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Does Physical Therapy Work for Back Pain?

man suffering from lower back pain

Research shows most Americans experience back pain during their lives. Lower back pain is the second most common reason people visit their doctor and is the most frequent reason people miss work.

Physical therapy clinicians agree that lower back pain is one of the most common reasons clients seek physical therapy rehabilitation services. See our blog, What to Expect During Physical Therapy for Lower Back Pain, for insight into how physical therapy for back pain works.

Poor posture, degenerative conditions, frequent forward bending, lifting heavy items, non-mechanical disease processes, and repetitive strains may cause acute or chronic back pain, according to VeryWellHealth. Sometimes it is difficult to determine the cause.

The Spine and Back Pain

The spine comprises the vertebral column that runs from the skull to the lower back, supporting the body and protecting the spinal cord. An intervertebral disc between each vertebra acts as a shock absorber, cushioning the stress the body experiences during movement, and preventing the vertebra from grinding against one another. Pain in the neck or back is often linked to strain or injury to the spine.

Lumbar spine

The lumbar spine is the lowest part of the spine, containing five vertebrae which are referred to as L1 to L5. Lumbar vertebrae are the largest of the spinal vertebrae, designed to support the cervical and thoracic spine, carry the weight of the body, and handle the stress of lifting and carrying heavy objects.

The coccyx, or tailbone, and the sacrum are at the bottom of the spine, containing fused vertebrae to form one solid bone.

Thoracic spine

The thoracic spine contains the twelve vertebrae between the lumbar spine and the neck. Thoracic vertebrae are numbered from T1 at the top down to T12 at the bottom, with those at the bottom the largest. The twelve thoracic vertebrae are connected to the ribs, and, along with the sternum, form part of the thoracic cage. This area functions to protect the heart and lungs.

Cervical spine

The cervical spine is the neck region, comprising seven vertebrae numbered C1 at the top and C7 at the bottom. The two top vertebrae, C1 and C2, also called the atlas, enable the neck to turn and tilt.

Health experts estimate that 30 to 50 percent of Americans complain of neck pain each year. The cervical spine and thoracic spine are connected, which can mean poor posture that causes dysfunction in the thoracic spine may also affect the cervical spine. Because the ribs support the thoracic spine, people feel pain more often in the neck than in the mid-back.

Studies Agree: Physical Therapy to Treat Back Pain Works

There are many studies recommending physical therapy as an effective treatment approach for back pain. Physical therapy is especially effective when recommended as the first course of treatment before resorting to surgery or other aggressive approaches.

Physical Therapy for Lumbar Pain

A study published in the journal Health Services Research entitled Physical Therapy as the First Point of Care to Treat Low Back Pain found patients who worked with a physical therapist as the first treatment approach had a lower probability of needing:

  • A prescription for opioids
  • Advanced imaging services
  • Emergency room visits

These patients also incurred significantly lower out-of-pocket costs.

Authors studied data from 150,000 insurance claims submitted between 2009 and 2013 and concluded, “Patients with low-back pain are better off seeing a physical therapist first,” noting this resulted in a “lower utilization of high-cost medical services as well as lower opioid use.”

In another study, Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis: A Randomized Trial, published in the Annals of Internal Medicine, researchers evaluated 169 patients, half of whom received back surgery for lumbar spinal stenosis and half who took part in a physical therapy program.

Both groups reported positive benefits beginning about ten weeks after surgery or physical therapy. Over the next four months, both groups reported a reduction in pain and an increase in function. When evaluated 24 months later, researchers found no difference in pain or function between the two groups.

Twenty-five percent of the surgery group experienced complications related to their surgery, including infection, or the need for additional surgery. Only ten percent of the physical therapy group reported worsening symptoms, which may have required surgery or other interventions.

When considering back surgery or physical therapy, “the risks of physical therapy are considerably less,” said study author Anthony Delitto, a professor of physical therapy and associate dean of research with the School of Health and Rehabilitation Sciences at the University of Pittsburgh.

A 2017 study entitled Timing of Physical Therapy Referral in Adolescent Athletes with Acute Spondylosis: A Retrospective Chart Review by researchers at the Children’s Hospital in Columbus, Ohio found athletes with stress injuries of the spine who began physical therapy soon after the injury could return to their sport sooner than those who delayed treatment.

Athletes who started physical therapy immediately were able to resume their sport after about three months’ time, while it took about four and a half months for those who delayed treatment.

Physical Therapy for Thoracic Pain

Study results vary widely when evaluating the causes of and treatment for thoracic pain. Experts believe this is because “referred pain,” meaning pain that is felt in one area but originated elsewhere, is common in thoracic complaints. For example, pain may originate from a shoulder or neck injury but is felt in the thoracic area.

An article published in the Journal of Orthopedic & Sports Physical Therapy reviewed multiple studies seeking to evaluate the effectiveness of manipulation of the thoracic spine, a technique that is commonly used by physical therapists to reduce pain, increase range of motion, and improve function in the thoracic and cervical areas.

Patients studied received immediate relief from the manipulation, and, after attending physical therapy sessions for three weeks, relief lasted up to six months.

Physical Therapy for Cervical Pain

The Journal of Manual and Manipulative Therapy published the findings of a large-scale review of randomized clinical trials regarding the Effectiveness of manual physical therapy in the treatment of cervical radiculopathy.

The authors of the study concluded that treating neck pain, specifically cervical radiculopathy, with a physical therapy program using manual therapy techniques and therapeutic exercise effectively increased function and range of motion and decreased pain and disability.

Why Use MOTION for Relief of Back Pain?

Since 2015, MOTION has provided transformative physical and occupational services to clients of all ages. Our specialty programs include a Post-Acute COVID Recovery Program and our Wellness@MOTION program designed to help you stay on track after your initial plan of care.

At MOTION, our mission is “to get you back to what moves you” as quickly as possible. Guided by our values of compassion, empowerment, integrity, and teamwork, we promise we will not stop until you’ve reached your goals.

We are experts in the treatment of back pain. By designing a program specifically for you, using a combination of scientifically proven hands-on techniques along with some of the most advanced treatment modalities available, we will get you the relief you need and deserve.

Our therapists are certified in a broad range of specialties that effectively treat back pain, including active release technique (ART®), aquatic therapy, ergonomics, functional dry needling®, kinesiotaping, McKenzie Method® of Mechanical Diagnosis and Therapy®, myofascial decompression (cupping), and more.

We pride ourselves on our personalized attention and commitment to each client, the expertise of our staff, and our state-of-the-art facilities. In order to ensure you have the one-on-one time you need with your therapist, each MOTION appointment lasts 40 minutes, which is longer than a typical session at most PT providers.

We understand how much you want to get back to an active, pain-free life, and we want to get you there. Contact us today to schedule an in-clinic or telehealth appointment.