Physical Therapy Intervention for Lower Back Pain

Physical Therapy for Lower Back Pain

There are a variety of ailments that are treated with physical therapy methods and modalities, including lower back pain. In general, those who seek medical attention for lower back pain are usually referred by their physician to a physical therapist for about 4 weeks before involving more invasive procedures – such as surgery – to solve the problem. Physical therapists will use the modalities necessary to alleviate pain, increase function and mobility, and teach the patient how to maintain back health and minimize the chances of further increasing back pain.

Physical therapy for lower back can involve one or both of the following:

Passive physical therapy – where modalities and other methods are used on the patient while they relax and allow the therapist to do all the movements on the patient;
Active physical therapy – where the patient uses his or her own force to apply therapeutic measures, such as actively exercising or stretching.

The majority of physical therapists focus on active physical therapy to alleviate lower back pain, and eliminate the cause of the pain and discomfort.

Exercise During Physical Therapy for Lower Back Pain

The idea behind exercising to treat lower back pain issues is to help stabilize the core and take some of the pressure off the muscles in the lower back. Lower back stability depends a lot on the supporting abdominal muscles and lower back muscles. The abdominal muscles provide the spine with support in the front of the torso, while the lower back muscles support the spine from the back. By strengthening and developing the muscles in these specific areas, a great deal of stress can be taken off the discs and joints of the spine, therefore alleviating lower back pain.

This is why exercise and stretching play a vital role in helping to reduce pain and discomfort felt in the lower back region. A regular exercise routine can help to improve and increase mobility and function, as well as decrease the chances of another episode of severe lower back pain.

The following types of exercises are common in physical therapy clinics to help treat lower back pain in patients:

Stretching – Adequate stretching before, during and after an exercise routine can help alleviate pain in the lower back by improving range of motion, relieving muscles that are not used enough, and reducing muscles spasms caused by improper posture and irritated nerves. A physical therapist will assign specific stretches for each patient to tailor the program specifically for each individual. In general, stretching muscles of the lower back, abdominals, hips and legs are usually recommended.

Strengthening of the Core Muscles – Physical therapists will usually encourage strengthening the muscles of the core, including the abdominals and lower back muscles. Doing this will strengthen the ‘belt of muscles’ around the body, which will help to stabilize the spine and relieve pressure and tension on the discs. Common exercises for this purpose usually include the following:

  • Abdominal crunches
  • Leg raises
  • Lower back raises
  • ‘Good mornings’ (lowering stomach/back until parallel with the ground, keeping the legs straight, then raising back up to starting position)

Any type of exercise that strengthens the muscles of the core will be beneficial.

Dynamic Stabilization Exercises – These types of exercise routines helps to strengthen the secondary muscles in the spine, and help to support the spine. This type of exercise typically involves the use of equipment such as exercise balls or stabilizing machines, as well as simply performing specific stabilization exercises.

Hydrotherapy for Lower Back Pain

There are many physical therapy clinics that offer hydrotherapy to help alleviate lower back pain. This involves the use of warm, pulsating water in a whirlpool or hot tub to help relieve tension and discomfort in the lower back. The effect of this warm water helps to lift the weight off the lower back, therefore providing some relief. Engaging in hydrotherapy can also loosen the muscles enough to get them prepared for an exercise routine.

Lumbar Traction for Lower Back Pain

Many physical therapists will also make use of lumbar traction to help deal with a patient’s lower back pain. Traction involves the use of a machine that unloads the disc space and muscles in the lower back area, which helps to relieve pressure off the muscles and discs. This method involves having the patient lay down on their back on a special table, and fastening them to a strap that is placed around the patient’s hips. This cable is then attached at the foot of the table, which gradually pulls down on the cable to create this disc space.


Physical therapy methods and modalities can be highly effective in treating lower back pain and discomfort in patients. Physical therapists will tailor a specific program for each patient in order for them to reap as many benefits as possible to a physical therapy program. It is extremely important that the patient continues and maintains the exercise and stretching program at home prescribed by their physical therapist in order for the patient to maintain the lower back pain alleviation, and prevent any future episodes of pain and discomfort in the lumbar region.

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