What to Expect When Visiting a Physical Therapist for Lower Back Pain

By Paul Gaspar
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Physical therapists (PTs) are a diverse group of health care professionals. They are employed in hospitals, skilled nursing facilities, outpatient private practices, and in many more locations. There are nearly half a million PTs in the United States, who were trained in various universities, all around the country. In addition to their formal graduate school education, PTs must take continuing education every year and most often focus on courses that appeal to their practice preferences.

So it should come as no surprise that patients attending PT for lower back pain have a wide variety of experiences. Patients are human, so it’s not necessarily a bad thing that different PTs, or even the same PT, might approach the exact same problem in different ways.

Having said that, a PT examination and initial treatment should include the following:

  1. Competent assessment of the problem and its severity.
  2. Determination if the problem is mechanical and can be helped by a PT.
  3. Teaching how movement, posture, positioning, and exercise may influence the symptoms and recovery.
  4. Clear instructions on how to self-manage the problem
  5. Open-minded approach regarding physical treatments that could be used to speed recovery.
  6. Clear communication of prognosis, expectations for recovery time frame, and how often the patient will be expected to attend treatments or follow up.
  7. Two-way interaction with patients, allowing time for answering questions and including patient in goal setting.

Experienced PTs have a vast arsenal of treatment tools and techniques at their disposal to improve your pain and function and they will be able to tell you which methods have the highest probability of working. The following is a list of general treatment types, how they work, and when they might be utilized:

  1. Patient education- PTs always utilize education to decrease patient anxiety, as well as to improve their confidence in restoring movement, exercise, return to work, and self-care ability.
  2. Exercise- PTs are experts on exercise and how it should be applied to patients with pain, disease, and disability to restore their function. There are thousands of passive and active exercises prescribed by PTs. There are also hundreds of exercise philosophies, but they are all intended to improve the body’s health, mobility, and overall function. A PT will select very specific exercises for you based on your history and exam.
  3. Manual therapy- Perhaps PTs are historically known best for treatment techniques they apply to the patient with their hands. Again, there are dozens of skilled soft tissue and joint mobilization techniques utilized by PTs, especially in the acute and subacute stages of lower back pain. The goal here it to reduce pain, improve circulation and mobility, and prepare the patient for more active, restorative treatment.
  4. Modalities- These are tools or electronic equipment that are intended to improve pain and speed the healing process. Laser, heat, ice, traction, electrical stimulation, traction, ultrasound, taping, and cupping (to name a handful) are sometimes used as adjuncts to the above treatments #1-3, which have more scientific merit. That does not mean that modalities do not work, but they should not be the focus of the care.

Do you have questions about your back or your treatment? Just ask your licensed health care provider!


Paul Gaspar
Author: Paul Gaspar