What is physiotherapy treatment for back pain? Physiotherapy is a type of therapy that helps improve the movement and function of your joints and muscles. If you have back pain, physiotherapy can help reduce it and return to normal mobility. It can also help you make changes that make your backless likely to hurt again. Physiotherapists use a wide variety of treatments and techniques to help with back pain and also offer advice on looking after your back. Physiotherapy treatment for back pain.
Causes of back pain
Back pain is a common occurrence and in most cases is not usually caused by a serious problem.
Back pain usually gets better within a few weeks. It’s important to stay active and limit bed rest during this time.
What can cause back pain?
In most cases, it is not possible to determine the exact cause of back pain. It is important to know that any structural damage is rare.
Although painful and upsetting, this type of back pain usually gets better quickly. It can be managed and remain active with advice.
Many physical or psychological factors can cause back pain and often a combination of them is involved.
Many factors can cause back pain and often a combination of them is involved.
These can be:
- Physical factors such as “protecting” the back and avoiding movements or a simple strain.
- Psychological factors such as fear of being hurt or not being healed, depressed, or stressed.
- More general health and lifestyle factors, such as being tired and run down, not getting enough quality sleep, being overweight, or not getting enough physical activity
- Social triggers such as difficult relationships at work or at home, low job satisfaction, or stressful life events such as family death or illness.
Most importantly, it’s important to know that all pain is 100 percent real and never “completely in your head”, even when it comes to factors like stress or mood.
Each of the factors can increase the volume of your pain, and having a better understanding of when this might happen puts you in a stronger position to get to know them and learn how to turn the dial down again.
Sometimes there are certain causes of back pain, especially when there is leg pain, tingling, and pins and needles, or numbness. This can be caused by irritation or compression of the nerves in the back.
Symptoms to watch out for:
These symptoms are very rare, but if you experience any of these you should consult a doctor:
- Difficulty urinating or a feeling of passing water that isn’t there
- Numbness/tingling in your genitals or hip area
- Loss of bladder or bowel control
- Impaired sexual function, such as loss of sensation during intercourse
- Loss of strength in your legs
- If you have pain that runs down the back of both legs
- If you feel unwell with your back pain such as fever or significant sweating that wakes you up from sleep
Why do I need physiotherapy for back pain?
Physiotherapy treatment for back pain: If you have back pain that causes you serious problems or does not seem to improve after a few weeks, it may be worth seeing a physical therapist. Physiotherapy can be beneficial for various types of back pain. It can help with the following.
- Nonspecific back pain – This is back pain for which no specific cause (such as an underlying medical condition or injury) has been identified.
- Sciatic pain – this is pain that radiates from your back to your legs; It may be caused by a sagging disc. A prolapsed disc is when a disc in your spine comes out of its normal shape and presses on a nerve.
- Back pain (degenerative disc disease) caused by the aging of the discs in your spine.
- Spinal stenosis – This is when the space around your spinal cord becomes narrow and puts pressure on your spinal cord.
Your GP can refer you to a physical therapist or you can make an appointment yourself (for more information see our section: Finding a physical therapist). Your doctor or physical therapist may recommend physiotherapy as part of a treatment package that includes exercise programs, pain relievers, and psychological support. Having a combination of treatments like this one can give you the best chance of relief from your back pain.
Physiotherapist, osteopath, or chiropractor?
Physiotherapists, chiropractors, and osteopaths are healthcare professionals who treat back pain with manual therapies, but their approach to treatment is slightly different.
- Physiotherapists focus on performing the movement and function of your entire body after suffering from illness or injury. They look at how nerves, muscles, and bones in your body are affected and how exercise therapy and manual therapies can help. They will encourage you to play an active role in your rehabilitation rather than relying on passive treatments.
- Osteopaths look at the health of your body as a whole and aim to make sure that all your bones, muscles, and joints are working together smoothly. They focus on manual therapies to return your body to a state of balance.
- Chiropractors have an expert interest in neck and back pain. They look at your body as a whole and see how problems with your bones, muscles, and joints affect your nervous system and overall health. Their focus is on the manipulation of the spine – but they can use other techniques as well.
Which type of GP you see is your choice, but if you are looking for NHS treatment it will depend on what services are available in your area. If you are booking treatment specifically, think about what you are hoping to get from therapy and which approach best appeals to you. It may be worth contacting a few different practitioners to discuss your situation. If you have health insurance, contact your insurance provider to find out what you may be insured against.
What will happen when I see a physical therapist?
The first time you see a physical therapist, they will receive a detailed medical history. They will ask you questions about all the medical conditions you have, your lifestyle, and the medications you take. They will also want to know what symptoms you are experiencing and what triggers them. Next, they will do a thorough physical exam, including looking at how you move and how your back is working. They can also perform a neurological assessment to see how well your nerves are working. You may need to remove some of your outer clothing when you go to physiotherapy so that your physiotherapist can see and feel your back. If you prefer it to be with you, you can ask for a companion.
Your physical therapist will explain what treatment they recommend and how this can help your back pain. They should also warn you about the possible risks of treatment. If you are not sure about anything, feel free to ask. It is important to fully understand what your physiotherapist is recommending because you will be asked to sign your consent to continue treatment.
- Active treatment
Active therapies are exercises and movements that you do yourself. They are the most important part of any treatment. Overall, staying active in any way is the best thing for back pain. Exercises can help improve the flexibility, mobility, and strength of your back. A physical therapist can advise you on exactly which exercises are right for you and how to perform them. Below, we have included an overview of the different types of exercise you are likely to encounter.
- Aerobic exercise
This is an exercise that gets you moving and increases your heart rate. It is the most important part of any treatment program. Aerobic exercise can help with any stiffness you may have and keep you moving. It also helps you manage your weight and can improve your health as well. Your physical therapist will recommend low impact aerobic exercises initially; these include walking, swimming, and exercise bikes and using stepper machines. They will encourage you to do more as you can. It is generally recommended to do 20 to 30 minutes of aerobic exercise, up to 5 times a week. However, you may need to start with shorter activities.
- Stretching exercises
These aim to increase flexibility in your spine and reduce tension in the muscles that support your spine. You will probably be asked to do these every day. A typical stretching exercise is to lie on your back and stretch your back gently by pulling your knees towards you. Or you may be asked to stand up and lean forward to stretch your hamstring muscles on the back of your legs. This can relieve stress on your back.
- Strengthening exercises
Exercises aimed at strengthening your core muscles can sometimes be part of exercise programs for back pain. Your core muscles are your abdominal muscles around your stomach, the muscles in your back, and those around your pelvis. These exercises can help in the short term. However, there is growing evidence that basic exercises are no more beneficial than general exercise in the long run. So these types of exercises may not be something your physical therapist focuses on. It is more important to be active in general.
Your physiotherapist may also suggest that you try one of the following manual (‘hands-on’) techniques. This will always be in combination with an exercise program.
- Mobilization. In mobilization, your physical therapist will use slow, gentle movements to stretch your spine. It aims to return your back to its normal range of motion.
- Manipulation. In manipulation, your physical therapist will make a faster pushing motion with his hands at a specific point in your spine. You may hear a “pop” sound when they do this.
In the past, physiotherapists would offer other therapies such as transcutaneous electrical nerve stimulation (TENS) and acupuncture. However, these treatments are not recommended in guidelines for back pain because there is limited evidence of how beneficial they are. These treatments should not be offered to you at this time. Massage is another therapy for which there is little evidence of how well it works. It is not generally recommended for the treatment of low back pain.
Back pain treatment
Physiotherapy treatment for back pain: There are a variety of treatments for back pain, and we’re exploring short and long-term options for pain relief.
How can you treat back pain?
Studies show that most back pain can be successfully treated with a combination of:
- staying active as much as the pain allows,
- simple pain relievers if needed, and
- advice from a healthcare professional.
- If simple pain relievers and staying active don’t help, other treatments may be recommended.
Regular exercise for back pain
Exercise has been shown to be the most beneficial treatment for back pain. It doesn’t matter what type of exercise you exercise as long as you stay active. So choose something you like to do and move on!
Getting physical therapy for back pain
Practical treatments have been shown to have little benefit for back pain and when used as part of a complete treatment program that includes exercise only.
Similarly, injections can be beneficial as part of a treatment program, but not on their own. Injections may be tried if exercises and other treatments have not helped.
Other types of treatment for back pain
Official guidance does not recommend treatments for back pain such as traction, acupuncture, and various electrical treatments.
What is physiotherapy treatment for back pain?
What to expect after physiotherapy?
At the end of your first session, your physical therapist will usually tell you how many sessions you will need and how often you will need them. This will depend on how much your back pain is affecting you and how you manage your symptoms. You may only need a one-off consultation, or they may suggest physiotherapy appointments for several months.
Your physical therapist will also give you some advice on what you can do at home to help with back pain. This can include things like how to improve your posture and make sure that your car seat or office seat is set correctly.
Physiotherapy will only be part of your treatment for back pain. Making lifestyle changes and staying as active as possible, as well as completing other treatments given to you, will help you recover faster. It also means that your back pain is less likely to come back.
How can physiotherapy help me?
If your back pain has lasted for more than a few weeks, an exercise program with a physical therapist can provide relief and get you back on track. Manual treatments such as manipulation and mobilization have also been shown to help. The improvement in pain relief and functionality you get with physiotherapy can take long enough for you to start returning to your normal activities. The best thing for back pain is to stay active. It can get you back to work faster, you will have fewer long-term problems, and you are less likely to have back pain again.
It is difficult to get good evidence of how well certain exercises work for low back pain. One type of exercise is not considered to be better than another. Your physiotherapist will evaluate what they think will be best for you and your particular problem.
Your doctor or physical therapist can evaluate how your back pain is affecting you using a questionnaire to make sure you are getting the most appropriate treatment. There is some evidence that people who are evaluated in this way can benefit the most from physiotherapy.
Are there any side effects of physiotherapy?
You may find that certain exercises and movements make your back pain worse. Your physical therapist should monitor this and show you which exercises you should avoid and which ones will help relieve your pain.
Manual treatments such as manipulation can be associated with side effects. These are usually not serious and only last for a short time. For example, you may feel some stiffness or discomfort in the area where you received the treatment. It is possible that manipulation could cause a more serious injury, but this is very rare. Your physical therapist should talk to you about the risks of manual treatments before administering any treatment.
Your physiotherapist should also check how you feel while doing any “hands-on” therapy and will stop if you have any pain or discomfort.
Physiotherapy treatment for back pain:
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- Low Back Pain Fact Sheet. (2018).
- Yoga: In depth. (2018).