Back Pain Physiotherapy
Physiotherapeutic treatment for low back pain can be done using devices and stretches to relieve pain, in addition to massages to relax tense muscles and postural correction through exercises to eliminate the cause of pain.
In addition, the treatment indicated by the doctor can be done with anti-inflammatory drugs, analgesics, corticosteroids, infiltration and it can also be useful to use acupuncture for energy rebalancing and pain relief.
Some physiotherapeutic options to treat low back pain are:
1. Use of devices
Devices such as short waves, ultrasound, transcutaneous electrical stimulation, laser can be used to fight inflammation and bring pain relief by improving a person's daily life. However, the physiotherapist may recommend other equipment, if he thinks it is best for his patient.
Stretching exercises can be performed passively, always respecting the pain limit and as soon as it recedes, it is possible to proceed with stretching, to increase the range of motion and decrease its stiffness. When there is no pain, it is possible for the person to actively stretch.
Some stretching and strengthening exercises are performed in the protocols of global postural reeducation where the person needs to stay in the same position for about 10 minutes. During this period, while some muscles are being stretched, others are being strengthened in order to reorganize the entire bone structure and joints, eliminating the causes of pain.
To avoid spinal rotation, muscle strengthening should be started with static stability exercises in a closed kinetic chain, and for this reason exercises can be used sitting, lying down or with balls of different sizes to offer resistance or support.
The strengthening can initially be performed with the resistance of the therapist's hand and gradually different weight must be introduced for the muscle to recover. The elastic bands like the theraband must be used before the weights and their resistance should increase, as the symptoms presented improve.
Next, rotational stability exercises in an open kinetic chain can be introduced, which can be performed with the person lying on their side, to strengthen the glutes and the anterior and lateral thighs. To make progress, mobility exercises that work all 4 limbs at the same time and favor the movement of the body with or without spine rotation can be used.
Lastly, motor coordination exercises should be used because they require agility and complete absence of pain, being useful to improve all muscle functioning and healing.
The best exercises for low back pain are Clinical Pilates exercises. Here are some examples.
4. Spinal manipulation
This is a manual technique performed by the physiotherapist that can be indicated to release tension in the joints of the spine, TMJ and sacroiliac, for example. It is especially indicated when there is a postural change such as scoliosis or hyperlordosis but it cannot be used in all cases of low back pain and requires dexterity when performed in people with herniated discs, for example.
5. Hot compress
At the end of the treatment and at home to bring relief from possible discomfort that may arise, it may be indicated to put a bag of warm water to relieve the pain, for approximately 20 minutes, before bedtime and relaxation massages can also be indicated for relief of pain and improves local blood circulation.
Signs of improvement and worsening
The signs of improvement are observed in the first days of treatment, especially when the person is able to rest, avoiding efforts and follows all the guidelines of the physiotherapist and doctor, which may include not carrying heavy bags, not holding children or babies in the lap and avoid wear high heels, for example.
Treatment can take 3 to 6 months if physical therapy is performed at least 3 times a week.