When back pain calls for physical therapy

doctor examing back pain

Back pain can be a nuisance. It can be a simple tweak that clears up after a few days or it could be an ongoing problem that calls for physical therapy or even surgery. 

The proof is in the numbers. More than 540 million people around the globe experience back pain at any given time. In the United States, 8 out of 10 people suffer back problems at least once. And Americans spend about $50 billion each year on healthcare expenses due to back pain.

Ashley Gunlock is a physical therapist at OSF HealthCare who specializes in treating back pain. Gunlock says one of the greatest challenges physical therapists deal with is educating patients on how to properly care for their back to avoid serious injury.

“The biggest thing that we see as physical therapists is people don't always know how to use their body,” she says. “Either they are moving it too much or not moving enough. Our back is the center of our movement and it's also the center of our control. If you don't have control or stability, or you over utilize it, then you're going to hurt your back. Since your back has the nervous system right in the middle of it – if you're using it wrong the nerves are going to tell you you're doing something wrong.”

Most back pain is due to muscle strain, disc damage or other conditions such as osteoporosis. Back pain can also be the result of injuries from things such as moving heavy material or lifting improperly or even poor posture. Age plays a significant role in back pain. The older we get the more likely we are to develop lower back pain due to many factors such as degenerative disc disease and arthritis. 

“In physical therapy, we're going to find the movement patterns that you're doing wrong that impact the disc or impact the sciatic nerve, and what we try to do is reverse or improve that motion so that there's less strain or stress on the area that's getting hurt repeatedly,” says Gunlock.

Gunlock adds that there are two types of back pain – acute and chronic. Acute pain starts suddenly and can last for up to six weeks. Acute pain can occur if, for example, you move heavy furniture into a new home or participate in a strenuous activity that you haven’t done in a long time.

Chronic pain, however, can last for three or more months and cause ongoing problems. If home remedies such as ice, heat and rest don’t do the trick, it’s probably more serious and might call for medical intervention such as physical therapy.

“Outpatient physical therapists will treat low back pain more than any other diagnosis. We see this all the time,” says Gunlock. “What makes it tricky is that every patient does not look the same. Your movement pattern might be different. Your presentation alone might differ, you might have some underlying weakness that may be associated with this, or may not. So, we try to individualize each plan of care to the movement faults that we find, the weakness that we find, the ability for you to understand what we're saying and how to change the way that you move or hold your body through postural exercises.”

Gunlock adds that a physical therapy care plan can last from three visits to as many as 18 depending on the severity of the back pain and how well the patient responds to treatment.

The bottom line Gunlock says is once physical therapy is finished it’s imperative to continue caring for your back. That includes stretching and back exercises, avoiding poor posture, lifting properly and knowing when to not overdo it.

“Our biggest goal as therapists is to teach you how to move your body,” she says. “If you come in to do exercises and then you go back and do the thing that's creating that pain, you will get very frustrated and feel defeated. Our goal is to help you understand what the most efficient way to use your back is, how to relieve the pain when you have it, and how to get stronger to prevent that reoccurring pain.”

For more information, visit OSF HealthCare.