Highlighting Best Physical Therapy Treatment for Low Back Pain

Low back pain is a widespread condition impacting a substantial portion of the global population. According to recent studies, it is estimated that 84% of individuals experience low back pain at some point in their lives. 50% of those have a recurrent episode. This high prevalence underscores the significance of understanding and addressing the issues.  

Low back pain can be the result of underlying health conditions, poor posture, weakness and inefficiency in core muscles, restrictions in joints and tissues that lead to excessive strain on discs, facet joints and nerves. Diagnosing the source of the pain and understanding its cause is essential in developing effective strategies for not only eliminating pain but preventing its recurrence. Throughout this blog post, we will delve into these aspects, shedding light on the importance of diagnosis in low back pain and emphasizing the pivotal role our specialized physical therapists can play in its treatment and mitigation.  

Identifying the Source of Low Back Pain  

The first step in getting out of low back pain is identifying the source. The source of pain is the structure sending afferent messages from the body to the brain. These “danger” messages alert the brain that there is something non optimal happening in the tissue. It is important to identify if inflammation is present or if a structure is being compressed. Some common sources of low back pain include muscle strains, ligament sprains, myofascial trigger points, facet joints, disc herniation, osteoarthritis, and nerve irritation. KNOSIS physical therapists work alongside physiatrists, orthopedists, and other spine specialists to identify the source of low back pain. The source of the pain is also called the “pathoanatomical diagnosis”. This is what the MD will write on your prescription for physical therapy and what is submitted to the insurance.  

There are many tools and techniques for identifying the source of low back pain, but it starts with a comprehensive subjective and objective examination. It is important to have a health care practitioner who will take the time to listen to your whole story. KNOSIS physical therapists will ask you a series of questions about your back pain. Using a clinical reasoning model, they will generate a hypothesis for what the most likely source is and then test it in a comprehensive objective evaluation. Your MD may also use imaging such as X ray, MRI and ultrasound to ID the source of the low back pain.  

Common Causes of Low Back Pain  

Once the pathoanatomical diagnosis has been identified, the real work begins. To eliminate the pain and prevent it from coming back, we need to know what is causing it. This is what makes KNOSIS physical therapists truly unique. We are experts in movement and get to the root cause of low back pain. In a detailed “whole body” assessment, we clinical reason to help our clients understand what has caused the irritation to the joint, nerve, muscle, or disc.  

Some common causes of low back pain include poor posture, trauma, non-optimal gait and biomechanics, joint and myofascial restrictions, muscle tension, structural issues like scoliosis, uncontrolled movement especially in one direction, history of low back pain and finally stress and anxiety.  

Understanding Physical Therapy for Low Back Pain  

The KNOSIS philosophy is about going beyond symptom alleviation and restoring optimal movement choices. To identify an effective treatment, it is imperative to first know the source and have sleuthed out the cause of the low back pain. Our physical therapists then employ various techniques, including manual therapy, movement reeducation and individualized therapeutic exercise prescription.  

General treatment with hot packs, Thera guns and/or basic exercises merely address the symptoms of back pain and it most likely will return. This type of general physical therapy is unfortunately very prevalent especially in “in network” environments where there is little time for clinical reasons and 1 therapist must oversee 3-4 patients' treatment at the same time. 

Best Practice Physical Therapy Treatment for Low Back Pain.  

KNOSIS physical therapists have advanced training in the diagnosis and treatment of low back pain. Our founder did a second master's degree in Spine, in 2003 at the prestigious University of Queensland, and shares her knowledge. As an internationally recognized continuing education center, KNOSIS hosts researchers and clinicians from around the world sharing their insights and expertise. Our goal is to provide the best holistic physical therapy for low back pain.  

Physical therapy treatment is a direct result of a thorough assessment and diagnosis. Once we know the patterns we can design an individualized treatment plan. Treatments we use for low back pain include:  

1. Identifying and Treating the Driver:

low back pain can come from non-optimal movement in any area of the body. By assessing the painful functional task such as squatting or one leg standing, a physical therapist can help identify and treat the driver to the pain. Common drivers for the low back are the foot, hip and thoracic spine. Treating the driver is one way we treat the root cause of low back pain.  

2. Manual Therapy to Mobilize Restrictions:

Our manual physical therapists are experts at releasing joint and myofascial restrictions. These restrictions can be at the site of pain or far from it. One or multiple restrictions can lead to compensation and excessive movement or strain on the painful tissues. Identifying and releasing these restrictions is key to setting the stage for optimal healing.  

3. Movement Coordination Training:

Once we have been diagnosed with the site and direction of uncontrolled movement, we train stabilizer muscles to co activate and protect the painful area. These exercises focus on precision and control more than power or strength. They are done for 2 min a few times a day.  

4. Targeted Therapeutic Exercises for Muscle Efficiency:

One of the most important things you can do to prevent low back pain from coming back is to change the recruitment of the muscles around the area. We call this muscle efficiency training. In the presence of pain and pathology, deep muscles, shut down and superficial muscle, get more tense. To eliminate and prevent low back pain we must inhibit the over-recruitment of the large outer tight muscles (mobilizers) and wake up the small inner inefficient muscles (stabilizers). Our physical therapist helps you understand these important muscle synergies and train them with regular home exercises, and a Pilates based wellness program.  

5. Clinical Neurodynamics:

In cases where a nerve such as the sciatic nerve is the source of pain, specific techniques need to be administered to desensitize the nerve. These techniques are performed by an expert Physical Therapist, and or taught as part of a home exercise program.  

6. Pain Neuroscience Education:

Especially for chronic low back pain. It is important to educate patients on the neuroscience of pain. Realizing that pain is an expression of how much danger one's brain perceives is crucial. Moving from danger to safety is a big part of eliminating chronic low back pain.   

Benefits of Physical Therapy for Low Back Pain 

Choosing physical therapy over other interventions for low back pain provides many benefits:  

1. Cost:

Physical therapy that gets to the root cause of low back pain is much more cost effective than treating symptoms for months on end or getting costly medical procedures.  

2. Non-Invasive:

Physical therapy is a non-invasive technique that can often prevent the need for injections, medications and spinal surgery. If these procedures are necessary, then physical therapy is an excellent complement to restore optimum movement and muscle efficiency to prevent recurrence.  

3. Movement Optimization:

Beyond pain relief, specialized physical therapy optimizes movement patterns, reducing the risk of future injuries and pain. Restoring movement choices feels good!  

4. Long-Term Well-Being:

By addressing the whole body and mind, physical therapy contributes to long-term resilience and well-being.  

Conclusion  

Physical therapy is an excellent solution for low back pain. The right physical therapy can not only eliminate pain but to prevent its recurrence. Key principles include identifying its source and cause, enhancing movement variability, and incorporating specific therapeutic exercises. If you are experiencing low back pain, consult with a physical therapist to develop a tailored treatment plan that addresses your unique needs.