Physical Therapy can be a key component to treatment of your pain. Physical therapists work closely with the referring physician to help tailor your treatment program to the presenting diagnosis. The physical therapy program will begin with a complete musculoskeletal evaluation and will help you return to your prior functional status as fast as possible.
The current best evidence in the treatment of lumbar back pain (LBP) includes a process known as impairment-based classification. No two episodes of LBP are typically the same and the use of a protocol alone has been shown to increase cost and reduce outcomes. Impairment based classification is a process that involves combining your medical diagnosis along with your prevailing signs and symptoms at the time of assessment. The therapist will then choose a treatment program based on the best evidence for the presenting impairments at that time. It is important to note that as your symptoms and presentation changes your program and the treatment intervention will change as well. Typically, a patient might begin treatment in one impairment category and progress into one or two others as therapy progresses. Benefits of an impairment-based classification approach includes; reduce treatment variation, reduced treatment utilization, improved patient outcomes and reduced episodic cost.
Possible treatment interventions associated with impairment-based classification:
Neuro -muscular reeducation/Stabilization:
Lumbar back pain can cause interruption in the activation of deep muscle that help to stabilize and control your spine. These muscles are not only vital in proper functioning of the lumbar mobility but can actually produce pain both at the spine as well as distal to the location of injury. Some research suggests that the lack of this “local control” may contribute to a recurrence of lumbar pain. Interrupting the pain response and restoring local activation of these important muscle is a vital step in restoring function. Studies indicates that while your back pain may resolve, restoring the activation of these muscles requires specific types of exercises that your PT will help you perform. Physical therapists are well trained to identify these impairments and help to restore your functioning.
DIRECTIONAL PREFERENCE
Some types of lumbar back pain present with certain movements that may increase or decrease symptoms. If your physical therapist notices that certain movement patterns increase or decrease your pain/symptoms; they may implement a treatment strategy that involves these pain-relieving movements. Identification of the correct movement preference is vital to success with this treatment approach. Research supports the use of repeated movements and directional treatments in patients that display preference in certain movement patterns.
