PHYSICAL THERAPYFOR

LOW BACK PAIN

Z Altug, PT, MS, CSCS, NSCA-CPT

Physical Therapist / Fitness ConsultantLos Angeles, CA

www.zaltug.com

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Initial Physical Therapy Evaluation

• REVIEW REFERRING PHYSICIAN’S PRESCRIPTION

• PERFORM CHART REVIEW – review medical tests and check physician notes

• PERFORM SUBJECTIVE ASSESSMENT – identify onset of pain, pain level, sources of pain, medication, activity level

• PERFORM OBJECTIVE EVALUATION – assess gait, posture, range of motion, strength, sensation, reflexes, tenderness regions with palpation, function (pain or difficulty with daily tasks such as don/doff shoes)

• PERFORM TREATMENT – manual therapy, therapeutic exercise, modalities, patient education

• SEND PLAN OF CARE TO THE PHYSICIAN

• CONTACT THE REFERRING PHYSICIAN VIA PHONE OR EMAIL – if needed

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Some Sources of Mechanical Low Back Pain

• POSTURAL DYSFUNCTION – overuse, malalignment

• MUSCLE STRAIN

• LIGAMENT SPRAIN

• FRACTURE – osteoporosis, spondylolysis, spondylolisthesis

• HERNIATED DISC

• ARTHRITIS

• SPINAL STENOSIS

• DECONDITIONING

• GAIT DEVIATION

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Some Tools of the Physical TherapistModalities

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Modalities are typically used to reduce pain, reduce muscle spasm and increasecirculation for tissue healing.

• ULTRASOUND

• INFRARED LIGHT THERAPY

• LASER LIGHT THERAPY

• INTERFERENTIAL ELECTRICAL STIMULATION

• TENS (Transcutaneous Electrical Nerve Stimulation)

• HOT PACKS

• COLD PACKS

Some Tools of the Physical TherapistTraction

Traction is typically used to reduce muscle spasm and decompress a joint.

• CERVICAL TRACTION – clinic or home unit

• LUMBAR TRACTION – clinic or home unit

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Some Tools of the Physical TherapistSoft Tissue Mobilization

Soft tissue mobilization techniques are typically used to reduce pain, reduce musclespasm, improve range of motion, and increase circulation.

• MYOFASCIAL RELEASE

• MASSAGE

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Some Tools of the Physical TherapistJoint Mobilization Techniques

Joint mobilization techniques are typically used to reduce pain, reduce muscle spasm,and increase range of motion.

The following are some joint mobilization techniques:

• NATURAL APOPHYSEAL GLIDES

• SUSTAINED NATURAL APOPHYSEAL GLIDES

• MOBILIZATIONS WITH MOVEMENT

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Some Tools of the Physical TherapistTaping Techniques

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Taping techniques are typically used to reduce muscle spasm, provide support, and increase circulation.

• KINESIOTAPE (lightweight and very elastic tape)

Some Tools of the Physical TherapistAssistive Devices

Assistive devices are typically used to unload a joint, provide stability, and improve dailyfunction.

• CANES

• CRUTCHES

• WALKERS

• BRACES

• ORTHOTICS (shoe insoles)

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Some Tools of the Physical TherapistPatient Education

Patient education is typically provided in the following areas:

• PAIN MANAGEMENT STRATEGIES – positioning, cold versus heat

• PROPER BODY MECHANICS GUIDELINES

• PROPER POSTURE INSTRUCTION

• FALL PREVENTION TECHNIQUES

• OFFICE ERGONOMICS

• CAREGIVER EDUCATION

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Some Tools of the Physical TherapistTherapeutic Exercise

Therapeutic exercises are typically used to increase mobility, reduce spasm, increasecirculation, improve balance, increase endurance, and maintain or build strength.

• FLEXIBILITY EXERCISES

• MOBILITY EXERCISES

• AEROBIC EXERCISES

• STRENGTH EXERCISES

• BALANCE EXERCISES

• COORDINATION EXERCISES

• AGILITY EXERCISES

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Sample Back Conditioning Program

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A physical therapist will design a personalized back conditioning program for each person depending on a person’s pain level, functional level, type of back pain, goals, and equipment availability.

A. AEROBIC Exercise by walking, hiking, bicycling, or swimming

B. STRENGTHExercise by using a mat, elastic bands, machines, dumbbells, or a pool

C. FLEXIBILITYExercise by using a mat, Yoga, or Tai Chi

D. BALANCEExercise by dancing, Tai Chi, or home balance exercises

THANK YOU!

Z Altug, PT, MS, CSCS, NSCA-CPT

Physical Therapist / Fitness ConsultantLos Angeles, CA

www.zaltug.com

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