Low back pain is one of the leading causes of disability and it often causes significant distress to those who are affected with the condition. Finding an effective treatment to help manage the pain and get patients back to their daily lives is important. Research has found that combining psychological care with physiotherapy helps people recover faster than rest or other traditional treatments.
What Do The Guidelines Recommend?
International guidelines for low back pain regularly recommend the use of physical exercise for non-specific LBP. The main goal of physical exercise and physical therapy is to help improve function and to help stop the disability from getting worse. Studies have shown that passive methods like rest and medications are associated with “worsening disability”. When it comes to chronic low back pain, physical therapy exercise is often recommended as first-line treatment to help restore function.
What Is Physical Therapy For Low Back Pain?
Physical therapy (PT) is a type of treatment that focuses on easing pain and improving function. The goal of treatment is to get clients moving again and getting back to their daily activities without pain.
Benefits Of Physical Therapy Include:
Recovery from injury or trauma
In most states you don’t even need a referral from your doctor - you can just go directly to a physical therapist. Reimbursement for this treatment does vary, depending on the type of health insurance plan that you have.
What Does A Physical Therapist Do?
When you first meet your physical therapist they will do a thorough assessment and examination to see what your needs are and what type of movements you can do. They should also do an assessment that will help you track your progress and see how much improvement you will gain over time. They will assess your pain using tools like the Oswestry Disability Index so that you can see how your pain gets better.
Some physical therapy tests include:
Your level of mobility such as how well you can move around, bend over, or reach
How good your balance is
What your posture is like
How well you walk/climb stairs
Favorite PT Exercises For Low Back Pain
When it comes to the types of exercises that physical therapists prescribe for their patients there are many that are tried and trusted. These exercises are designed specifically to help strengthen the core muscles that help to support the spine, as well as to improve and increase flexibility. Here are 5 favorite physical therapy exercises for low back pain.
1. Cat-Cow Stretch
The Cat-Cow stretch is a wonderful stretch that is based on a yoga pose designed to improve both posture and balance. It is a great stretch for supporting your back and for helping to maintain a healthy spine. This makes it an ideal stretch for those who suffer from low back pain.
The Cat-Cow stretch is excellent for stretching and strengthening the neck and spine, and is awesome for improving coordination. This stretch can be done as part of a yoga sequence to warm up, or to relax, so you can do it morning or evening, or even both if you are really enjoying it.
When you do movements that both flex and extend the spine, you can significantly improve circulation in the discs in your back. The “cat” part of the stretch loosens the spine while stretching out the hips and abdomen. It releases tension in the back and the neck. This movement is all about flexing and rounding the spine as you contract your abdomen. On the opposite side, in cow pose the spine is extended and the sternum and tailbone are lifted, lengthening everything. By incorporating both movements, your spine is fully mobilized.
The Cat-Cow stretch is also a great way to relax as the movement is often linked to your breathing. This makes it a great way to relax your muscles and ease some of the day’s stress. With its calming properties, it is an excellent stretch to do before getting into bed.
2. Bird Dog Stretch
The Bird Dog Stretch is another fantastic exercise for strengthening your core muscles, using both the abdominals and the back muscles. Because of its ability to target the lower back muscles so effectively, physical therapists and trainers often suggest this stretch for patients who have lower back issues. It is a wonderful movement to improve the alignment of your spine, strengthen your glutes, and improve stability and balance.
Probably the number one challenge with this stretch is that it requires a bit of coordination. You might feel a bit awkward in the beginning, but after a few tries you will soon get the hang of it! The key to the stretch is to be very intentional with your movements. Form over speed will help you to focus and coordinate. As you get stronger, some people even use light weights to make this more challenging. Using a towel or mat under your body can make this comfortable if you need some extra cushioning under your hands and knees.
3. Pelvic Tilt
The Pelvic Tilt is one of the easiest low back stretches that you can do and it is an amazing move to strengthen your abdominals and stretch out your back! Doing pelvic tilts regularly can reap huge benefits in terms of pain reduction and easing the tension in your low back. Because pelvic tilts are so easy and safe to do (even pregnant ladies can do them), they are one of the most recommended stretches for low back pain.
The research behind this exercise shows that pelvic tilts concentrate on two main groups of abdominal muscles, the transverse abdominis (muscles that wrap around the spine, and help to stabilize it) and the multifidus (muscles that stretch and rotate the spine). As your pelvis rocks back and forth it moves between flexing and extending, and this movement helps to restore mobility to the spine.
The main benefit of the pelvic tilt is to strengthen your lower abdominal muscles and stretch out your lower back, but it is important to make sure that the movement is done correctly.
4. Trunk Rotation
The trunk muscles are vital to almost any movement you make with your body. The trunk muscles provide stability to our movements and help with everything from walking to balancing. The muscles that make up our trunk muscles include the rectus abdominis, pyramidalis, external abdominal oblique, internal abdominal oblique and the transverse abdominis. These muscles are more commonly known as your core.
The trunk (or core) muscles can weaken or tighten up if they are not regularly strengthened or used. Things like sitting for a long time can cause the muscles to weaken and can end up causing pain. When our shoulders are slumped or we don’t sit up straight, our core weakens and our posture suffers. A weak core is one of the main causes of low back pain.
With this in mind, the trunk rotation stretch (also sometimes referred to as a supine spinal twist) is a very popular exercise that is often used by trainers and physical therapists to reduce low back pain. The trunk rotation stretch increases your core strength, as well as improving stability, mobility and flexibility of the spine.
The trunk rotation stretch is easily modified with lots of options as to which one feels best for your body. You can also continue to make modifications and challenge yourself as you start to get stronger.
5. Cobra Stretch
The Cobra stretch is a wonderful pose that can really strengthen the back muscles. This pose is not for everyone with low back problems so it is important to check with your doctor before doing it or ask for a modification if you are feeling any sort of discomfort or pain. Your physical therapist should be able to make those modifications fairly easily if you need them.
The core movement of the cobra pose is the arching of the spine in a backwards motion - thereby working and strengthening your back muscles. The cobra pose can also help to strengthen your pelvic and abdominal muscles, making it a great all-round strengthening exercise for people with low back pain.
Careful execution of this pose will help ensure that you get the most out of this move. While it may seem as if it is doing more stretching of your pelvic and abdominal muscles, pressing the tops of your feet into the floor will engage these muscles, adding the strengthening component. Good form is key here!
The extension part of the movement may help to stretch out your spine and has the potential to alleviate either some, or all, of your spinal disc discomfort. The extent of this stretch will vary quite widely from person to person, but as long as your healthcare provider has said you can go ahead with this movement, or your physical therapist is recommending and supervising, the cobra pose can help significantly in reducing lower back pain.
Physical therapy and other forms of exercise are the number one recommended treatments for low back pain. These treatments have a huge amount of data and clinical trials to support their effectiveness in helping with low back rehabilitation. What’s more - if you have health insurance there is a good chance that your health insurance company will pay for around 10 sessions.
If you don’t have health insurance, or if you happen to have a huge deductible, there are more cost effective options. Some physical therapy practices offer cash pay discounts, or alternatively there are other options like digital physical therapy clinics that might be more affordable. If your doctor recommends physical therapy, or if you just want to try it yourself, you should definitely speak to a reputable physical therapist in your area and see what options are available to you.