Physical Therapy and its Role in Improving Your Back's Health

After the history taking is completed, the PT takes an objective look at the person. The evaluation includes assessment of spine as well as arm/leg flexibility, strength, and postural alignment among other things. Walking is also observed to note gait abnormalities that might contribute to pain. The person is then taken through motion testing in all directions of either the neck or back (often repeatedly) to help determine the nature of the pain and deficits in motion. After the evaluation, the PT will come up with a "mechanical diagnosis" (versus the medical diagnosis given by a doctor, like degenerative disk disease). Based on the findings, history, and mechanical diagnosis, an individualized treatment program is designed to address the specific deficits that have been identified.

Types of Conditions that Physical Therapy Can Help
Physical Therapy can help acute and chronic neck and back pain resulting from a variety of diagnoses. Types of conditions include, but are not limited to:

1.) Neck and lumbar sprains and strains

2.) Degenerative disk and joint disease of the spine

3.) Bulging or slipped disks

4.) Stenosis

5.) Myofascial pain of the back or neck

6.) Chronic headaches

7.) TMJ dysfunction

Ideal Candidates for Physical Therapy
In order for Physical Therapy to be truly effective, the patient must be willing to take the responsibility for getting better. This includes regularly attending scheduled appointments to learn postures, techniques, and exercises to be employed as part of a "home program" to address the neck or back pain. While "passive modalities," including massage or various electrical or thermal agents, may be used initially in conjunction with therapeutic exercise and postural training, it is "active" things like postural and body mechanics awareness and commitment to the exercise program that are responsible for the most significant and lasting decreases in pain. An ideal candidate for PT is someone who says, "I want to learn what I can do to get rid of this pain once and for all, or at least to know how to control or prevent it." This is in contrast to a less ideal candidate who comes to PT looking for something external to be applied that will "fix" the problem.

Physical Therapy Interventions
Specific Physical Therapy interventions for neck and back pain include therapeutic exercise (Figure A) (on mats, on balls, in the water, etc.), manual techniques (soft tissue massage to help improve stretching or gentle joint mobilization to help improve flexibility), training in proper body mechanics and posture, and patient education regarding ergonomics at work or in the home. (Note: ergonomics is adapting the environment to address a specific body's needs; for example, changing the set up of a work station to help employ better body mechanics with computer use.)