Low back pain is commonly associated with soft tissue pathology, often with resulting compensatory muscle guarding (spasm). This often involves both the paraspinal and abdominal musculature. Physical rehabilitation, including strengthening of the abdominal and paraspinal muscles through lumbar stabilization protocols has been shown to reduce pain and improve function.
In many cases, muscular pathology is the primary cause and instigator of the chronic low back pain and can be effectively treated with a lumbar stabilization program. Physical therapy is by and large short term and very goal oriented, with the hopeful end result being a patient whose pain has been decreased and having a home program for continued benefit.
Patients are educated on lumbar stabilization exercises and activities designed to prevent further injury to the spine. The overall goals for physical therapy with chronic back pain include the following:
- Promote and maintain function
- Prevent further injury
- Reduce pain and promote return of normal function using modalities (e.g. heat and cold, TENS - transcutaneous electrical nerve stimulation, ultrasound)
It is imperative that patients remain active participants in their rehabilitation to achieve maximum benefit in cases with relentless chronic LBP. Trigger point injections may be beneficial along with the physical rehabilitation along with chiropractic treatment. Spinal adjustments along with physical therapy may facilitate functional improvement. Spinal decompression therapy may add to pain relief as well.
Many times it's not simply one treatment that makes all the pain go away, it may in fact be a combination of treatments provided. Seeking treatment at a comprehensive pain center may therefore be in the best interest when dealing with recalcitrant chronic low back pain.
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