Back Pain Assessment & Treatment Plan
When it comes to back pain, there are three major sections of the spinal column that we consider when assessing injuries, pain triggers, and treatment options.
The first area of the back is the neck or cervical spine, which is the upper-most portion of the spinal column. The second is the thoracic spine, which is the middle section and is situated in the upper back and abdomen. The third is the lumbar spine, which is located in the lower back and largely supports the body’s weight.
Given that each section of the back is susceptible to different injuries and has different roles when it comes to support and movement, the physical therapy associated with each varies as well. In all cases, however, the three distinct phases of rest, recovery, and return remain.
Before beginning with any treatment plan, you will be given a complete evaluation of your back so we can pinpoint the problem and determine what is generating your pain. Once a diagnosis has been made, we will provide recommendations of how to manage your discomfort throughout the day and get the rest you need. This will come in the form of a home plan that is catered to your goals with the intention of helping you recover faster to get back to your pain-free lifestyle.
After outlining your treatment plan, you will begin a regular physical therapy routine to help with mobility, pain reduction, and overall recovery. The process and exercises within the plan will be different depending on a variety of factors associated with the patient, the injury, and its severity. Still, there are some key areas of focus for physical therapy for pain in each section of the back:
Cervical Spine
Physical therapy is a frequently recommended treatment for chronic neck pain. During every session, we dig deep into possible triggers that may be limiting your recovery process. Once identified, we show you how to perform your daily activities without continuing the positions that may be slowing down your rehabilitation. It is important to treat the source of pain or stiffness so that you are able to begin an exercise program.
By utilizing stretches and exercises to improve the strength and flexibility in the neck, your pain should be reduced. We also want your neck muscles to be able to effectively maintain good posture, which will help to reduce the overall stress on the cervical spine. Occasionally passive physical therapy may be recommended to help reduce pain and swelling. This can come in the form of massage therapy, heat therapy, ice packs, ultrasound, electrotherapy, among other treatments.
Thoracic Spine
For thoracic spine or upper back pain, we again focus to find and remove the triggers that continue to agitate your back. Common sources of pain include (but are not limited to) joint inflammation, muscle strains and knots, and rib dysfunction. Pain can be caused by issues as simple as poor posture, which activates muscles for abnormal durations and causes muscle fatigue, tightness, and pain.
Pain relief often comes by determining the appropriate balance of stability and mobility in the spine. If your upper back needs more mobility, we would work on joint mobilization techniques including foam rolling and stretching. Alternatively if stability was more of an issue, a focus on strengthening the muscles around the affected area would be the priority.
Lumbar Spine
Given the weight-bearing nature of the lumbar region of the spine, injuries and issues in this area are highly common. Several structures within the lumbar spine can trigger low back pain, including the facet joints, vertebral bones, intervertebral disks, and spinal muscles. Muscle strains caused by heavy lifting, repetitive use, or poor lifting form can cause varying levels of pain or lower back stiffness.
Our goal is to give you the tools you need to help relieve pain, hopefully without the use of medication or additional visits. These tools often come in the form of neurodynamic mobilizations, exercise, recovery positions, and trigger management. Many of these you can do from the comfort of your own home. As important as immediate pain relief is, we also provide long-term plans to reduce chronic pain and avoid further injuries that can be prevented.
What Kind of Physical Therapy Is Good for Lower Back Pain?
When low back pain is present, physical therapy and movement are generally good for you - especially when they involve strengthening the back, stomach, and leg muscles. You should always consult a healthcare professional (such as a physical therapist) before pursuing exercise for lower back pain, as some movements could be detrimental to your specific condition.
Common lower back pain exercises that can be considered within physical therapy include:
- Partial crunches
- Lying hamstring stretches
- Wall sits
- Press-up back extensions
- Lying knee-to-chest raises
- Lying lateral leg raises
- Lying pelvic tilts and hip raises
- Controlled and targeted weightlifting
- Aerobic exercise such as walking, swimming, or biking
- Core-strengthening Pilates moves
Regardless of which exercises for lower back pain that you use, you do not want to overexert yourself or worsen the condition of your back muscles. Exercises that put targeted stress on the lumbar region and increase the intensity of low back pain should be avoided, such as toe touches, full sit-ups, and leg lifts. By working with a trusted physical therapist you will be able to avoid potential pitfalls and work from a custom plan of lower back exercises and treatment options for your specific form of low back pain.
Conclusion
When back pain is present, it can have the potential to be debilitating and demobilizing in a way that makes everyday tasks difficult. Fortunately, in most cases physical therapy can be a powerful tool at your disposal for recovery or pain relief. The approach to treating back pain with physical therapy will vary with each individual and will likely incorporate a variety of movements, exercises, and passive physical therapy options outlined by your physical therapist.
If you need relief from back pain in any form, the physical therapy team at Keystone Therapy can assess your condition and help you on your road to recovery. Our treatment plans take into account both a short term (for relief) and long term (for management) outlook that will help you feel like yourself again. Contact us today to set up an appointment with a trusted physical therapist to outline a plan that is right for you.
