Physical therapy is the most mainstream back pain treatment offered by the medical profession. Assuming that the physical therapy treatments and exercises are taught and supervised by a qualified physical therapist, this course of therapy is considered to be safe and beneficial in most cases. Physical therapy is prescribed by doctors after a back injury or given amount of time has passed in which the condition will be unlikely to heal on its own. Physical therapy is typically reimbursed by most insurance companies, unlike treatment such as chiropractic or acupuncture in which patients will be likely to have to pay much higher deductibles. Physical therapy is a mainstream nonsurgical cure for back pain. Physical therapists will administer treatments designed to provide pain relief. Physical therapists will also teach and supervise patients as they use machines and do floor exercises to increase flexibility and strength to the muscles and ligaments surrounding the injured soft tissues.
Physical therapists wok on patient's posture and body mechanics by teaching patients how to correctly use their bodies to avoid strain. PTs will also improve posture through stabilization exercises, and strengthen the muscles that support the spine.
There are two categories of physical therapy: passive and active.
The passive pain relieving techniques involve ones where patients are being passively treated while a physical therapist is working on one or more parts of their body. the passive pain-relieving techniques used by physical therapists in these treatment sessions are called "modalities." During these sessions, the patient lies still while the therapist moves his or her body, or applies pressure, to reduce pain, stretch the muscles, or release muscle tension. These passive treatment sessions are only a means to an end. The end goal is for the physical therapist to make the patient strong enough to perform his or her own strength and flexibility exercises so that they will heal and not experience pain again in the future. These passive treatments should provide enough relief so that the patient is no longer in severe physical distress. The passive treatments will also continue long enough to provide the patients with enough relief so that they may be able to perform the active techniques with enough comfort that they won't terminate these treatments.
As part of your treatment with modalities, the physical therapist may apply heat or ice packs to your neck or back. The ice treatment is designed to reduce pain, swelling, and inflammation. By icing the affected areas, you are reducing circulation to the injured tissues and reducing inflammation. Icing is most commonly used in the first 24-48 hours following an injury. Heat has the opposite effect on blood circulation. Heat therapy increases blood circulation, which increases healing to sore tissues. The physical therapist may also use ultrasound, which sends heat deeper into the damaged tissues.
A physical therapist may also use electrical stimulation to relieve pain. The most common therapy unit that used electrical stimulation is the Transcutaneous electrical nerve stimulation (TENS) unit. If TENS units don't achieve their desired effect, then other therapy units may be used to try to deliver electrical stimulation into the deeper subcutaneous tissues. Inferential current (IFC) and Galvanic Stimulation (GS) units use different frequencies to provide relief to the deeper muscles of the abdomen and back, as well as the soft tissues closer to the spine.
Therapeutic massage is another modality that may provide pain relief as well as accelerated healing to strained muscles and muscles affected by chronic tension. Many massage therapists are professionally trained to provide this treatment. Patients who may have serious back problems such as herniated discs should only receive a massage from a trained professional, so as not to aggravate their injury from untrained hands.
Until recently manipulative therapy was only performed by osteopathic physicians and chiropractors. Today, some progressive therapists are learning manipulative therapy techniques similar to those performed in chiropractor offices. This fact represents quite a big change among the medical and chiropractic professions. Prior to the 1990s, patients would go to chiropractor's offices to have their joints of their spines adjusted, and PT clinics to do the stretching and exercise. All the while the two professions viewed each other with distain. Today, chiropractors, physical therapists, and massage therapists work together within the walls of the same treatment centers. The end goal of all of these modalities is to get the patients well enough for them to begin and continue an active exercise program. Lasting recovery won't occur for the sore muscles until they may become strong and flexible again. The constructive part of the therapy will include the stretching and strength exercises that you can do for yourself, without the assistance of the physical therapist.
The therapy modalities that are available to you may be affected by the policies of your insurance provider. Increasingly, the goal of many insurance providers is to accelerate patient recovery. To this end, some place a greater emphasis on active physical therapy programs, and may not provide coverage for passive treatments such as therapeutic massage.