Physical Therapy

Specialized Rehabilitation Equipment

Group Back Schools and Other Back Education

Chiropractic

Injections

Orthotrac – A Potential Nonsurgical Alternative to Back Surgery

Lumbar Corsets, Traction, Braces, Etc.

The mainstream remedies that doctors and physical therapists use for a patient’s back injury and pain have changed over the last 10 years. It used to be recommended that long-term bed rest was one of the best ways to treat the pain. Now doctors know better and recommend only a day or two in bed, as was discussed in the chapter called First Aid Remedies for Back Pain.

This is not the only thing that has changed over the years in regards to mainstream ways to treat back injury and pain. Professional physical therapy is more active than passive as it used to be. Special equipment is used to restore strength and mobility to the back and educating the patient about the their own back and ways to help themselves is becoming more important.

The next few chapters discuss today’s mainstream professional remedies for back injury and pain.

Physical Therapy

Physical therapy is probably one of the most commonly used and conventional methods to treat back pain without surgery. If you have terrible back pain that has gone on for 4 to 6 weeks, it is reasonable to start thinking about looking for the help of a physical therapist. The whole purpose of physical therapy is to reduce the pain, improve mobility and function in the back, and provide you with a maintenance program you can do at home to prevent the injury from recurring. This therapy can also fix any bad patterns in your body movement like the way you walk. It can improve your posture with the use of specific exercises and also strengthen the muscles that support your back.

There are two types of physical therapy: passive and active. The techniques used for passive pain relief are called modalities. In passive physical therapy, the therapist is doing something to you. It prepares you for active physical therapy in which you become more actively involved.

Some of the passive modalities involve the application of heat and ice as described in First Aid Remedies for Back Pain . A therapist has different and possibly more effective methods to send the heat deeper into the muscles, like the use of ultrasound. Another treatment that therapists may use is what is known as transcutancous electrical nerve stimulation (TENS). This involves sending a mild electrical current into the muscles via electrodes attached to the back to relieve pain. Passive therapy can also include therapeutic massage as was discussed in the chapter on Body Work.

All of these passive treatments applied by a physical therapist are done to relieve the pain and prepare the patient for active exercise. Exercise helps the muscles get back their strength and flexibility. When you are ready to be actively involved in your therapy, it will probably take place in a gym at the therapy clinic. Here you will be taught exercises to stretch the muscles and increase your flexibility. Some of these types of exercises were explained in the chapter on Exercises to Relieve Back and Neck Pain. By the time this part of your therapy is completed, the therapist will have designed an exercise program for you to do at home or in a gym of your choosing that treats your particular problem.

Specialized Rehabilitation Equipment

Since the trend these days is going away from treating back injuries with surgery, there are more and more companies creating exercise machines that can help with making the back and its supporting muscles stronger. Famous names like Nautilus and Medex are now not only making exercise equipment for the gym but for physical therapy centers as well. Therapy centers often use the exact kind of equipment you find in the typical gym. Gyms and therapy centers have a common goal and that is the strength and fitness of their clients. There is one big difference and that is that one of these places is for people who are healthy and the other is for those who are injured and in pain.

One of the major players in making specialized equipment for rehabilitation is Medex. They use computers with their exercise machines that can display important information about your body as you work out. One example is a machine that can gauge your strength at different areas of your range of motion. In one exercise, this type of machine can gauge the exact point at which the spine muscles are having trouble straightening the back.

There are four benefits to using specialized equipment like this when recovering from back problems.

1. Some machines provide norms for both male and female back patients that can be used by the therapist to set goals for their patient’s recovery and the recovery can actually be charted against real data.

2. The same machine that is doing these diagnostics can be used at the same time by the patient to perform the needed exercise.

3. A lot of back problems can get better with specialized strength training. Machines like these allow the therapist to control how much load is being put on the neck and the spine.

4. Probably the most important benefit is that it is the patient that powers the machine and applies the resistance rather than pulleys and gravity.

Group Back Schools and Other Back Education

Not new to the physical therapy profession are Group Back Schools. These are classes often taught at physical therapy clinics by trained therapists. Frequently, your spine physician may prescribe these classes at the time he or she prescribes the physical therapy. These classes can be of benefit because they teach you about the anatomy of your spine so that you can understand better how you may have injured your back and what it takes to recover. The information received in these classes cover in more detail what was discussed in the chapter called Understanding How Your Spine Works.

These types of classes often teach things that are important to know so that you don’t re-injure your back. You may learn the right way to lift heavy objects and how to go about your daily activities. These days, many physical therapy clinics are moving away from the organized group classes, believing that the students get bored and don’t absorb important information. It is more common now for the physical therapist to have one-on-one training with the patients.

Chiropractic

Chiropractic treatment is often thought of as an alternative medicine for back pain, one of the several methods of treatment known as body work. However, these days it is becoming more mainstream. Refer to the chapter called Body Work for more information on how chiropractic is performed as well as other forms of treatment that fall into the body work category.

Chiropractic has been around since 1895 when the philosophy was that the nervous system played a large role in the body’s functions. Today, this practice is based on how important the muscles, joints, and bones are in keeping the body functioning properly. The balance between these three things is restored by manipulating the spine, joints, and muscles. This also relieves pain. But most chiropractors also recommend specific exercises that strengthen the back and help return flexibility similar to those described in the chapter called Exercises to Relieve Back and Neck Pain . Along with adding exercise to patient care, many chiropractors also reinforce the chiropractic treatment by education the patient about their back and what may have caused their injury. They often even have nutritionists consult with their patients.

Many people with back pain swear by the relief they get from their chiropractic sessions. In fact, nearly 40% of people who suffer from back pain seek the help of a chiropractor and some time or other. Even with this, there are still many medical doctors who are skeptical. Because of this skepticism, many health insurance plans won’t cover chiropractic unless a doctor has prescribed it. The issue may be finding the right doctor who trusts chiropractic to prescribe the care.

Injections

There are a number of different types of injections that spine doctors use in order to relieve back pain. The different injections used for this are cortisone, epidural steroids, trigger point injections, and nerve blocks. These types of injections do not fix the problem, but they relieve the pain enough that the patient can begin physical therapy and exercise so that the problem can be dealt with.

These injections, especially steroids injected into the spine, are a common way to stop a particularly painful episode so that the patient can move again. This may mean just beginning to walk again if the injury and related pain kept the patient from even being able to do that. Besides steroids injected into the spine, doctors sometimes use lidocaine to relieve the pain and a saline solution. Saline helps to flush out the inflammation.

Injections can also be a good way to diagnose the back or neck problem. The way that the pain responds or does not respond to the injection can help the spine doctor identify what exactly is generating the pain.

There are some risks involved whenever injecting directly into the spine. These injections can cause bleeding, infection, damage to nerves and even spinal fluid. But a large number of spine specialty centers firmly believe that there are enough benefits to these injections to warrant using them.

Orthotrac – A Potential Nonsurgical Alternative to Back Surgery

There once was time when it was believed that keeping the spine immobilized with orthotic devices or traction was the way to treat an injured back. Now we know that there is very little benefit to that type of treatment. But there is one orthotic device available now that may be of some help. It was made for people who suffer from chronic pain in the lower back caused by disc disorders or who have facet joint pain or stenosis. These conditions are described in the chapter called What Causes Back Neck Pain .

The Orthotrac belt uses a pump to redistribute as much as 50 percent of the body’s weight off the spine and onto the hips. There are some indications that the belt can give enough relief that lasts long enough for the injury to heal sufficiently so that surgery can be avoided.

Lumbar Corsets, Traction, Braces, Etc.

As mentioned in the previous chapter, the old idea of using traction and remaining confined to bed has long been found to be ineffective. This applies to any old-fashioned braces or lumbar corsets that supposedly immobilize the back. Studies have shown that these devices do nothing to reduce pain.

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