The role of physiotherapy in the management of lower back pain

25th September 2007 at 19:16 BST by Dr C.A.Jenner MB BS, FRCA. Permalink.

This article discusses the role of physiotherapy in the management of lower back pain.

The role of physiotherapy in the management of lower back pain

Introduction

Lower back pain is one of the leading causes of physical disability, especially at the workplace. Research indicates that almost 80% of the population is likely to suffer from lower back pain in their lifetime.

Physiotherapy and Low Back Pain

Physiotherapy is one of the most widely used forms of treatment adopted for gaining relief from low back pain. It is used in both modes, as a single line of treatment as well as in combination with other treatments such as massage, heat, traction, ultrasound or short wave diathermy.

The human back is basically a highly complex system of series of interlocking elements including the vertebrae, discs, facet joints, ligaments and muscles. Owing to such a complex structure, an episode of back pain needs a strong physiotherapy-based rehabilitation program, once the basic medication course has been undertaken.

Key Aspects

In this section, we have briefly listed the key aspects of the role of physiotherapy in management of lower back pain.

1. Advice and early activity – There is significant evidence to prove that encouraging early movement in case of lower back pain is one of the most significant aspects of treatment in this condition.
2. Mobilization or Manipulative physiotherapy – This aspect concentrates on promoting mobilization of the specific affected area. The approach of manipulative physiotherapy is used to target the specific point of pain for the purpose.
3. Specific stabilization exercises – In this aspect of physiotherapy, stress is laid on improving the strength and stability of the muscles which have been weakened due to the lower back pain.
4. General exercises and stretches – A series of properly structured exercises and stretches are usually carried out in context of the patient's individual condition and cause of the lower back pain.
5. Ergonomic advice – Since work-related hazards account for more than 65% of lower back problems, physiotherapists also concentrate on providing accurate ergonomic device, guiding the patient on using the appropriate infrastructure at work to avoid and cure lower back pain.
6. Postural guidelines – This aspect of physiotherapy focuses on guiding the patient about the correct postural habits and ways to maintain accurate posture to avoid lower back pain.

Types of Physical Therapies

There are basically two types of physical therapies involved in providing cure for lower back pain. Here we have briefly explained each one of these.

1) Active physical therapy

Active physical therapy is extremely important to rehabilitate the spine. To get effective results, a generalized back exercise program should include the following:

1. Stretching for back pain exercise, which includes simple hamstring stretches
2. Strengthening for back pain exercise, involving 15-20 minutes of dynamic lumbar stabilization or other prescribed exercises
3. Low impact aerobic conditioning

2) Passive physical therapy

In cases where exercise is either too painful or otherwise not possible, the therapist may consider passive therapies, including:

• Heat/ice packs
• TENS units
• Ionophoresis
• Ultrasound

Specific Exercises

There are a series of stretching, weight-training and miscellaneous exercises that help alleviate lower back pain. The main ones amongst these include:

• Ankle Pumps
• Heel Slides
• Wall Squats
• Straight Leg Raises
• Single Knee to Chest Stretch
• Hip Flexor Stretch
• Piriformis Stretch
• Lumbar stabilization exercises

Appointments and more information

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