Discover when it's time to consider physical therapy for your low back pain and how professionals can help alleviate your discomfort and get you back to the activities you love .
It is important to understand that low back pain (LBP) is EXTREMELY common. An estimated 619 million people live with LBP and it is the leading cause of disability worldwide.1Despite this however, a more serious diagnosis is very rare. Previous studies found that less than 5% of patients in the primary care setting presenting with low back pain have serious pathology. Up to 80% of people will experience low back pain at some point in their lifetime. The vast majority of these individuals go on to improve on their own without treatment, within 6-8 weeks.1
The cause of low back pain is not always known. Nearly 90% of cases of LBP can be referred "non-specific", meaning that there is not a true pathoanatomical cause.2 This is why imaging such as radiographs and/or MRI are not typically ordered right away and why physical therapy is most often the first line of conservative treatment.
This is also why LBP can be one of the most challenging diagnoses to treat and why it costs the healthcare system billions of dollars every year. In some cases (typically a traumatic injury), LBP symptoms can be caused by a specific tissue such as: muscle strains, ligament sprains, herniated discs, and degenerative conditions.
Improper lifting techniques, overload, stress and sedentary lifestyle can also contribute to low back pain.
Other factors such as obesity, age, and certain medical conditions may also increase the risk of developing low back pain at some point in your life.
Persistent low back pain that lasts greater than several weeks despite self-care measures.
Difficulty performing daily activities or movements due to low back pain such as driving, dressing, bending or lifting.
Frequent disruptions or difficulty sleeping due to pain.
Pain that radiates down the leg or causes numbness and tingling.
Limited range of motion in the back or hips accompanied by stiffness that affects mobility.
Previous episodes of low back pain that have not fully resolved.
IF you experience any of the following symptoms associated with your low back pain, it is imperative to seek out emergency consultation immediately as it could be a sign of a more serious underlying diagnosis:
Physical therapy can help relieve low back pain by improving strength, mobility and by learning how to modify your activities and manage your pain.
Therapeutic exercises and stretching can target specific muscles in the deeper layer of the abdominals, hips and trunk. Strengthening these muscles and improving your tolerance to load/activity can help prepare you for the activity or sport that you are looking to get back to.
Manual therapy techniques such as joint mobilization, dry needling, lumbar unloading and soft tissue mobilization can work to temporarily reduce pain and improve mobility and function.
Education on proper body mechanics, activity modification and ergonomics can help prevent future episodes of low back pain.
Physical therapists can provide personalized treatment plans and guidance for managing low back pain to help you reach your goals. Your treatment plan should always be collaborative and include you in the decision making process.
Look for a licensed physical therapist with experience in treating low back pain other other spinal conditions. Therapists with credentials such as OCS (Orthopedic Clinical Specialist) have underdone additional education and testing specific to orthopedic physical therapy and should be up-to-date with current evidence. This does not mean, however that you should ONLY seek out a provider with additional credentials. There are plenty of fantastic providers out there without the "alphabet soup" after their name.
If you have the option to ask or speak with your provider ahead of time, ask them how they would typically structure a treatment plan for someone dealing with a similar issue. You want to confirm that your treatment will prioritize "activity based interventions" over passive modalities (ice, electrical stimulation, ultrasound). Getting you moving as soon as possible should be the goal for anyone dealing with a low back pain issue.
Engage in regular exercise to strengthen the muscles that help support the spine. Core exercises can be great, but there is a lot more that you can be doing in the gym to help reduce the risk of recurring low back pain. You want to also focus on strengthening your lateral (hip abductors) and posterior (glutes) hip musculature when creating an exercise program aimed to reduce the incidence of low back pain.
Use proper lifting techniques, bending at the knees and keeping the back straight when lifting heavier loads. This strategy is most effective when the load is heavy and your arms are out in front of you (e.g.: lifting to pick an air conditioner out of a trunk).
Take frequent breaks during prolonged activities or work that involves repetitive motions.
It sounds obvious, but I can't stress how important it is to prioritize healthy lifestyle factors such as quality sleep and nutrition, managing stress, avoiding smoking and maintaining a positive attitude.
If you do end up in pain, DO NOT WORRY! A 2024 study revealed that catastrophizing about your pain is an independent risk factor for low back pain progressing to chronic widespread pain.3
The first step is to find movements, activities, or positions that are comfortable to you. You can and should continue to move and exercise, but try to do so in a way that does not make your symptoms worse.
If several weeks go by and you are not noticing an improvement in your pain, it may be time to reach out to a professional for help.
I have helped thousands of people dealing with both acute and chronic low back pain and I would be HAPPY to guide you in the right direction.
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