Should I Go See a Physical Therapist for Low Back Pain?
So here is the million dollar question - Should I go see a Physical therapist for low back pain?
The answer is YES! In fact a Physical Therapy can and should be your first and last/only stop for diagnosis and treatment of low back pain. For many people dealing with low back pain for the first time it can come on suddenly or even gradually and can be mild or severe. Excluding times when your pain is so severe that you can’t walk/stand or for the rare times that your back pain will be in combination with loss of bowel or bladder control you can and should see a Physical Therapist first.
The 1st step is the diagnosis of the low back pain which your therapist should take you through a full physical exam. The purpose of this Physical Therapy initial examination is to see what will increase or decrease your pain. If your Physical Therapist can reproduce or decrease your low back or leg symptoms with movement testing in the initial exam then he/she will be able to tailor your treatment to decrease the symptoms. In addition to getting you a specific exercise program the ability to reproduce symptoms with movement testing will provide your Physical Therapist with clinical evidence to suggest this injury is within the Physical Therapy scope of care and can be effectively treated at a Physical Therapist’s clinic.
The 2nd step is started once you initial exam is complete and this phase is the actual treatment of your low back and/or leg pain that is caused by your low back injury. This should start on the first day and can vary from as little as 1-2 sessions to as long as 8-12 sessions. Every patient has varying degrees of pain and those specific patients with high levels of pain can take a few weeks to reduce symptoms. The main aspect of treatment should be focused on educating the patient on what specific movement activity will centralize your lower extremity and back symptoms and reduce pain. These exercises and positions will be determined on the 1st visit and you should progress at each visit based on how you present.
There are some misconceptions out there about the type of stretches and positions that will help decrease low back pain. Many patients believe that bending forward and stretching their hamstrings or even sitting will help resolve their lower back and leg pain, when in fact if you have a lumbar disc injury usually bending backward is the most beneficial stretching activity. Think of the lumbar disc in your back, between each bone vertebra, as a moveable substance that when you bend backward you are actually pushing that bulging disc back into place and taking pressure off the nerve root being compressed. When this exercise activity is preformed the patient should see their symptoms move closer to the middle of the back and eventually decreased in intensity and frequency.
Below are a few examples of few simple back extension exercises that could reduce pain and centralize your symptoms. It is important to note to never continue these exercises if your radicular symptoms (leg symptoms) get worse in anyway. It is okay to continue if you see a presentation of more central (closer to the midline or spine) pain. Those central symptoms may increase at first but should subside after a few days.
In conclusion, if you and your therapist are unable to centralize and reduce your pain to a level that is manageable with conservative treatment after a few weeks than a visit to a pain management medical doctor may be the next step. To get a full evaluation and diagnostic tests in order to determine what the next steps are in your intervention process.
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