By Kathryn Trumble, DPT, ATC/L
With over $80 billion spent annually on back pain treatment, it is vital to get a handle on this problem. The back is the epicenter of the nerve function for the arms and legs. Not only can you have pain in the back with an injury, but you can also have pain, numbness, and tingling into the arms and legs. Physical therapy focuses on 4 main aspects of treatment and prophylactic care to make sure you have a healthy back. The 4 main aspects of treatment are mobility, stability, posture, and body mechanics.
Mobility is important in the spine to be able to perform functional activities such as turning your neck to drive, bend forward to put on your shoes and socks, or participate in sports like gymnastics and swimming. It is important to have good mobility of the neck and low back to be able to function correctly and maintain lubrication between the joints to prevent break down of these tissues. If you do not keep the joints throughout the back and neck mobile with stretching, they can tighten up and cause stiffness and pain. In addition to the joint being mobile, it is important to keep the muscles flexible throughout the back, neck, arms, and legs. Not only can the paraspinal muscles that run up and down the spine get tight and cause stiffness, the muscles in the back of the neck, front of the shoulder, and front and back of the hips can get tight. This throws off normal movement of the spine. The hamstrings are very often tight and can pull on the back of the pelvis causing the low back to be flattened. The hip flexors can get tight sitting for long period of time and pull on the front of the pelvis causing more curve in the low back. It is essential to make sure you are maintaining proper mobility of the joints and muscles to limit pain and promote function.
Stability is another aspect of physical therapy to prevent and treat the low back. If you have ever gone physical therapy for your back, it has probably been ingrained in you to make sure you have proper core stability. The reason why we promote having core stability is because it helps to support the low back. We are not talking about getting a 6-pack abdominals or doing 100 crunches, but about trying to strengthen a group of muscles that surround the low back like an internal back brace. When you tighten these muscles, it helps to take strain off the low back with any activity. Moving up the chain, it is also important to when good stability of the muscles that run between the shoulder blades (scapula) and in the forgotten muscle group in front of the neck. These groups of muscles are important in promoting good posture and head positioning, and help improve the mechanics of the shoulder. It might take a while to get these muscle groups strong enough to function all day, but it is vital to your back health.
Posture is another very important aspect of physical therapy treatment for the back and neck. With a large amount of workers having to sit at a desk for hours on end, it is essential to try not to slouch or lean forward. When a person slouches in a chair, you flatten out the low back and put pressure on the low back instead of having your body weight be supported by the bones in your rear-end. Additionally, for people that sit at a desk all day, it is not good to start rounding out in the shoulders and bringing the head forward. This will cause tightness in the front of the shoulder and rounding in the upper back. This can also cause pain in the back of the neck. It is important to sit up straight and bring the shoulders back. It will be hard, but trying not to utilize the back rest in some chairs will help to support your back.
Utilizing proper body mechanics when lifting or carrying something heavy; and even when getting in and out of bed, is important to avoid acute back injuries to discs and muscles. When lifting and carrying a heavier item, it is important to keep the item close to you to avoid increased straining the back. When lifting something from the ground, it is important to have a wide stance and use your larger leg muscles to do all the work. It is important to squat and lift with your legs verses trying to bend forward at the waist and lifting with the smaller back muscles. We often also teach patients to perform a “log roll” when getting in and out of bed to take the strain of the low back. Rolling onto one side and then pushing up or laying down, helps keep the back in alignment and take the work off the muscles in the back.
Read more about low back pain here: