PHYSICAL THERAPY FOR LOW BACK PAIN

Z Altug, PT, MS, CSCS, NSCA-CPT Physical Therapist / Fitness Consultant Los Angeles, CA www.zaltug.com

Initial Physical Therapy Evaluation

REVIEW REFERRING PHYSICIANS PRESCRIPTION PERFORM CHART REVIEW review medical tests and check physician notes PERFORM SUBJECTIVE ASSESSMENT identify onset of pain, pain level, sources of pain, medication, activity level PERFORM OBJECTIVE EVALUATION assess gait, posture, range of motion, strength, sensation, reflexes, tenderness regions with palpation, function (pain or difficulty with daily tasks such as don/doff shoes) PERFORM TREATMENT manual therapy, therapeutic exercise, modalities, patient education SEND PLAN OF CARE TO THE PHYSICIAN CONTACT THE REFERRING PHYSICIAN VIA PHONE OR EMAIL if needed

Some Sources of Mechanical Low Back Pain

POSTURAL DYSFUNCTION overuse, malalignment MUSCLE STRAIN LIGAMENT SPRAIN FRACTURE osteoporosis, spondylolysis, spondylolisthesis HERNIATED DISC ARTHRITIS SPINAL STENOSIS DECONDITIONING GAIT DEVIATION

Some Tools of the Physical Therapist Modalities

Modalities are typically used to reduce pain, reduce muscle spasm and increase circulation for tissue healing.

ULTRASOUND INFRARED LIGHT THERAPY LASER LIGHT THERAPY INTERFERENTIAL ELECTRICAL STIMULATION TENS (Transcutaneous Electrical Nerve Stimulation) HOT PACKS COLD PACKS

Some Tools of the Physical Therapist Traction

Traction is typically used to reduce muscle spasm and decompress a joint.

CERVICAL TRACTION clinic or home unit LUMBAR TRACTION clinic or home unit

Some Tools of the Physical Therapist Soft Tissue Mobilization

Soft tissue mobilization techniques are typically used to reduce pain, reduce muscle spasm, improve range of motion, and increase circulation.

MYOFASCIAL RELEASE MASSAGE

Some Tools of the Physical Therapist Joint Mobilization Techniques

Joint mobilization techniques are typically used to reduce pain, reduce muscle spasm, and increase range of motion.

The following are some joint mobilization techniques: NATURAL APOPHYSEAL GLIDES SUSTAINED NATURAL APOPHYSEAL GLIDES MOBILIZATIONS WITH MOVEMENT

Some Tools of the Physical Therapist Taping Techniques

Taping techniques are typically used to reduce muscle spasm, provide support, and increase circulation.

KINESIOTAPE (lightweight and very elastic tape)

Some Tools of the Physical Therapist Assistive Devices

Assistive devices are typically used to unload a joint, provide stability, and improve daily function.

CANES CRUTCHES WALKERS BRACES ORTHOTICS (shoe insoles)

Some Tools of the Physical Therapist Patient Education

Patient education is typically provided in the following areas: PAIN MANAGEMENT STRATEGIES positioning, cold versus heat PROPER BODY MECHANICS GUIDELINES PROPER POSTURE INSTRUCTION FALL PREVENTION TECHNIQUES OFFICE ERGONOMICS CAREGIVER EDUCATION

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Some Tools of the Physical Therapist Therapeutic Exercise

Therapeutic exercises are typically used to increase mobility, reduce spasm, increase circulation, improve balance, increase endurance, and maintain or build strength.

FLEXIBILITY EXERCISES MOBILITY EXERCISES AEROBIC EXERCISES STRENGTH EXERCISES BALANCE EXERCISES COORDINATION EXERCISES AGILITY EXERCISES

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Sample Back Conditioning Program

A physical therapist will design a personalized back conditioning program for each person depending on a persons pain level, functional level, type of back pain, goals, and equipment availability.

A. AEROBIC Exercise by walking, hiking, bicycling, or swimming

B. STRENGTH Exercise by using a mat, elastic bands, machines, dumbbells, or a pool

C. FLEXIBILITY Exercise by using a mat, Yoga, or Tai Chi

D. BALANCE Exercise by dancing, Tai Chi, or home balance exercises

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THANK YOU!
Z Altug, PT, MS, CSCS, NSCA-CPT Physical Therapist / Fitness Consultant Los Angeles, CA www.zaltug.com

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