October is National Physical Therapy Month: Treating chronic back pain

Physical Therapy Team at Veterans Memorial Hospital ... October is National Physical Therapy Month. The Physical Therapy Team at Veterans Memorial Hospital in Waukon is pictured above, left to right: Amy Robinson, PT, Rehabilitation Director; Laurel Hagensick, PT; Amy Ghelf, PT Assistant; Brad Krambeer, Athletic Trainer; Sara White, PT Assistant; Dacia Johnson, PT Aide; Shelly Valley, PT Assistant and Alana Gavin, PT. Submitted photo.

by Amy Robinson, PT, Veterans Memorial Hospital

Millions of Americans suffer from chronic back pain.  Chronic back pain is often defined as pain that lasts for six months or longer. It may remain constant or it may come and go. Often times, chronic pain begins as pain caused at the tissue level, but after prolonged pain signals are sent to the brain, the pain threshold of the transmitting nerves decreases making them more sensitive. Also, the brain becomes more sensitive to the pain it is receiving, so your pain feels much worse even though your injury or illness is not getting any worse.

Chronic Back Pain Facts:

· Low back pain disability depends more on fear of activity than on pain or physical pathology.
· Increased time off work decreases the likelihood of returning to work.
· Pain sensation does not equal injury or physical damage.
· Abnormal spine images such as disk bulges/herniations, disk cracks, and degenerative joint disease have been found to correlate more positively with increased age versus pain symptoms.
· Chronic pain is often accompanied by symptoms of depression and anxiety.

Physical therapy looks at several aspects leading to low back pain. Although back pain may be caused by a specific injury, it is typically the result of:

1. Poor posture.
2. Faulty body mechanics.
3. Loss of strength and flexibility.
4. Stressful living and working habits.
5. General decline of physical fitness.

After a thorough evaluation, the Physical Therapy staff at Veterans Memorial Hospital will look at the above factors and personalize them to each client on an individual basis. We educate our clients on proper posture and lifting techniques, discuss possibilities for changes in their home/work environment, correct specific muscle imbalances, and begin an overall fitness program. Not only do we treat our client’s immediate symptoms with pain relieving agents such as ultrasound and electrical stimulation, but we also give them the knowledge and appropriate exercises to rid themselves of the immediate pain and the possible reoccurrence in the future.

A Physical Therapist can evaluate and treat persons with acute or chronic back conditions in order to alleviate pain. Typically, the therapist will perform a posture and alignment assessment, perform special tests and take measurements to determine the cause of the back pain. Treatment may consist of modalities such as ultrasound or electrical stimulation. Stretching, massage, traction and exercise may also be prescribed depending on the condition. The patient is always given home instructions on ways to relieve the pain and help stretch or strengthen particular muscle groups.

What Are Five Good Exercises for My Back?
Most people tend to ignore their lower back when exercising, so it’s very easy for an individual to have weak muscles in that specific region. Believe it or not, you may even be weakening your back by doing all those crunches for your abs. Over-emphasizing the abdominals without also working the low back can lead to the abs getting shorter, which in turn stretches out the muscles in the low back.  When the back muscles are in this elongated position, they are more prone to strain and injury. Any kind of back extension, with resistance or not, will help keep the low back strong and in proper balance with the abdominals. Try these exercises at home.

1. Pelvic Tilt: Start on your back with you knees bent. As you exhale, contract your stomach muscles, push your belly button towards the floor and flatten your lower back. Hold for five seconds. Repeat 10 times.
2. Knee to Chest: Start on your back and gently pull one knee towards your chest using your hands to hold your leg. Hold for 10 seconds. Repeat 3-5 times on each leg.
3. Lower Trunk Rotation:  Start on your back with your knees bent. With your knees together, bring them to one side. Your feet should stay on the floor. Hold 3-5 seconds, then contract your abdominal muscles while moving your legs to the opposite side, again holding for 3-5 seconds. Repeat 5-10 times on each side.
4. Hamstring Stretch:  Start on your back. Keep your leg as straight as possible and gently pull it up until you feel a stretch. You can use a towel to help you pull. Hold for 20 seconds then switch to the other leg. Repeat three times on each side.
5. Bridge: Start on your back with your arms by your side and your knees bent. Slowly raise your hips off the floor, contracting your buttocks and your hamstrings as you go up. Hold 3-5 seconds and repeat 10 times.

What you can do…

· Stay active! Movement will not cause damage.
· Focus on your goals and achievements, not on your pain.
· Think positively, expect results.

Contact the Veterans Memorial Hospital Rehabilitation Department if you have any questions or talk to your doctor if you think you may need physical therapy to regain back strength.

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