A Physical Therapist’s Guide to Lower Back Pain Management

Movement is one of the best things you can do for your overall health, especially when managing or preventing low back pain. But before you start to think about taking part in physical activities or adding exercises for low back pain to your workout routine, you should first speak with a healthcare professional, such as a doctor or physical therapist.

Physical therapists are movement experts. They can identify the source of your pain and the factors impacting your quality of life. Physical therapists work with their patients to improve or restore movement through hands-on care and personalized treatment plans aimed at helping to achieve and maintain individual goals.

Low back pain is common, affecting 8 out of 10 people at some point during their lives. Low back pain can worsen when a person is inactive but can improve with regular physical activity and taking time to stretch. When instructed by a physical therapist or other healthcare professional, movement is safe and effective. In fact, the CDC cites high-quality evidence supporting physical therapy exercises for low back pain over the use of prescription opioids.

How Does A Physical Therapist Treat Low Back Pain?

To develop a personalized treatment plan, a physical therapist will first gather their patient or client’s background information and perform an examination to determine what is causing and affecting their pain or movement issues.

For instance, when examining a patient experiencing low back pain, they can evaluate movement patterns, strength, flexibility, and posture, to help develop the right pain management plan for them. Pain management plans may include:

  • Exercises and stretches focused on strength and flexibility.
  • Manual or hands-on therapy to improve the mobility of joints and soft tissues.
  • Education on how to maximize their ability to perform daily activities and movements while managing or minimizing pain.

Which Exercises and Stretches Are Right for Your Back Pain?

Each person’s pain is unique to them, so the recommendations for treating back pain and its underlying cause(s) will vary. Physical therapists are uniquely qualified to design programs for their patients that aim to target the actual problem behind their pain and ensure they keep moving.

When determining suitable stretches, exercises, and activity modifications for you, a physical therapist will consider what is causing or contributing to your pain and whether it is acute or chronic. Acute pain is pain that lasts for up to six weeks or less, while chronic pain is pain that lasts longer than three months. Physical therapists will also make sure that you can do any exercises, stretches, and activity modifications they recommend correctly and safely.

If you are experiencing low back pain and have not yet seen a physical therapist or other healthcare professional, it’s recommended to keep workouts to low-impact exercises and avoid stretches, positions, or movements that cause you more pain and could lead to further injury. Each person is different, but high-intensity aerobic exercises, like running or bicycling, may worsen your symptoms if you are having a pain flare-up.

Keep in mind —you should also avoid long periods of lying down, sitting, or not moving (such as staying in bed all day). Doing so can often lead to increased stiffness and pain. Remember, our bodies are made to move.

If your pain lasts more than a few days or gets worse, schedule an appointment to see a physical therapist or other healthcare professional. When small changes aren’t working, an individualized assessment of your body and how you move can be helpful.

At-Home Treatments for Back Pain

Over-the-Counter Pain Medicines

Over-the-counter (OTC) pain medicines are a safe and effective way to temporarily relieve mild to moderate back pain. They aren’t meant to treat chronic pain conditions on a consistent or long-term basis, unless directed by a healthcare professional.

OTC pain medicines come in many forms – some are taken orally by mouth, and others are applied to the skin. When taking an OTC medicine, it’s always important to read and follow the Drug Facts label found on the medicine’s bottle or packaging. The KnowYourOTCs Pain Reliever Assessment can help you identify which OTC oral pain medicine may be right for you but it always important to speak with your local pharmacist, doctor, or healthcare professional especially if you are taking other medications.

Yoga

Yoga is a mind-body form of therapy that can help to relax and strengthen your body. Since yoga involves movement, it may be beneficial when combined with other recommended treatments provided by your physical therapist or other healthcare professional.

Heat and Cold Compresses

Applying heat or a cold compress to your back can provide some temporary pain relief or comfort, though it will not treat your pain or lead to long-lasting relief. Ice tends to be best if your back is bothered by swelling or inflammation, while applying heat may be better if you are trying to relax stiff or tight muscles. Again, hot and cold compresses should not be used as a long-term pain management solution.

Misconceptions About Treating Back Pain

Restricting or Overdoing Exercise

A misconception is that you have to “go harder” with exercising when your back is hurting or not do anything at all. What exercises are appropriate is specific to the person and the problem causing the pain, and the intensity should be prescribed by a physical therapist or a qualified healthcare professional.

Sleep Positioning Devices

When you have back pain, sleeping can be hard. But before investing in a sleep positioning device or special sleeping surface, it is best to speak with a physical therapist or other healthcare professional. That way you don’t waste your money buying something that may not be helpful.

How to Prevent Back Pain

It’s important for people to stay active – doing so can help to prevent low back pain injuries as well as help you recover from injuries or pain flare-ups more quickly. Even taking walks regularly and avoiding long periods of sitting is beneficial to most people.

Physical therapists teach different strategies to prevent low back pain, including ideal body positioning at work, home, or during leisure activities. They can also provide tips for lifting objects or people, such as making sure to bend your knees and keep your back in a stable position throughout the lift.

Always make sure to speak with a physical therapist or other healthcare professional if you are looking to change the way you feel or move, or are looking to become more physically active.

Hadiya Green Guerrero, PT, DPT

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Hadiya Green Guerrero, PT, DPT

Hadiya Green Guerrero, PT, DPT, is a senior practice specialist at the American Physical Therapy Association and a board-certified clinical specialist in sports physical therapy. To find a PT near you, visit ChoosePT.com/FindaPT.