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Physical Therapy for Lower Back Pain: How it Can Help, Exercises, and More

You know it well.  That nagging, burning sensation you feel in your lower back every time you take a step and every time you roll over in bed. Or maybe you’ve “thrown your back out” one too many times. Not only is lower back pain, well, painful, but it’s also extremely common. It has been estimated that approximately 31 million Americans experience low back pain. If you’re ready to put an end to your back pain, physical therapy for lower back pain may be just what you’re looking for. This article will discuss lower back pain and ways PT can: 

  • Reduce pain
  • Increase mobility
  • Get you back to doing the things you love the most

Table of Contents

Lower Back Pain: What Qualifies?

The lower back, also known as the lumbar region, is the area of your back that begins just below your rib cage and ends at the upper part of your buttocks  Your lower back supports the weight of your upper body and includes 3 types of muscles: 

  1. The extensor muscles attach to the back of your spine and allow you to stand up and lift objects. The extensor muscles include your erector spinae (which help hold up the spine), as well as your gluteal muscles.
  2. The flexor muscles attach to the front of your spine and allow your lower back to:  
    • Flexing
    • Bending forward
    • Lifting
    • Arching
  3. The oblique muscles attach to the sides of your spine, helping your spine to rotate and allowing you to maintain proper posture.

Your lower back also has plenty of nerves that supply feeling to the muscles in your:

  • Pelvis
  • Legs
  • Feet

What Causes Lower Back Pain?

The causes of lower back pain are varied and may include:

  • Muscle sprains and strains: These can occur when excess physical activity causes the muscles or ligaments in the lower back to stretch or tear. This may result in stiffness, pain, and muscle spasms. 
  • Herniated disc: Also sometimes referred to as a slipped or ruptured disc, a herniated disc occurs when the inner part of the disc located between your vertebrae pushes through the outer ring. In extreme cases, a herniated disc may lead to permanent nerve damage.
  • Degenerative disc: Degenerative discs are the result of natural wear and tear that happens to the spine as you age. As the discs weaken, they no longer absorb the shock that they once did and can cause back pain.
  • Osteoarthritis: The most common form of arthritis, osteoarthritis is generally caused by joint deterioration, with the weight-bearing joints of the knee and hip being the most commonly affected.
  • Osteoporosis: Osteoporosis is a common aging disease that causes the thinning and weakening of the bones.
  • Sciatica: Sciatic pain radiates through the path of your sciatic nerve, which branches from your lower back—through your hips and buttocks—down each leg.
  • Hyperlordosis: A postural issue, hyperlordosis is characterized by an exaggerated inward curvature of the spine in your lower back. This curvature causes your stomach to lean forward and your bottom to push out. If you were to look sideways in the mirror, you would see a C-shaped arch. Hyperlordosis may be caused by:
    • Spinal injury
    • Structural issues
    • Obesity
    • Neuromuscular disease
    • Rickets 

Symptoms of Lower Back Pain

Lower back pain can involve a wide variety of symptoms. It can range from mild and somewhat annoying to severe and debilitating. It can start as a gradual, coming and going type of pain or may begin suddenly and be so severe that you can’t get off the couch. Low back pain may manifest as…  

  • Stabbing
  • Burning or stinging
  • Aching and dull
  • Throbbing
  • Spasming
  • Tightness
  • Sharpness

Low Back Pain Treatment: Physical Therapy – How Can it Help?

Physical therapy for lower back pain can help:

  • Reduce pain and discomfort
  • Speed healing
  • Improve posture
  • Strengthen muscles to prevent injury

PT for Mechanical Lower Back Pain

Mechanical low back pain is the most common cause of lower back pain. Also referred to as axial pain, mechanical lower back pain comes primarily from the …

  • Muscles
  • Ligaments
  • Vertebrae
  • Joints (facet and sacroiliac)
  • Discs

… in and around the spine.  Mechanical lower back pain tends to remain localized in your:

  • Lower back
  • Buttocks
  • Occasionally the top of your legs

This type of low back pain is generally influenced by loading the spine and may feel differently, depending on the motion being performed. Physical therapy for lower back pain when dealing with mechanical issues might include the McKenzie method. The McKenzie method for physical therapy of the low back believes there is a cause-and-effect relationship between a patient’s normal sitting standing or moving positions and their pain.  This method moves the patient through a series of activities and test movements in order to gauge the patient’s pain responses.  That information is then used to develop a personalized exercise process to help alleviate the pain.

PT for Radicular Lower Back Pain

Radicular pain may occur if a spinal nerve root becomes inflamed or impinged (pinched).  Radicular low back pain radiates from your back and hip into your legs, through the spine. It may follow a nerve root pattern down into the buttock and/or leg.  The pain from radicular low back pain can sometimes manifest as muscle weakness and may feel:

  • Sharp
  • Burning
  • Electric
  • Tingling
  • Numb

Radicular low back physical therapy often results in faster and better results than surgery or strong pain medications, and may include components such as:

  • Postural work
  • Stretching
  • A strengthening program 

PT for Chronic Lower Back Pain

Chronic lower back pain is pain that may be experienced for three or more months. The causes for this pain can be uncertain, and it’s possible that a single event is not what caused your chronic low back pain.  Chronic lower back pain may be the result of doing multiple activities, such as lifting incorrectly for an extended period of time. One day, all of a sudden, a normally simple movement, such as reaching for the remote, or bending over to pick up your shoe, leads to pain. Many individuals who experience chronic low back pain also have arthritis. Or they may have extended wear and tear of the spine due to: 

  • Repetitive motions at work
  • Overuse from sports
  • Injury
  • Fractures
  • Surgery

When dealing with chronic conditions, physical therapy exercises for lower back pain may include stretching and flexibility exercises in order to reduce pain, improve functional limitations of movement, and improve overall movement to the:

  • Hamstring
  • Piriformis
  • Quadriceps
  • Hip joint capsule

What to Expect at Physical Therapy for Lower Back Pain

What is physical therapy for low back pain like? The goal of physical therapy for lower back pain is to identify the cause of your pain and determine whether it is acute or chronic.  In order to do this, your physical therapist will most likely conduct:

  • An in-depth review of your complete medical history
  • An evaluation of your symptoms
  • An assessment of your strength and range of motion
  • An analysis of your posture and your gait

Following this, your physical therapist will create an individual treatment plan that includes …  

  • Goals
  • Education
  • Exercises

… all designed to relieve your pain and get you back to functioning as close to 100% as possible

4 Common Physical Therapy Exercises for Lower Back Pain

Part of your PT protocol is sure to include physical therapy stretches for lower back pain.  Proper stretching will help:

  • Maintain normal range of motion 
  • Keep your muscles from shrinking from lack of use
  • Provide pain relief
  • Loosen and activate your muscles
  • Relieve any muscle spasms

Below is a sampling of some exercises that your physical therapist may recommend. Please note: It’s important not to attempt any physical therapy exercises for lower back pain without consulting with a PT and developing an individualized treatment plan.

#1: Wall Sits

To do wall sits, follow these instructions:

  1. Stand facing away from a wall, with your back and heels about 1-foot out from the wall.
  2. Lean your back flat against the wall.
  3. Slide down until your knees are slightly bent, like you’re sitting in a chair.
  4. Gently press your lower back into the wall, until you are in a sitting position.
  5. Remain in this position for 10 seconds before sliding back up the wall.

Perform 8 to 12 repetitions.

#2: Bridges

To do bridges, follow these instructions:

  1. Lie on your back with your knees bent, feet touching the floor.
  2. Slowly raise your hips by keeping your back in a straight line with your knees and shoulders
  3. Hold this position for 6 seconds.

 Repeat 8 to 12 times.

#3: Partial Crunches

To do partial crunches, follow these instructions:

  1. Lie on your back with your knees bent, feet flat on the floor.
  2. Put your hands behind your head, or cross your arms over your chest.
  3. Tighten your abdominal muscles and raise your shoulders off the floor while breathing out.
  4. Hold the crunch for one second before slowly lowering yourself back down.

Do 8 to 12 partial crunches.

#4: Press-up Back Extensions

To do press-up back extensions, follow these instructions:

  1. Lie on your stomach and place your elbows underneath your shoulders with your hands flat on the ground.
  2. Push down on your hands while lifting your shoulders away from the floor.
  3. Maintain this position for several seconds.

Repeat 8 to 12 times.

How Long Does Physical Therapy Take for Lower Back Pain?

The length of time required for physical therapy for lower back pain will vary by patient and depends on:

  • The severity of the injury
  • Pre-existing deficits
  • Age
  • Level of health
  • Patient goals

Can Lower Back Physical Therapy Prevent Re-Injury?

It can. One of the huge benefits of physical therapy exercises for lower back pain is that it stretches and strengthens the muscles in your back.  By improving the functionality of the affected area, physical therapy of the low back helps to prevent re-injury in the future.

The Licensed Physical Therapists at PRO~PT Are Here for Your Lower Back Physical Therapy Needs

PRO~PT is the go-to clinic serving the Central Valley since 2001. Our convenient locations in Fresno North and Fresno West provide you with the personalized care you deserve.  In addition to treating lower back pain, we specialize in …

  • Orthopedic injuries
  • Sports-related injuries
  • Spine conditions
  • Post-surgical care
  • Balance and fall prevention
  • Other specialties, such as pelvic floor physical therapy

Our goal is to return our patients to their best quality of life.  Request an appointment today.

Categories: Back Pain• August 16, 2021