Physical Therapy for the Lower Back: How to Prevent and Treat Lower Back Pain

By | August 7, 2017

Lower back pain is one of the most typical causes of job-related disability and why some people skip work. It is also the second most common neurological ailment in the United States, second only to headaches. In fact, approximately 80% of adults in Western countries have, at some point, experienced lower back pain.

For some lucky people, pain in the lower back may be resolved by itself or with the aid of medication within two to four weeks. However, there are some cases of lower back pain that may last for more than a few weeks, throughout which case the condition is termed as “chronic” and “progressive,” meaning it can only grow worse over time.

Furthermore, 60-80% of those patients who suffer their first episode of lower back pain may experience recurring pain within one year.

according to current research, there are certain muscles in the back that work to stabilize the spine. When the spine or the back suffers an injury, these muscles are mechanically inhibited or shutdown. Worse still, these muscles do not spontaneously recover, and this is true even if patients do not feel pain and are able to come back to normal activity levels.

As a result of the inhibition of these muscles, called lumbar multifidi and the transversus abdominus, lower back pain happens. Still, there are steps you can take to prevent the same thing from occurring to you.

Physical Therapy for Lower Back Pain

One way to put a stop to the inhibition of the lumbar multifidi and transversus abdominus is through a series of physical therapy and exercises.

Planned to strengthen the muscles of the lower back and keep the spine good for your health, these physical therapy exercises may range from back stabilization exercises to muscle strength development and several wide variety of techniques.

In addition, a physical therapist may also recommend such methods as heat therapy, ultrasound, massage, mobilization, and education about posture and body mechanics in order to prevent lower back pain from recurring.

Some of these techniques will be discussed later on. You will also find some useful self-help tips provided by experts to help you avoid lower back pain or prevent the condition from worsening.

Nonetheless, before we head on to learning how lower back pain is treated through physical therapy, it is important that we first understand what causes lower back pain.

Lower Back Pain: CAUSES

There are actually many types of back pain, but the most normal is pain in the lower back. Why? You might ask. The reason is simple: you hold most of your weight in the lower back. Thus, it is highly likely that a person would endure pain in that area.

There is no perfect cause of lower back pain. Sometimes, the causes of the condition are so complex that it is hard to find just a single one.

Still, physical therapists and other healthcare professionals have observed that lower back pain is often a result of stressed back muscles and ligaments due to any of the following activities:

Improper posture

Heavy lifting

Unexpected clumsy movement

Muscle twinge


We could all be guilty of the above actions. We may not suffer any back pains now, but it is possible that as we get older and the level of inhibition of the back muscles as a result of these activities increases, back pain becomes a very clear possibility.

In addition to these regular activities, lower back pain may also result from exact conditions, such as:

Herniated disk (when the disk material presses on a nerve)

Sciatica (when a herniated disk presses on the sciatic nerve. The condition causes strong, shooting pain through the buttocks and the back of the leg).

Spinal stenosis (when the opening around the spinal cord and nerve roots becomes narrow. This is caused by arthritis and bone overgrowth, the ache resulting from when a nerve gets pinched in the narrow space.)

Spondylosis (a type of arthritis touching the spine due to degenerative changes brought on by aging)

Spondylolisthesis (when one vertebra in the spinal column slips forward over another)

Lower Back Pain: TREATMENT

The healing of lower back pain depends on several factors, including the exact type of lower back pain (whether it is persistent or acute) and the supposed cause.

For example, acute lower back pain is commonly treated with pain relieving drugs, such as analgesics, or some forms of exercises that can help relax the muscles.

On the other hand, chronic back pain or one that lasts for more than two weeks and is progressive may be caused by some underlying circumstance, during which case the treatment plan may consist of resolving the underlying situation to treat the back pain.

Lower Back Pain and Physical Therapy Exercise

Physical therapy exercise is one of the most regular methods of treating lower back pain. In fact, many home remedies for lower back pain consist of exercise, because the common theory is that if you stay active, you stay healthy. This is true in most cases.

Though, for purposes of this editorial, the exercises featured here will be those that are practiced by physical therapists to treat patients with lower back pain.

In general, in physical therapy exercises, the exercise program for back pain should cover a set of stretching exercises, strengthening exercises, and low impact exercises. Read below for more on these exercises:


The back of a person is composed of the spinal column and adjacent muscles, ligaments and tendons. All these are designed to move in consonance with each other so that any limitation in the range of gesture in any of these components of the back result in back pain.

Stretching for lower back pain specifically targets soft tissues, such as muscles, ligaments and tendons, found in the back and around the spine. By stretching, the spine and soft tissues are mobilized, growing motion and like so, relieving pain.

There are many kinds of stretching exercises used by physical therapists. One is the Hamstring Stretching Exercise which works to relax tight hamstrings, a common symptom of lower back pain. This exercise is said to help decrease the intensity of lower back pain among sufferers.


Physical therapists in general use two forms of strengthening and back pain relief exercises, commonly depending on the specific condition of the patient. These are the McKenzie exercises and dynamic lumbar stabilization exercises. Nonetheless, the two forms of strengthening exercises may also be combined should the therapist find it appropriate to do so.

McKenzie Exercises

Named after a physical therapist in New Zealand, McKenzie exercises are primarily extension exercises that could help lessen pain generated from the disc space and also may help decrease the symptoms of herniated disc by reducing stress on a nerve root.

For acute pain, the McKenzie exercises should be done regularly, at least once every two hours. In addition, patients are advised to avoid flexing their spine when exercising.

Dynamic Lumbar Stabilization Exercises

Using this back exercise technique, the first thing that a physical therapist does is to look for the patient’s “neutral” spine. This refers to the position that helps the patient to feel the most comfortable.

Afterwards, when the patient is in that position, the back muscles are then exercised in order to “teach” the spine how to stay in this position.

Performing these exercises on a regular basis can help strengthen the back muscles and keep the spine well-positioned.

Low Impact Aerobic Exercises

The reason of low impact aerobic exercise is to repair the back. Patients who undergo reconditioning of the back through low impact aerobic exercise will have fewer episodes of lower back pain.

Additionaly, every time an episode of lower back pain does arise, the pain is less intense and lasts no more than for a short period.

Another benefit of low impact aerobic exercise is that patients tend to stay functional that is, they can continue with their regular work and carry on with recreational activities. In contrast, patients who do not undergo low impact aerobic exercises typically experience the gradual loss of their functional abilities.

For low impact aerobic exercises to achieve their desired results, they should be continuous. This will increase the heart rate and keep it elevated as well as improve the production of endorphins, which are pain fighting hormones released by the body.

Here are some examples of low impact aerobic exercises that you may need to try in order to lessen or decrease lower back pain:


One of the simplest forms of aerobic exercises, walking is in general considered as very gentle on the back. To get the greatest benefit from walking as a form of low impact aerobic exercise, walk two to three miles three times per week.

Stationary Bicycling

This form of aerobic exercise is less hurting on the back since there is lower impact produced. This is beneficial for patients with lower back pain who may find walking too painful.

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