Physical Therapy for Back Pain

By: Dr. Sarah Kostyukovsky, PT, DPT, OCS

Back pain is the “common cold” of the musculoskeletal world. According to the National Institute of Health, 80% of adults will experience back pain at some point in their lives. We are biased, but physical therapy should be up there as the first line of defense against back pain. Physical therapy for back pain is non-invasive, inexpensive, and a conservative treatment.

Studies have shown that patients recover more quickly from an episode of acute low back pain when they get in to see a physical therapist for treatment within the first 4 weeks of pain onset. Fortunately, most states including New York, are direct access states for physical therapy. Direct access means that you can see a physical therapist for an evaluation without a prescription from a doctor. Physical Therapists can treat you for 10 visits or 30 days, whichever comes first. Following that 10 visits or 30 days, your Physical Therapist would have to send you back to your doctor for a prescription to continue treatment. If you’re not improving from physical therapy or your back pain is getting worse, this may be a good time for you to see a doctor for additional evaluation. What to expect for physical therapy for back pain?

What to expect from physical therapy for back pain?

Physical therapists will usually have more time to spend with you than your medical doctor, so we have the ability to do a thorough evaluation. We are experts in the musculoskeletal system and movement! After asking you lots of questions about your symptoms, lifestyle, activity level, past medical history, etc, we will look at how you move.

Bad postural habits and poor movement patterns are fairly common issues that we can address and possibly provide you with immediate relief from your symptoms. Your standing and sitting posture may be causing stress on parts of your back. We can correct your alignment to reduce this stress.  How you are picking things up, working out at the gym, or walking down the street can also be contributing to your back pain. More efficient movement patterns and avoiding provocative movements are key for treatment as well as prevention of back pain recurrence.

Physical therapy for back pain also involves assessing your mobility and strength. A physical therapist will not only look at your spinal mobility but also your hips, knees, and ankles! If you have limitations in your ankle mobility, this may be decreasing the shock absorption function of your feet and cause more stress to your lower back. Yes, stretching your calves may help your back! The point of utilizing physical therapy for back pain is to get and keep you moving. Blood flow is good for healing and important for healthy joints, soft tissue, muscles, etc. The goal is to get you moving in a pain-free way and address any mobility and strength impairments that are found during your evaluation.

You’ve probably heard that a strong core will help decrease or prevent back pain. Core strengthening is frequently prescribed when someone is experiencing back pain, with emphasis on educating you on the appropriate core exercises for your symptoms. The core is more complex than you may think and involves both the diaphragm and the pelvic floor (and yes, men have pelvic floors too). Physical therapists will teach you about your core, how to activate it properly, strengthen it appropriately and use it efficiently and effectively. Just because you can hold a plank for 10 minutes doesn’t mean that you are off the hook from having an episode of low back pain.

In summary, physical therapists are musculoskeletal and movement experts that can often conservatively and effectively treat your back pain without a prescription from your doctor. If we do not think that physical therapy is the appropriate treatment for you, we will refer you to another provider. During our evaluation and treatment, we will examine your whole system, not just where you are having pain. We will work with you on improving your posture and movement patterns and addressing your mobility and strength deficits that may be contributing to your symptoms. You will be educated about your body and how to move better! We want to treat not only your back pain, but we want to get you moving and prevent a recurrence of your pain.

What are you waiting for? If you’re having back pain and want to see if physical therapy for back pain is an option, contact a physical therapist. If you’re in the New York City area, reach out to us by filling out the form below or just give us a call.

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