physical therapist may
try something different.
There are basically two types of physical therapy, passive and
active. Passive therapy is done to you and includes heat,
electrical stimulation, ultrasound, massage, and
lontophoresis. In heat, or thermal, therapy, the therapist
applies heating pads, heat wraps, or warm gel packs to the affected
area. This works to increase the flow of oxygen to the muscle,
allowing it to heal faster and relieve pain by softening muscles.
In cryotherapy, cold is applied rather than heat, and is considered
more effective than heat in reducing inflammation. Electrical
stimulation sends mild electrical impulses to the nerves and spinal
cord, which releases endorphins and blocks pain signals from the
brain. Ultrasound heats the deep tissue and allows it to relax
and stretch more easily. Massage breaks up scar tissue and
encourages the relaxation of muscle spasms. During
lontophoresis treatment, a painkiller and steroid are rubbed into
the skin and a low level electrical current is applied to speed up
the absorption of the drugs. It works similarly to transdermal
patches used to quit smoking.
You participate in active therapy, and it includes stretching,
strength building exercises, and aerobic exercise. A good
physical therapist will combine passive and active treatments, as
exercise is essential to treating back pain. The therapist
will determine which exercises are best for your particular
condition and supervise you in those exercises to ensure you are
doing them correctly. You will likely be given stretches to be
done daily, fifteen to twenty minutes of strengthening exercises,
and thirty to forty minutes of low-impact aerobic exercise, such as
swimming or walking, to be done three times a week.
You may feel some soreness or discomfort after active physical
therapy, but it should go away in about twelve to eighteen hours.
If it doesn’t, let your therapist know. You may need to change
exercises or how you are exercising. Results vary depending
upon the type of treatment done and the severity of symptoms, but a
physical therapist should know in about two weeks if the treatment
is working or not.
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