Physical Therapy for Back Pain

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. I am biased, but physical therapy should be one of the first lines of defense against back pain. Physical therapy is a non-invasive, inexpensive conservative treatment for back pain.

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 (1). 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 and treatment without a prescription from a doctor.

What to expect for physical therapy for back pain?

Physical therapists will usually have more time to spend with you than your medical doctor, so we have the time 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 low hanging fruit that we can address that may provide you with immediate relief from your symptoms. Your standing and sitting posture may be causing more stress on parts of your back, and we can correct your alignment to reduce this stress. How you are picking things up, working out at the gym, 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.

We will also assess your mobility and strength. We will look at not only your spinal mobility, but we will look at your hips, knees and even 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 low back. Yes, stretching your calves may help your back! We want to get and keep you moving. Blood flow is good for healing and important for healthy joints, soft tissue, muscles, etc. Our goal is to get you moving in a pain free way and address any mobility and strength impairments that we have discerned from our evaluation.
You probably have heard that a strong “core” will help decrease or prevent back pain. Core strengthening is frequently prescribed when someone is experiencing back pain, but we will educate 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 (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. 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 your whole system.

What are you waiting for? If you are having back pain, get in to see a physical therapist.

1. Gellhorn AC, et al. Management patterns in acute low Back pain the role of physical therapy. Spine. 2012;37(9):775–782.