Non-surgical Rehabilitation

Physical therapy treatments are often prescribed for two to four weeks for patients with acute low back pain. If you suffer from chronic back problems you may need to continue therapy for two to four months. Treatments are designed to ease pain and to improve mobility, strength, posture, and function. You also learn how to control your symptoms and protect your spine.

Initially, your therapist may apply various forms of treatment to address your symptoms. You'll be shown ways to position your spine for maximum comfort while you move, recline, or sleep. To help calm pain and muscle spasm, your therapist may apply heat or ice packs, electrical stimulation, and ultrasound.

Therapists use pool therapy for patients with severe back pain. Treatments in the pool put less stress on the low back, and the buoyancy allows easier movement during exercise.

Hands-on treatments such as massage and specialized forms of soft-tissue mobilization may be used. Spinal manipulation also can be used, which has shown short-term benefits if you suffer from acute low back pain. Commonly thought of as "adjustment," spinal manipulation helps reset the sensitivity of the spinal nerves and muscles, easing pain and improving mobility. It involves a high impulse stretch of the spinal joints and is characterized by the audible sound of popping as the stretch is done. It doesn't provide effective long-term help when used routinely for chronic conditions.

People with back pain often limit their activities. As a result of pain and inactivity, their muscles become weak and de-conditioned, and their back doesn't function optimally. Therapists use active rehabilitation to prevent the harmful effects of de-conditioning. With this "active" approach patients are shown how to lift and move safely. They are shown how to strengthen their back muscles. In addition, aerobic exercises are used to improve general fitness and endurance.

Aerobic exercises may include walking on a treadmill, riding a stationary bike, or swimming. These activities can relieve the stress of low back pain, and they can cause your body to release endorphins into the blood stream. Endorphins are the body's own natural painkillers.

Active rehabilitation speeds recovery, reducing the possibility that back pain will become a chronic problem. Along with active exercise, this format is used to help patients resume normal activity as swiftly as possible. Pain is used to gauge the limits of activity fostering a greater sense of control. Treatment sessions focus on reassuring patients that getting back to work and other normal activities swiftly won't cause harm and can actually help them get better faster.

When needed, you are encouraged to take certain actions to improve your spine health. If you smoke you are encouraged to get help to quit your habit. Because of the limited blood supply in the tissues of the low back, smoking speeds the degenerative process and impairs healing. In addition, if you are out of shape you are encouraged to get fit. This strategy makes it less likely that back pain or injury will strike again in the future.

As the rehabilitation program evolves, you will progress with more challenging exercises. The goal is to safely advance your strength and function. Your therapist will work closely with your doctor and employer to help you get back on the job as quickly as reasonably possible.

Surgical Rehabilitation

Rehabilitation after surgery is much more complex. Some procedures, such as fusion surgery, may require a hospital stay for a few days. If you stay in the hospital, a physical therapist may see you soon after surgery. The treatment sessions help you learn to move and begin doing routine activities without putting extra strain on the low back. Therapy may also be needed outside of the hospital and usually starts soon after surgery. However, if you had fusion surgery your doctor may have you wait one to three months before starting therapy. Once in therapy, it usually lasts one to three months, depending on your individual condition.

Initially, therapists may use treatments such as heat or ice, electrical stimulation, massage, and ultrasound to help calm pain and muscle spasm. Pool therapy is often helpful for patients after lumbar surgery.

Exercises are used to improve flexibility in the trunk and lower limbs. You may begin exercises designed to strengthen your abdominal and low back muscles. You are shown safe ways to sleep, sit, lift, and carry. Ideally, you will be able to go back to their previous activities. However, you may need to modify your activities to avoid future problems depending on your doctor's advice.

When treatment is well underway, regular visits to the therapist's office will end. The therapist will continue to be a resource. But you are in charge of doing your exercises as part of an ongoing home program.