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For lower back pain that has lasted between two and six weeks, or
frequently recurs, physical therapy may be considered. Some
specialists begin physi- cal therapy sooner, especially if the pain
is severe. Physical therapy can help decrease back pain and increase
the patient’s ability to function, and pro- vides a routine that can
help prevent recurrence of the problem. Physical therapy can be
passive (something is done to the patient) or
active (the patient engages in an exercise program).
Initially, therapists may need to focus on reducing the pain, which
is often done with the following passive modalities:
Heat/ice packs
Heat and ice are very commonly used to help reduce muscle spasm and
inflammation, as well as reduce the amount of pain experienced, and
also assist in healing. The therapist may apply this treatment, but
if a non-professional is going to do it a medical care provider
should be consulted before beginning to be sure it will be done
correctly. Importantly, care should be taken with both ice and heat
so as not to burn the skin.
Some patients experience better pain relief by using heat and
others have better results with ice. Many find that the best
approach is to alternate the two. Treatments should last ten to
twenty minutes once every two hours, and are most useful in the
first few days of a flare-up of pain.
Iontophoresis
Iontophoresis is a way to deliver steroids through the skin. The
steroid is applied to the skin, and an electrical current is then
applied that causes the steroid to migrate under the skin. The
steroids then produce an anti- inflammatory effect in the area of
the pain. This is especially effective in relieving acute pain.
TENS Units
A transcutaneous electrical nerve stimulator (TENS) unit emits
electrical stimulation into the area of the lower back pain. This
stimulation overrides the pain signals that are sent to the brain,
and can be effective in relieving pain. Usually a therapist will do
a trial with this therapy on a patient, and if substantial pain
relief is experienced the unit may be sent home with the patient to
be used as needed for long-term pain relief.
Ultrasound
Ultrasound is a form of deep heating in which sound waves are
applied to the skin and penetrate into the soft tissues. This
modality is especially useful in relieving acute episodes of pain
and may also enhance tissue healing.
Once the pain is lessened through passive therapies, active
physical therapy (exercise) is needed to rehabilitate the spine.
Therapists will work with patients to develop a proper exercise
routine that will help patients avoid recurrences of low back pain,
and help reduce the severity and duration of potential future
episodes of low back pain. |
