How We Can Help
Patients with mechanical back pain, sciatica, herniated or bulging discs, spinal stenosis, degenerated disc disease or muscular low back pain are commonly prescribed physical therapy. It will assist in reducing pain and inflammation, and improving mobility and strength.
We will provide you with an extensive back evaluation by an expert physical therapist who has years of training in medical evaluation of musculoskeletal conditions. At the end of your initial evaluation you will receive a customized plan of care that is indicated to your specific spinal surgery or other back diagnosis. Treatment may include stretches, strengthening, core/stability exercises, postural education, manual techniques/soft tissue massage, and/or modalities including ultrasound and Electrical Stimulation.
If ordered by your physician, and covered by your insurance plan, you may be fitted for a home TENS unit in order to help manage your pain.
Mechanical Low Back Pain
Most people regard back pain as an injury, but mechanical pain is typically aggravated by static loading of the spine (i.e., prolonged sitting or standing), by long lever activities (i.e., vacuuming or working with the arms elevated and away from the body), or by levered postures (i.e., bending forward). These activities can wear and tear on the joints in your spine, the disc, spinal musculature, and the spinal ligaments which can cause stiffness, inflammation and low back pain.
Studies point to mechanical low back pain as the second most common symptom physicians see in their offices. According to Dr. Everett C. Mills, MD., medical director of Penn State Hershey Medical center, studies show that 85% of the US population will suffer an episode of mechanical low back pain in their lifetime. The severity of an acute traumatic event varies widely, from lifting something to being involved in a motor vehicle accident. Mechanical low back pain due to chronic trauma tends to occur more commonly in the workplace or as we age.
Sciatic Pain
Sciatica is a relatively common form of leg pain that is often misunderstood by patients. There are frequent misconceptions about what the term sciatica means. Sciatica describes leg pain that is localized in the distribution of one or more lumbosacral nerve roots, typically L4-S2, with or without neurological deficit. Sciatica is actually a set of symptoms rather than a diagnosis for what is causing the pain. Especially for more severe cases, the cause of leg pain needs to be correctly addressed in order to relieve discomfort.
Sciatica can be caused by many different reasons such as a herniated disc, spinal stenosis (narrowing of the spinal canal where the nerve exits the spine), an entrapped sciatic nerve by the piriformis muscle located deep in the buttock, it may even be referred pain from the spinal facets joints or SI joint, or from a pelvic rotational deformity.
Herniated or Bulging Discs
Herniation is defined as a localized displacement of disc material beyond the limits of the intervertebral disc space. Herniated discs may take the form of protrusions or extrusions, depending on the shape of the displaced material. Protrusions may be focal or broad based. Protrusions with a base less than 25% of the circumference of the disc are focal. If disc material is herniated, so that the protrusion encompasses 25-50% of the circumference of the disc, it is considered a broad-based protrusion.
There are many misconceptions on bulging and herniated discs. The discs are fluid filled sacs in-between the vertebrae in your neck and back which provide cushioning to the spine and give the joints space. The primary age group for people affected with herniated discs is between 25 and 45. A bulging disc is the beginning stage of a disc herniation and is typically not symptomatic. A large percentage of the population is walking around with bulging discs right now without any problems.
Bulging discs can become worse and “herniate” into the space where the nerve roots from your spinal cord are coming out. This can occur at any level in the spine, but most of the time this occurs in the mid part of the neck and the lower back. If you have back pain in the morning, struggle to attain erect posture, experience numbness/tingling to a specific part of your arm, hand, leg, or foot, or complain of sharp, stabbing back pain you may have a herniated disc.
Spinal Stenosis and Degenerated Disc Disease
Spinal Stenosis and Degenerated Disc Disease (DDD) are common and potentially crippling conditions affecting most of us to some extent as we get older. It usually occurs in the cervical and lumbar regions of the spine. Although there are many types and causes of spinal stenosis, the most common occurs over the age of 60, affecting women slightly more than men.
Degenerative Disc Disease with resulting loss of disc height may induce spinal instability. Such instability causes spinal joint bone spurs, arthritis, pain and inflammation. This process causes narrowing of the spinal canal (central spinal stenosis) and where the nerves exit the spinal canal (lateral foraminal stenosis).
The most common initial step in treatment of Spinal Stenosis and DDD is physical therapy. Emphasis in physical therapy is placed on strengthening the muscles of the back, stretching exercises, and improving posture and decompression therapy. By better supporting the spine, symptoms of nerve compression are often improved.
Muscle Pain or Strain in the Low Back
Low back pain may also be a result of muscle strain from an injury such as a car accident, a fall, or from a repetitive activity. Trauma may create bleeding or swelling between the muscle fibers and surrounding tissues making it possible for there to be scar tissue adhesions. Adhesions in one area may affect other areas of the body. Nerve entrapments may occur when the nerve passes through the muscle between tight bands or when it is compressed between a band and bone (i.e., piriformis).
Ultrasound treatment on lower back
Lumbar Spinal Surgery Recovery - Discectomy, Laminectomy, Fusion
Following back surgery, it is extremely important to receive physical therapy in order to properly return back to your daily activities (work, sporting activities, grocery shopping, and housework). Restoration Physical Therapy will focus on strengthening your core/deep lumbar stabilization muscles, reducing scar tissue, improving flexibility, reducing pain and swelling, and teaching proper body mechanics (getting in/out of bed and lifting).