Physical therapy is a conservative treatment for back pain that involves passive and active treatments that are designed to build flexibility and strength in the human body. Physical therapy is a very popular back pain treatment, because it is covered by most health insurances and because it has such as high success rate to complications ratio. Whether this form of treatment works or not, there is a very low complication rate, because it does not involve any invasive medical procedures or pharmaceutical medications. During physical therapy sessions, patients may receive treatments such as ultrasound, Iontophoresis, TENS Therapy, hot therapy, and cold therapy (with heat/ice packs). These therapies are designed to block the transmission of pain signals, reduce inflammation, and to loosen up muscles that have become tight in reaction to degenerative changes in your body or injury. But these treatments are designed to put you in a good position to perform the exercises necessary to get better from your orthopedic condition in order to enjoy lasting health benefits. The physical therapy exercises that your doctor and physical therapists put together for you to learn and perform are designed to strengthen the areas around your body where the injury has occurred. If you are able to continue the exercises to the point that these areas are strengthened, than it is likely that you will feel less pain and stiffness at the site of injury. By maintaining an exercise routing of muscle strengthening around the site of the original injury, it will also be less likely that your injury will return there.
Most physical therapy exercises involve the muscles and ligaments of the body. These exercises are designed to either build muscle strength or restore your range of motion to those areas that are affected, to pre-injury levels. In some cases, you may not be able to reverse the damage caused by injuries and degenerative joint changes as a result of the physiotherapy exercises that you perform. However, by building strength around the degenerated joints and ligaments, you will promote a new stabilization of that body part that may result in significant pain relief.
Typically, doctors will be very conservative in terms of their treating back pain in the first couple of weeks. Often doctors will recommend rest and relaxation in response to acute back pain, due to their knowledge that most acute cases resolve themselves within a couple of weeks. After a couple of weeks, though, the doctor may make the assessment that the patient's pain is less likely to go away on its own. For cases of subacute or chronic back pain, doctors may order physical therapy to resolve the condition.
Physical therapy may consist of treatments where you are passively sitting or standing there while the physical therapists applies hands on treatments (e.g. stretching or massage) of the application of treatments using machines or other products. Physical therapy may also involve exercises where you are actively involved in stretching your body and performing various movements. These movements may be done on various surfaces or on machines. Typically, the physical therapist will cater your treatment program to a system of back pain exercises that you may be able to continue at home or at your local gym. The ultimate goal of these exercise sessions is to lower pain levels, increase function, and provide education in how your body works and how you may prevent episodes of pain in the future.
Once the in clinic phase of your therapy has been completed, your physical therapist will provide you with a maintenance program that you will need to adhere to at home, so that you maintain the strength and flexibility needed in your body so that the injury that caused your pain does not return.
Passive physical therapy modalities include Ice/Heat packs, TENS Units, Iontophoresis, and Ultrasound. These treatments are considered to be passive therapies because the patient is usually lying in the supine or prone position while they are receiving treatments. Ice packs are designed to reduce inflammation in the affected structures. Heat therapy may increase blood flow to the muscles or injured structures to speed up the healing process. Transcutaneous electrical nerve stimulation (TENS) involves the delivery of specific frequencies of energy from patches placed on the skin, to the muscles in need of treatment. The muscles in need of treatment are typically tense or in spasm as a result of direct injuries to those muscles, or an injury in the immediate area. As a result of this electrical stimulation, pain signals were blocked from being transmitted to the brain, resulting in pain relief. Iontophoresis involves the delivery of pain medication to the affected tissues without an injection or oral consumption of medication. This form of treatment combines a low-voltage current with an analgesic medication, enhancing the effects of one another. It is believed that this treatment works by opening up the pores of the skin to allow the skin to be able to absorb medication without puncturing the skin. As the skin pores are open, they become capable of absorbing the medication at the same time that the low voltage electric current is able to provide its own analgesic effects.