Tag Archives: low back pain

What Should I Tell My Physical Therapist?


If you have never been to a physical therapist before you may have some questions about your care and expectations. Here are some general questions and points about physical therapy you may want to talk about during your initial evaluation.

Talk about the pain you are experiencing.
Go into detail about what sort of activities you have trouble with and where the pain is coming from.  The more details you can provide the more it will help your therapist develop a treatment plan.

How did your injury happen and/or when did your pain begin?
Did you have an injury or accident, or did the pain develop gradually over an extended period of time? Whether it’s sports, work or surgical post-op related your PT can guide you to recovery following an injury. As part of physical therapy, they can teach you exercises, stretches, and techniques using specialized equipment to address your pain.

What are your recovery goals?
If you have specific goals in relation to your recovery, let your therapist know. Do you want to be able to run a marathon, or is the goal to cook dinner and be able to reach up into your cabinets? Maybe your goal is to have enough strength to play with the grand kids. Your Physical Therapist needs this information when designing a treatment plan that best suits your needs. Whether you’re a professional athlete who’s suffered an injury or an orthopedic patient who needs assistance following surgery, your recovery starts with physical therapy.


Give your physical therapist you primary care provider’s information.
Good communication between your physical therapist and your primary care provider can help eliminate the need for unnecessary drugs/medications and provide great detail about your medical history. Your physical therapist can help clarify referral guidelines and the decision-making process as well.

Tell your physical therapist about any medications you are currently taking.
Different medications can cause adverse side effects due to physical activity and your physical therapist wants to make sure you are ready for physical therapy. Make sure you have a detailed list of your medications and be ready to discuss them at your evaluation.

Always tell your physical therapist your pain levels and how you feel your progress is going.
Physical Therapy is intended to make changes in your body.  As physical therapists make changes to your tissues and mechanics, the stresses on your body will change, and may change where you feel the pain or symptoms. Be open with your physical therapist. If you have any questions about your treatment or want to go over any pain you are experiencing let your physical therapist know and they can go over it with you. Chances are what you are experiencing is completely normal and part of the healing process.

For more information about physical therapy programs and treatment techniques visit our About Physical Therapy section by clicking here.

Need to find a physical therapist? Visit our Find A PT Page

physical therapy during pregnancy

Physical Therapy for the Pregnant and Postpartum Woman


If you are encountering problems during your pregnancy, don’t stress. Many women are able to find pain relief by going to physical therapy during pregnancy. A licensed physical therapist, specifically trained in women’s health, can evaluate and address the physical issues affecting you. Some of the techniques a PT would use in alleviating these discomforts are postural awareness/education, individualized stretching and strengthening programs, soft tissue mobilization/myofascial release (types of massage), breathing exercises, bladder education and pelvic floor strengthening. A PT can also assist you in implementing an exercise regimen that is safe and easy to take part in no matter what your level of fitness. All of this is performed in concurrence with your OB/GYN’s care.

Musculoskeletal complaints of the Pregnant Woman:
• Postural stresses (accentuated lordosis)
• Pelvic girdle instability pain
• Back pain or SI joint dysfunction
• Round ligament pain
• Nerve entrapment syndromes: carpal tunnel, tarsal tunnel, thoracic outlet syndromes
• Neck pain
• Foot or Ankle pain (especially overuse of the gastrocnemius muscles due to COG shifted anterior)
• Tendinitis: lateral epicondylitis and trochanteric bursitis
• Circulatory problems:
• Lower leg cramps
• Edema in lower extremities
• Groin / coccyx pain
• Urinary complaints (due to reduced bladder capacity as the fetus pushes on the bladder ): stress or urge incontinence

Musculoskeletal complaints of Postpartum Woman (effects of hormonal laxity):
• Diastasis Recti
• Symphysis pubis separation
• C-section scar or episiotomy scar adhesions/pain
• Pelvic floor Dysfunction: pain with sexual activity
• Postural stresses: nursing, holding and carrying baby
• Low back pain or SI joint dysfunction
• Urinary complaints (due to weakness of the pelvic floor muscles / trauma during labor and delivery)
• Stress Incontinence
• Urge incontinence


Goals and benefits of exercise for the Pregnant Woman:
• Promotes good posture
• Increases or maintenance of aerobic fitness
• Improves muscle tone
• Improves sleep
• Prevents low back pain
• Reduces risk of gestational diabetes
• Improves physiological and psychological health
• Prepares mom for labor and delivery

Goals and benefits of exercise for the Postpartum Woman:
• Faster recovery from labor and delivery
• Increases endurance for taking care of self and baby

Make the right choice today. Ask your doctor how physical therapy can help you!

This information about physical therapy during pregnancy was written by by Rachna Mehta, PT, DPT, CIMT – Hamilton Physical Therapy Services, L.P. in Hamilton, NJ. Hamilton Physical Therapy Services is a well established provider of rehabilitation services in Mercer County since 1978. They take pride in offering personal and compassionate care with a patient-centered approach helping transform lives, one life at a time. For more information click here.

Low back pain

Exercise May Reduce Risk of Low Back Pain


Low back pain is a common complaint that can last a few days or weeks or become a chronic condition with significant impact on well being. Treatments can vary depending on the cause.Chronic back pain can be difficult to successfully treat and it may take some time to find what treatment works best for each person. Since treatment is not guaranteed to work, prevention is the best option. Back pain is often the result of long term stress on the back such as poor posture, sedentary behavior, or regular strain on the back. Prevention will likely involve a number of different steps to reduce these stresses. However, existing studies have not found clear recommendations for the best methods to go about it.

Researchers wanted to investigate the effectiveness of a number of interventions for the prevention of low back pain. The study, published in JAMA Internal Medicine, found that exercise alone or in combination with education was most effective for preventing low back pain.

About the Study
The systematic review of 21 randomized controlled trials included 30,850 men and women without low back pain. The participants were randomized to 6 different prevention strategies, including exercise, education, exercise plus education, back belt, and shoe insoles. The control groups received no intervention, minimal interventions, or placebo.

When compared to the control group exercise was associated with:
• Fewer low back pain episodes in the first 12 months (in 4 trials with 898 people)
• Fewer sick days due to back pain in follow up 12 months or longer (in 2 trials with 128 people)
• Reduction in short-term (4 trials with 422 people) and long-term low-back pain episodes (2 trials with 138 people) when combined with education

Education alone, back belts, and shoe insoles did not appear to have any benefit during the trials.

man stretching

How Does This Affect You?
A systematic review combines the results of several smaller studies to arrive at one result. The benefit of this type of review is that it increases the number of participants which increase reliability of results. However the review is only as reliable as the studies that are included and the method used to combine the results. There were some flaws in every trial that were included in this analysis. For example, many of the included trials had a high dropout rate during the trial which decreases the reliability of their results.

Low back pain is often associated with an imbalance or weakness of certain back muscles. An exercise program will improve your physical fitness, strengthen your back muscles, and help you maintain a healthy weight. Regular physical activity may also help maintain a healthy weight which can also put strain on your back. Choose exercises or activities that you enjoy and will make a regular part of your day. For most people, this could include 30 minutes of moderate aerobic exercise per day.

Check with your doctor before starting any exercise program.

by Cynthia M. Johnson, MA

Family Doctor—American Academy of Family Physicians

Ortho Info—American Academy of Orthopaedics

Acute low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 2, 2016. Accessed March 22, 2016.

Steffens D, Maher CG, et al. Prevention of low back pain: a systematic review and meta-analysis. JAMA Intern Med. 2016 Feb 1;176(2):199-208.

Last reviewed April 2016 by Michael Woods, MD

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

back pain

Managing an Aging Back


Most people at some point in their life will have to deal with a painful back. The time and intensity of the back pain is different for everyone, some will have had symptoms when they were in their teens, mid-life or in their golden years. No matter when you first start to receive symptoms more than likely these symptoms will increase in intensity and frequency as you age. Fortunately there are ways to manage back pain as well as counteract our aging process to prevent further problems from developing.

In the back there are many conditions which can develop. The important thing to remember is that not all back conditions are the same and what works for one condition doesn’t necessarily work for other conditions. This is important because in the age where answers are literally at your fingertips every piece of information on back pain needs to be taken with a grain of salt. In order to help manage your own condition it is important to really pay attention to what makes your symptoms better and what makes them worse. By being in tune with your body and what is going on with your symptoms you can take some beginning steps at managing your back pain.

As we age our body changes dramatically in all areas especially in the back and often once we understand how our back ages it is easier to understand your own symptoms.

1. JOINTS: As we age whether in our back or in other areas of our body our joints begin to break down. By breaking down we literally mean that the edges of the bone that interface with other bones change in shape and surface area. Some joints literally develop bone spurs or extra calcification of a bone surface as well as elimination of bone or jagged surfaces as opposed to flat rounded surfaces. With all the changes in the boney surfaces it causes movement between the surfaces to be less fluid or more restrictive resulting in stiffness, loss of motion and pressure put on other structures such as nerves.

2. MUSCLES: Our muscles during aging also begin to lose fluid and suppleness. As we age certain muscle fibers are lost which are more responsible for strength and power and we are left with more fatty tissue. Our muscles also lose elasticity and become more rigid and tight. This all in turns leads us to have a loss in motion, flexibility and strength.

3. DISCS: As discussed with degenerative disc disease and the conditions associated with the disease, the discs in our back literally shrink down. We lose the big cushiness of the fluid filled disc which unfortunately causes us to loose some shock absorption forcing more force.

With all of the changes described above there is an underlying theme of restricted motion and mobility in the spine. Therefore it is important to remember in order to counteract these changes we need to work on restoring and maintaining appropriate flexibility, mobility and strength. For example as described above our discs shrink which causes our joints to take more brunt of the force of the body. Therefore in order to prevent a constant break down of our joints our muscles must be flexible and strong enough to absorb this force and strain on our body.

Managing your back as you age can be possible but requires many steps and hard work. It isn’t something that can be done in two days or two weeks it takes a long in order commitment to change your body. It took a lifetime for your body to age so it isn’t realistic to expect a change in the aging process in a few weeks. Key aspects in managing your low back are:

lower back pain

1. FLEXIBILITY: As we mentioned motion and stiffness is a key factor in our aging process therefore it is extremely important to make sure our muscles stay as lengthened as possible. Some of examples of these exercises are: press ups, long thoracic rotations, SKTC, DKTC, and corner stretch. Remember these are key exercises for the back but it is important to keep all muscles flexible as all of our joints in our body break down.

2. CORE STRENGTHENING: This is a term which has been widely popularized in the last few years. It specifically describes strengthening the muscles which are responsible for controlling your entire spine. This means these muscles help to absorb the shock and forces put on your spine and body by preventing them from going to your joints. Another term also associated with this is lumbar stabilization exercises. Which means working on strengthening both sides of the spine at one time in order spread the force out evenly throughout the back. Some basic examples of these are: bridges with a squeeze, prone alternating arms and legs, seated marches with and without arms on ball, and supine alternating arm to legs.

3. POSTURE: As we age our posture is certainly affected. As a society we tend to be very prone to sitting and slouching forward and as we age this process is enhanced by the changes in our body which force us more into a forward flexed or “hunched” position. Therefore in order to retaliate against this it is important to work on key exercises which work on extending or maintaining the proper position of the spine. Some of these exercises are described in our stretching exercises but others are: scapular squeezes, extension over a roll, and standing hip extension.

When dealing with back pain it is important to remember that exercising is a key to help manage and control your current symptoms as well as prevent further symptoms. Unfortunately we can not take back the changes that occur as you age but we can change certain aspects of your body to help minimize these effects. By making a commitment to work with your back and body as it ages you can truly change the way your body will perform specific movements and how these movements will affect your body. In exercising with a problematic back it is important to remember that discomfort and general soreness is normal but true pain is not. You need to listen to your body and pay attention to how certain symptoms are affected by your new exercise routine.

If you have had symptoms for a long period of time and they aren’t changing with exercises or are getting worse it may be time to seek formal medical attention. This is especially important if symptoms are beginning to travel into your leg or symptoms are advancing to more neurological signs such as tingling/numbness in your feet/leg and weakness or giving way of your legs. This is a sign that symptoms are progressing and are becoming more neurological.

Physical Therapy can be a successful tool in combating back pain. In going to physical therapy you will have a formal evaluation in order to determine your condition and based on this condition an appropriate treatment strategy. This often will occur with appropriate modalities in order to help with the inflammation of muscles and nerves as well as help reduce pain. Once pain has gotten under control you will be instructed on specific exercises/activities that will be beneficial to your back. You also will be given specific tools to help reduce the inflammation of certain structures and improve the overall condition of your back. Your therapist should also work with you to set you up with a program in which you can continue to perform while you are at your home.

spine rehabilitation

Spine Rehabilitation and Its Benefits


31 million Americans experience low-back pain at any given time. Back pain is the most common cause of loss of activity among adults under 45. It’s estimated that over 80% of all American workers suffer back pain at some time during their careers. From chronic to acute back pain, physical therapists are highly trained to accommodate the spine rehabilitation needs of a variety of patients.


Poor Posture and Body Mechanics
Poor posture is when your spine’s normal curves are either increased or decreased. This puts uneven stress on your spine and all of the supporting tissues. This uneven stress leads to pain and dysfunction and increases the likelihood of injury. The most commonly seen poor posture is a flat low back. Losing your natural low back curve is a major risk for back pain.

Poor Lifting Techniques
Poor lifting techniques is another cause for back problems. The forward bending position with your legs straight puts a great deal of stress on the muscles and ligaments of your back. The discs in your back are also under tremendous strain in this position. This position can increase your chances of ligamentous and muscular strains. It also increases your chances of getting a bulging or herniated disc.

Poor Physical Fitness
Poor physical fitness also contributes to potential back problems. Poorly conditioned muscles lack the strength and endurance that conditioned muscles have. They become fatigued much sooner and cannot provide the type of support a well conditioned muscle can.

back pain

Physical therapists provide a comprehensive approach incorporating manual therapy, prescriptive therapeutic exercise and modalities. A program will improve the patient’s physical condition and symptoms. Therapists also provide the patient with movement awareness, knowledge of safe positions, functional strength, and coordination. All of this promotes the management of low back pain (LBP).

• Comprehensive Evaluation with an emphasis on determining the source of the problem.
• Individualized & Specific Exercise Programs
• Manual Therapy (hands-treatment)
• Modalities as Needed
• Progressive Home Program to help restore independence and self-management

• Improve Mobility
• Knowledge of Safe Positions
• Movement Awareness
• Functional Strength
• Coordination

If you have back pain that is prohibiting you from doing the things you enjoy, take the first step towards your recovery and contact your physical therapist.

low back pain in pregnancy

Low Back Pain in Pregnancy?

low back pain in pregnancy

Pregnancy and new motherhood should be times of joy and promise – not pain. Fortunately, times have changed, you don’t have to live with pain or other problems related to pregnancy or delivery.  That’s because physical therapy has changed too. It is no longer solely for joint problems; it’s also a safe, proven and widely prescribed treatment for pregnant women and new mothers.

Physical Therapy can help you manage your low back pain in pregnancy safely!
Many women experience low back pain during pregnancy. This is due to several factors such as:

  • Hormonal Changes – this causes increased looseness of the pelvic ligaments to prepare your body for birthing your baby.
  • Increased Weight Gain – This places increased stress on all the joints of the body. Increased breast weight can overload the neck and upper back.
  • Postural Changes – Body weight shifts forward as the baby grows and this increases the arch in the lower back. Stomach muscles and the lower pelvic muscles become weaker which decreases support for the lower back.
  • Altered Movement Patterns – Due to your changing body, women often begin to move in different patterns that can increase stress to the low back or pelvic joints.

A physical therapy evaluation will include an assessment of:

  • Pelvic/Sacro-iliac joints
  • Abdominal Musculature
  • Spinal Alignment
  • Strength/Flexibility
  • Posture
  • Body Mechanics

Treatment objectives are to:

  • Reduce Pain
  • Promote improved posture
  • Education re: safe movement patterns
  • Teach proper exercises for strengthening and flexibility and guidance toward cardiovascular fitness

The physical therapist may also plan a specialized exercise program for a pregnant or postpartum patient.
The goals and benefits of exercise for pregnant women include:

  • Promotes good posture
  • Increases or maintains aerobic fitness
  • Improves muscle tone
  • Improves sleep
  • Prevents low back pain
  • Reduces the risk of gestational diabetes
  • Improved physiological and psychological health
  • Prepares mom for labor and delivery

The goals of an exercise program for new moms (postpartum patients) are.

  • Faster recovery from labor and delivery
  • Increased endurance for taking care of self and baby

If you are experiencing low back pain in pregnancy please check out our Find A PT Page to find a women’s health specialist in your area.