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  • APT Staff

Physical Therapy and Back Pain Relief 



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Back pain is one of the most common medical issues, affecting up to 80% of adults at some point in their lives. It can be caused by various factors like muscle strain, injury, arthritis, or even stress. Physical Therapy and Back Pain Relief go hand in hand, as managing this condition effectively is crucial to improving quality of life. It is also the leading cause of work absence, resulting in lost wages and reduced productivity. 


While back pain is very common, its severity can range from mild soreness to debilitating pain. It can be acute, meaning it lasts less than 3 months, or chronic if it persists over time. Low back pain is the most prevalent type, felt as tension, soreness or stiffness in the lower back. Other types include upper back pain, often caused by poor posture, or tailbone pain from injury. 


Seeking treatment for back pain is crucial to manage symptoms and prevent chronic issues. This article provides an overview of customized physical therapy programs to relieve back pain through rehabilitation exercises, lifestyle changes and long-term self-care. 


Causes of Back Pain 


Back pain can stem from a variety of causes including strains, injuries, poor posture, arthritis and more. Here are some of the most common causes of back pain: 


Strains - Strains to the muscles and ligaments in the back are one of the most prevalent causes of back pain. Sudden movements like bending, twisting or lifting heavy objects can cause strains. These injuries are often acute and temporary but can be very painful. 


Injuries - Direct injuries to the back such as falls, blows or accidents can result in issues like herniated discs, fractures, etc. These traumatic injuries often require immediate medical attention. 


Poor Posture - Maintaining poor posture by slouching, looking down frequently, or not supporting the back properly when sitting can place extra strain on the back. This can lead to chronic pain over time. 


Arthritis - Degenerative types of arthritis like osteoarthritis can affect the joints in the spine leading to breakdown of cartilage and bone spurs. This causes stiffness and localized back pain especially with movement. 


Spinal Abnormalities - Issues with the normal curvature and alignment of the spine like scoliosis or kyphosis put extra pressure on the vertebrae and surrounding muscles leading to back discomfort. 


Obesity - Excess weight places a great deal of strain on the back both in movement and while stationary. This extra load often contributes to muscle and disc problems in the back. 


Pregnancy - The extra weight gain and altered posture from pregnancy commonly leads to back pain. Factors like loosening ligaments and hormone changes further contribute. 


When to Seek Physical Therapy  


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If you experience chronic lower back pain or limited mobility, physical therapy can often help improve your condition. Some common situations that indicate you may benefit from physical therapy include: 


  • Chronic or persistent back pain that lasts more than a few weeks and interferes with your daily activities. Many back conditions, including strains, sprains and degenerative disc disease, can be helped with physical therapy.    

  • Limited mobility that restricts your ability to move properly and perform normal activities. Physical therapists can improve mobility through stretches, exercises, manual techniques and other treatments.    

  • Post-surgery rehabilitation. After spinal surgery or procedures, physical therapy is crucial for restoring strength and range of motion. Your surgeon will likely recommend physical therapy following surgery.    

  • Sciatica symptoms like numbness, tingling or weakness in your legs. Sciatica occurs when a herniated disc or bone spur puts pressure on your sciatic nerve. Physical therapy helps relieve pressure.    

  • Spinal stenosis causes narrowing in the spinal canal, which can compress nerves and cause pain, numbness or weakness. Physical therapy can help manage symptoms through stretching and strengthening. 


If you have chronic back pain or limited mobility, check with your doctor about getting a referral to see a physical therapist. An experienced physical therapist can evaluate your condition and design a customized program to help reduce your pain and improve mobility. 


Initial Evaluation   

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During the initial evaluation, the physical therapist will take a complete medical history and perform an exam to determine the cause of your back pain. They will ask questions about your symptoms, when the pain started, any accidents or injuries, daily activities, medical conditions, and family history. 


The therapist will assess your posture, mobility, strength, balance, and coordination. They will palpate the muscles and joints along your spine to identify problem areas. Range of motion, reflex, and neurological tests may be performed. You may be asked to walk or perform simple movements so the therapist can observe your mechanics. 


Diagnostic tests like x-rays, MRIs, or CT scans may be ordered to get more information about the structures in your back. These imaging tests can show issues like disc bulges or herniations, arthritis, spondylolisthesis, stenosis, or fractures. The physical therapist will review the test results to pinpoint the origin of your pain and identify any underlying conditions. 


This comprehensive evaluation provides the information needed to develop a customized treatment plan tailored to your specific back condition and goals. The initial assessment lays the groundwork for designing an effective physical therapy program to reduce your pain and improve your back function. 


Common Treatments 


Physical therapists utilize a variety of techniques and modalities to treat back pain and develop customized programs for patients. Some of the most common treatments include: 



someone laying down getting a massage

Certain exercises can help stretch and strengthen the back and core muscles, improving mobility and stability. A physical therapist will evaluate a patient's condition and then prescribe specific exercises tailored to their needs. Common exercise programs focus on improving posture, flexibility, core strength, and range of motion. The exercises are progressed over time and modified as the patient improves. 




Massage therapy applies manual techniques to muscles and soft tissues. It can help relax tight muscles, improve circulation, and reduce pain. Physical therapists may use massage as part of a customized back care program. Techniques like effleurage and petrissage are often used to ease muscle tension and spasms. 


Hot/Cold Therapy 


Alternating hot and cold therapy can relieve back pain and muscle spasms. Heat helps improve blood flow and relax muscles. Cold therapy reduces inflammation and numbs pain. Physical therapists may recommend using heat packs, ice packs, or contrast baths as part of a comprehensive back care plan. 




Spinal traction involves gently stretching the spine to relieve pressure on compressed discs and nerves. It can help reduce pain and muscle tension. Traction may be applied manually by a physical therapist or via mechanical equipment. Custom traction prescriptions are tailored to each patient's needs. 


In addition to these modalities, physical therapists have expertise in many other techniques to address back pain, including ultrasound, TENS, spinal manipulation, etc. The focus is on developing an integrated program using different treatments for the best results. 


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Customized Physical Therapy and Back Pain Relief Programs 


One of the key benefits of physical therapy for back pain is the ability to create customized programs tailored to each patient's unique needs, goals, and lifestyle. Unlike a one-size-fits-all approach, an experienced physical therapist will get to know their patient and design a personalized treatment plan accordingly. 


Some factors that go into customizing a back rehab program may include: 


  • The cause and nature of the back pain - Is it muscular, disc-related, arthritis? Knowing the origin of the pain informs the treatment approach.    

  • The patient's age and overall health - For example, therapies for a young athlete will differ from those for an elderly individual with osteoporosis.    

  • The severity of the back pain - More intense pain may require different modalities than mild soreness.    

  • The patient's regular activities - A construction worker will need a different program than an office employee. Exercises can target muscles and movements specific to a patient's daily routines.    

  • Treatment preferences - Some patients may prefer hands-on therapy while others respond better to exercise. Patient choice matters.    

  • Treatment goals - Is the focus short-term pain relief or longer-term strength building? Goals guide which therapies are emphasized.    

  • Other health conditions - Issues like obesity or diabetes can impact the safety and effectiveness of certain treatments.    

  • Psychosocial factors - Stress, anxiety and depression often accompany chronic back pain and may need to be addressed. 


The ultimate goal is to create a customized back rehab program that fits the patient's needs and gives them the tools to manage symptoms and improve function long-term. With a tailored approach, physical therapy has the greatest potential to help patients effectively relieve back pain and restore mobility. 


At-Home Exercises 


A physical therapist will often prescribe exercises that patients can do at home to help relieve back pain symptoms and prevent future back injuries. These at-home exercises are an essential part of a customized back care program. Patients are encouraged to incorporate the exercises into their daily routine. 



two men doing yoga on a back porch

Stretching the muscles in the back, hips, and legs can help reduce muscle tension and increase flexibility. This can alleviate pain and stiffness. A physical therapist may recommend stretches such as: 


  • Knee to Chest - Lying on back, pull one knee up to chest until stretch is felt in lower back. Hold for 30 seconds, relax, and repeat on other side. Do 2-4 reps per side. 

  • Child's Pose - Kneel on floor, sit back on heels, extend arms in front, walk hands forward, lowering chest to thighs and forehead to floor. Hold for 60 seconds. 

  • Cat-Cow - On hands and knees, arch back and look up, then round back and look at stomach. Repeat 5-10 times. 




Weak core muscles can contribute to back pain. Targeted strength training can build endurance in the muscles supporting the back. A physical therapist may recommend core exercises like: 


  • Planks - Hold a pushup position, resting on forearms and balancing on toes. Keep back straight and abs engaged. Start with holding for 10-20 seconds and work up to 60 seconds. 

  • Bird Dogs - Get on hands and knees. Extend one arm forward and the opposite leg back. Hold for 5-10 seconds. Repeat on both sides for 8-12 reps. 

  • Supermans - Lie face down, extend arms overhead, lift head, chest, arms, and legs up. Hold for 2-3 seconds. Do 10-15 reps. 




Low-impact aerobic exercise can help improve circulation and provide conditioning. Walking, swimming, or stationary cycling are often recommended. Start with 10-15 minutes at a time, 2-3 times per week, and gradually increase duration and frequency. 



Paying attention to posture throughout the day can help reduce strain on the back. Sitting with a lumbar support, avoiding slouching, and lifting properly are examples of good posture habits. Setting reminders can help maintain awareness. 


Lifestyle Changes 


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Improving posture, losing weight if overweight, and reducing stress are all important lifestyle changes that can help relieve back pain and prevent future injuries. 




Having good posture reduces strain on the back. Stand up straight with shoulders back, chin tucked in slightly, and avoid slouching when sitting by keeping your back aligned against the back of your chair. Be mindful of posture throughout the day. Using ergonomic chairs at work and lumbar support in chairs and car seats can help maintain proper spinal alignment. 


Weight Loss 


Excess weight puts more pressure on the spine and can contribute to back pain. Losing even a small amount of weight through diet and exercise can significantly relieve back pain if you are overweight. Focus on nutrient-dense whole foods, get regular physical activity, and work with a doctor on safe weight loss goals. 


Stress Management 


High stress and anxiety can increase muscle tension and exacerbate back pain. Try stress-relieving practices like yoga, deep breathing, massage therapy, or meditation. Set boundaries at work, practice good sleep habits, and make time for hobbies you enjoy. Manage stress levels with both lifestyle changes and professional help if needed. 


Making sustainable improvements to posture, achieving a healthy weight, and keeping stress in check can all prevent and ease back pain long-term. A physical therapist can provide posture tips, fitness guidance, and stress management advice tailored to your needs. 


Long-Term Management 


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Successfully managing chronic back pain long-term involves continuing with the at-home exercises and lifestyle changes recommended during physical therapy. Maintaining a regular exercise routine is crucial for building strength, flexibility, and endurance to support the back. Common recommended exercises include walking, swimming, yoga, tai chi, and Pilates. These low-impact activities help stabilize the spine and prevent muscle atrophy. 


It's also important to maintain proper posture and body mechanics during daily activities. Using correct lifting techniques, modifying sitting positions, and avoiding motions that aggravate pain can help prevent flare-ups. Managing stress through relaxation techniques like meditation helps too, since mental tension often manifests physically. 


Occasional flare-ups are expected even with diligent self-care. Applying ice packs, over-the-counter pain medication, massage, and rest can alleviate flare-up pain. Notify your physical therapist if flare-ups become frequent or severe. They may recommend adjustments to your home program or additional targeted therapy. 


With dedication to ongoing exercise, lifestyle modifications, and stress management, many back pain sufferers find they can successfully manage their condition and enjoy improved strength and mobility long-term. A customized physical therapy program empowers patients with the knowledge and tools to take control of their back health. 


When to Seek Surgery 


three surgeons dressed for surgery

Most cases of back pain can be effectively treated without surgery. However, in some severe cases surgery may be warranted. Here are some signs that it may be time to talk to your doctor about potential surgical options: 


  • Severe pain that does not improve with other treatments - If you are experiencing intense, debilitating pain in your back that does not get better with medications, physical therapy, injections, or other conservative treatments, surgery may be considered. Severe, unrelenting back pain can greatly diminish one's quality of life.    

  • Limited mobility or inability to walk - Back conditions like spinal stenosis or a herniated disc can sometimes impinge on the nerve roots, leading to weakness or paralysis in the legs. If you have trouble walking or standing upright, it's important to see a surgeon to prevent further damage. Surgery may help decompress the spinal cord and restore function.    

  • Progressive neurological deficits - In some cases, compressed spinal nerves can cause loss of bowel or bladder control, or weakness in the arms or legs. These neurological symptoms tend to get progressively worse without treatment. Surgery may be performed on an emergency basis to halt further neurological decline.   

  • No improvement after 6-8 weeks of nonsurgical treatment - If back pain persists for over a month despite active treatment like physical therapy and medication, surgery may be warranted to correct an underlying structural problem. It's generally better to avoid surgery if possible, but improvement is unlikely without it in some cases.     

  • Spinal instability - Traumatic fractures, infections, or other conditions can sometimes lead to instability between vertebrae. Surgery may be required to fuse parts of the spine together for stability. Without fusion, the spine is at risk of further damage. 


If you are experiencing any of the above scenarios, have a conversation with your doctor about whether spinal surgery may be appropriate. Though surgery does carry risks, it can also significantly improve pain, mobility, and quality of life in those with severe back problems. 

Don't wait for relief. Contact us today to schedule a consultation and start your journey toward a pain-free life with our expert physical therapy services!


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