A Physical Therapist's Guide on Managing Low Back Pain

By Dr. Jerry Jacob, PT, DPT | Elevation Spine & Sports Medicine

Low back pain is one of the most prevalent and debilitating conditions that affects millions of people worldwide. Low back pain can be caused by a lot of things...poor posture, muscle strains, disc herniations, injury, or other underlying health conditions. Thankfully, there are effective treatments to help alleviate and manage low back pain symptoms and physical therapists are experts when it comes to educating and treating low back pain in many different populations.

Exercises play a central role in both reducing pain and preventing future episodes of low back pain, but knowing when to seek professional help is key to long-term recovery and safety. In this blog post, we'll talk about ways that physical therapy can help you find relief and take back your life from low back pain. 

Why Exercise Helps Low Back Pain

Have you ever heard the term "movement is medicine?" There is a reason why so many health care providers, like chiropractors and physical therapists, preach this to their patients. Movement and exercise is essential for low back pain because it addresses weaknesses, stiffness, and/or poor posture that often contribute to the root cause of the pain, flare ups, or compensation patterns related to the low back pain.

Many times, low back pain may feel terrible and then feel immediately improved after walking, working out, or doing physical therapy exercises. There are several reasons for this physiologically, but the science behind it may bore you. Long story short, warming up muscle tissue through exercise with activation and lengthening strategies help painful muscle and connective tissue feel improved through painful range of motion. That being said, targeted exercises for low back pain can:​

• Build strength in core and back muscles, improving spinal support and reducing strain.​

• Increase flexibility and mobility, making daily movements easier and less painful.​

• Enhance blood flow and reduce muscle tension, which aids healing and prevents stiffness.​

• Teach proper body mechanics, which protects the back during everyday activities.​

Research consistently shows that staying active not only speeds recovery but also reduces the chances of developing chronic problems.

The Importance of Movement for Low Back Pain

It is a common misconception that when you have pain that rest is the first step to recovery. This can be quite far from the truth. The old acronym “RICE" which stands for rest, ice, compression, and elevation was used to help guide those through a painful episode. It is now recommended that we do quite the opposite. Prolonged rest can lead to stiffness, muscle atrophy and weakness, and even more pain.

As physical therapists, we emphasize the importance of staying active by incorporating targeted movement and exercise that you can incorporate into your daily routine to help manage low back pain on your own. It is important to find movement and exercise that is comfortable and can help keep pain levels down. These exercises are typically specific and individually-based according to your needs and how you move as a human. Your physical therapist will evaluate which are safe for you and which might not work.

Stages of Physical Therapy for Low Back Pain

Physical therapy for low back pain typically progresses through several stages, tailored to the severity and duration of your symptoms:​

1. Acute (Relief) Phase: Focuses on pain and inflammation management using stretching, manual therapy, and low-intensity movements. This stage also educates you on safe positions and early activity modifications.​

2. Mobility and Flexibility Phase: Introduces stretching and gentle range of motion exercises to restore movement without aggravating pain. Therapists use manual techniques and teach safe ways to move.​

3. Strengthening Phase: We have a focus on core, gluteal, and back exercises to strengthen muscles around the spine, improving posture and limiting recurrence of injury. Complexity and resistance of the exercises increase as strength improves over time.​

4. Endurance and Maintenance Phase: Focuses on functional movement, low-impact aerobic conditioning, and ongoing education for home exercise routines. This stage prevents future episodes by catching any movement dysfunction and keeps your back healthy long-term.​ 

   
   

When to Seek Professional Help

Many times, self-care and at home strategies for low back pain can help but it is important to seek professional help if your symptoms are persistent or worsen over time. Your Physical Therapist can help assess your injury or condition and develop a personalized treatment plan to address your symptoms and the root cause of your low back pain. Physical Therapy offers a comprehensive approach to pain with manual therapy, therapeutic exercises, and joint mobilizations.

If you are having weakness, numbness or tingling, changes in bowel or bladder control, unrelenting pain at night, or pain after an accident or trauma it is crucial to seek help as soon as possible. 

Why Choose a Physical Therapist

A PT can provide you tailored and comprehensive corrective exercises with safe progressions to help with pain relief, muscle strengthening, and movement re-education. Physical Therapists are trained to take you through individualized assessment to find the root cause of your low back pain symptoms. We will also provide education and support for lifestyle changes and ways to prevent injury in the future. 

Many Physical Therapists are trained in soft tissue therapies as well such as dry needling, shockwave therapy, Graston Therapy, or Instrument Assisted Soft Tissue Mobilization, Cupping and more! These types of therapies help patients reduce low back pain and improve more quickly!

Conclusion

Low back pain can be a challenging condition to navigate and it can be scary when it starts to impact your day to day life. With the right guidance and support from your Physical Therapist, relief and recovery are possible! By working with your Physical Therapist and utilizing their expert advice and treatment techniques, you can improve your posture, increase your strength, improve your body mechanics and have a better overall well-being and quality of life.

Early intervention leads to better outcomes, and personalized Physical Therapy helps you heal safely and effectively at each stage. If you are unsure of where to start or if your pain is not improving with at home remedies, it is time to connect with a physical therapist. Being proactive can get you back to normal, make you stronger and help you reclaim your overall health. 

Book your appointment now and see how physical therapy can help you with your low back pain!