The structure of the spine includes a network of joints, bones, discs, and nerves aligned in a curved position supported by muscles and ligaments. Back problems develop due to trauma, poor postural habits, repetitive movements, or activities of daily living. Treatment begins with a thorough evaluation that assesses strength, range of motion, and repeated movements. Spine health specialists then design a customized program with treatment options to help you restore normal motion and strength. The plan of care will also include education and instruction in home exercises for self-management of your symptoms. Spine rehabilitation also includes rehabilitation after spine surgeries by identifying the dysfunctions that led to having surgery in the first place. Having identified the dysfunctions, the therapist designs a treatment plan to decrease the effects of adjacent level instability/stress and improve functional mobility with the limitations of surgery.
A new review article published in the Journal of the American Academy of Orthopaedic Surgeons should help convince many patients with low back pain to consider physical therapy as a first line of treatment for their condition, according to the American Physical Therapy Association (APTA). The review, published in February 2009, recommends that in most cases of symptomatic lumbar degenerative disc disease, a common cause of low back pain (LBP), the most effective treatment is physical therapy combined with anti-inflammatory medications. Approximately 75 to 85 percent of adults will be affected by low back pain during their lifetimes.
Symptomatic lumbar degenerative disc disease develops when a disc weakens (often due to repetitive strain), is injured, or deteriorates from aging. As a result, the disc is unable to hold the vertebrae as it should and the lack of stability can cause back pain.
The review details the different treatment methods for symptomatic lumbar degenerative disc disease, including physical therapy with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and concludes that, in most patients with low back pain, symptoms resolve without surgical intervention. The review also concludes that physical therapy and nonsteroidal anti-inflammatory drugs are the "cornerstones" of non-surgical treatment.
Physical therapist intervention includes exercises to strengthening the core muscle groups, including the abdominal wall and lumbar musculature. Exercise and manual therapy have been shown to benefit many patients within a wide variety of spinal diagnoses. In addition, patient education to remain active and use appropriate body mechanics is beneficial. Physical therapists are trained to identify which of these treatment strategies will be most effective for an individual patient, which further improves the effectiveness of care.
Systematic reviews of the medical literature have found that exercise has been shown to improve function and decrease pain in adult patients with Low Back Pain.
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