Physical Therapy Evaluations: Study Affirms Physical Therapy as a Frontline Treatment for Low Back Pain

One of the simplest methods for treating Low Back Pain may actually be the best method. A review article published in February 2009 in the Journal of the American Academy of Orthopaedic Surgeons affirms that Physical Therapy should be the first treatment for low back pain. This review of previously published peer reviewed journal articles recommends that in the majority of cases the most effective treatment is physical therapy combined with anti-inflammatory medications.

This study examined people with symptomatic lower back pain arising from lumbar degenerative disc disease, a common cause of back pain. Symptomatic lumbar degenerative disc disease develops when a disc weakens (often due to repetitive strain), is injured, or deteriorates from aging. As a result, the disc is unable to hold the vertebrae as it should and the lack of stability can cause back pain.

Different treatment methods were detailed including surgery, medication and physical therapy with the use of nonsteroidal anti-inflammatory drugs (NSAIDS) such as over the counter medications aspirin, ibuprofen and naproxen. The study affirms that physical therapy with NSAIDS is the cornerstone of non-surgical treatment and that in 90% of patients with low back pain, symptoms will resolve without surgical intervention. Therefore, barring an emergency, the initial treatment should be noninvasive.

Millions of people suffer from low back pain each year and it is the #1 reason people miss work in the US. Approximately 75% to 85% of adults will be affected by this condition at some point during their life, and the cost of this care is estimated to be a staggering $ 90 billion dollars per year. This includes money spent on diagnostics such as x-rays and MRI’s (Magnetic Resonance Imaging) and treatment including medications and surgery.

Pain medications are a very common first treatment for low back pain, but this only masks the symptoms rather than address the cause of the pain. This course of treatment is not free of risk or 100% safe as many people can become reliant on pain medications. Over 100,000 people per year are hospitalized from common over the counter pain medications, with over 16,000 deaths. In 2003, complications arising from NSAID use were the 13th most common cause of death in the United States. This rate is higher than that found from cervical cancer, asthma or malignant melanoma.

The other common treatment for back pain, spinal surgery, is not always the quick fix we wish it would be and it does not necessarily address the movement problem causing or contributing to one’s back pain. This is not a risk free treatment either. There are thousands of people who die each year from complications arising from spinal surgery and up to 50% of spinal surgery patients have partial or no relief of their symptoms.

There is a safer option; Physical Therapy.

Orthopedic Manual Physical Therapy is any “hands-on” treatment provided by the physical therapist. Treatment may include moving joints in specific directions and at different speeds to regain movement (joint mobilization and manipulation), muscle stretching, passive movements of the affected body part, or having the patient move the body part against the therapist’s resistance to improve muscle activation and timing. Selected specific soft tissue techniques may also be used to improve the mobility and function of tissue and muscles. Manual Physical Therapy is a safe, cost effective, and proven treatment for low back pain. In specific subgroups 95% of patients achieve dramatic relief with manual physical therapy, which is 1/10 the cost of a spinal fusion. What would you choose?

A physical therapy evaluation should consist of a thorough history, postural evaluation, range of motion, strength measurements, and a physical evaluation. Treatment should include hands-on therapy, including joint and soft-tissue mobilization, body mechanics and core stabilization exercises. Physical therapists are the primary provider of treatment for musculoskeletal pain and movement dysfunctions, especially low back pain.

Current estimates suggest that 90-97 percent of all low back/leg pain is caused by dysfunction of either the spinal joints or muscles, or both. Surgery should be the last option, once all other noninvasive treatments have been explored. There are many alternatives to spinal surgery, and physical therapy is a proven and effective treatment for lower back pain. Physical Therapists are also easily accessible and you can see yours right away for low back pain and many other orthopedic conditions. Here are some highly effective exercises, which will help safely move your back and engage your core, that you can do if you have low back pain.

In North Carolina, you have the right to choose who you see for physical therapy and you can see your physical therapist without first having to see your physician. This is called Direct Access, and allows you to seek treatment for your condition today, get better faster, spend less money, feel great and return to the activities you enjoy. You can search for a manual physical therapist online or when you call the physical therapy practice of your choice, ask if they provide manual physical therapy as their main treatment for low back pain.

 

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Tags: occupational therapy, physical therapy practice, low back pain, magnetic resonance imaging, journal of the american academy of orthopaedic surgeons, san diego, physical therapy evaluation