Physical Therapist’s Guide to Low Back Pain

If you have low back pain, you are not alone. At any given time, about 25% of people in the United States report having low back pain within the past 3 months. In most cases, low back pain is mild and disappears on its own. For some people, back pain can return or hang on, leading to a decrease in quality of life or even to disability.

When to Seek Immediate Help

If your low back pain is accompanied by the following symptoms, you should visit your local emergency department immediately:

• Loss of bowel or bladder control
• Numbness in the groin or inner thigh

These symptoms might indicate a condition called “cauda equina syndrome,” in which nerves at the end of the spinal cord that control bowel and bladder functions are being squeezed.

Low Back Pain Signs and Symptoms

The symptoms of low back pain vary a great deal. Your pain might be dull, burning, or sharp. You might feel it at a single point or over a broad area. It might be accompanied by muscle spasms or stiffness. Sometimes, it might spread into 1 or both legs.

There are 3 different types of low back pain:

• Acute – pain lasting less than 3 months
• Recurrent – acute symptoms come back
• Chronic – pain lasting longer than 3 months

Most people who have an episode of acute pain will have at least 1 recurrence. While the actual cause of low back pain isn’t often known, symptoms usually resolve on their own. Psychosocial factors, such as self-confidence and a perceived ability to cope with a disability, have been shown to be predictors of who might not recover from low back pain as expected. We used to believe the cause of low back pain was related directly to the tissues of our body, but are now understanding the condition to be more complex.

Conditions Related to Low Back Pain

Although low back pain is rarely serious or life threatening, there are several conditions that may be related to your low back pain, such as:

• Degenerative disk disease
• Lumbar spinal stenosis
• Fractures
• Herniated disk
• Osteoarthritis
• Osteoporosis
• Tumors of the spine

While we used to believe the above list contributed directly to low back pain, research has shown these conditions are also present in people without any pain (asymptomatic).

How Is It Diagnosed?

Your physical therapist will perform a thorough evaluation that includes:

• A review of your health history.
• Questions about your specific symptoms.
• A thorough examination that includes assessing the quality and quantity of your movements, and any movement behaviors that might put you at risk for delayed recovery.
• Tests to identify signs or symptoms that could indicate a serious health problem, such as broken bones or cancer.
• Assessment of how you use your body at work, at home, during sports, and at leisure.

For most cases of low back pain imaging tests, such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) are not helpful for recovery. For example, in a recently published article comparing patients who received an MRI first vs physical therapy first for low back pain, the patients who received an MRI first spent on average $4,793 more (with similar outcomes in each group). If your physical therapist suspects that your low back pain might be caused by a serious health condition, the therapist will refer you to other health care professionals for further evaluation.

What to do if You Have Low Back Pain?

If you are having low back pain right now:

• Stay active, and do as much of your normal routine as possible—bed rest for longer than a day can actually slow down your recovery.
• Try some back stretches and at-home treatment to help your muscles relax, but proceed with caution as to not cause further injury.
• If your pain lasts more than a few days or gets worse, schedule an appointment to see your physical therapist.

How a Physical Therapist can Help

Your physical therapist can help you improve or restore mobility and reduce low back pain—in many cases, without expensive surgery or the side effects of medications.

Not all low back pain is the same, so your treatment should be tailored to for your specific symptoms and condition. Your physical therapist will start your first visit by getting some history and performing an examination. Once the examination is complete, your physical therapist will evaluate the results, identify the factors that have contributed to your specific back problem, and design an individualized treatment plan for your specific back problem. Treatments may include:

• Manual therapy, including spinal manipulation, to improve the mobility of joints and soft tissues
• Specific strengthening and flexibility exercises
• Education about how you can take better care of your back
• Training for proper lifting, bending, and sitting; for doing chores both at work and in the home; and for proper sleeping positions
• Assistance in creating a safe and effective physical activity program to improve your overall health
• Use of ice or heat treatments or electrical stimulation to help relieve pain

Find Relief With IMPACT Physical Therapy

If you’re experiencing low back pain, you don’t have to suffer any longer. The team at IMPACT Physical Therapy is here to help. Explore our services and contact us today to start relieving your low back pain.