Physical Therapy (PT)
Physical Therapy (PT), or functional rehabilitation, helps patients improve and maintain functional abilities needed for activities of daily living. PT includes:
Passive therapies: Treatments that do not require active patient participation, such as spinal manipulation, myofascial release, or ultrasound.
Active therapies: Therapeutic exercise to increase flexibility, build strength and endurance.
Biomechanics: Posture correction and learning how to move properly and safely.
Physical Therapy is an extremely effective means to treat pain, improve mobility, increase functionality and get you back to the activities you enjoy. Beware of imposters or physical therapy gyms that are more focused on trying to get you to come back for as many visits as possible. Physical Therapy is effective for certain periods of time – if in 6 weeks you do not feel like you have made significant progress, it may be time to see a Pain Management Specialist.
Manual Therapy – Manipulation and Mobilization
Manual therapy includes manipulation and mobilization. This involves restoring and increasing mobility, such as range of motion to stiff joints, and alleviating pain. Manipulation is a specific and controlled quick movement to release a joint so it returns to correct position. Manipulation and mobilization may help reduce muscle spasm contributing to spinal nerve irritation.
Prior to manual therapy, a passive therapy may be administered. Passive therapy may include application of heat, ultrasound, and/or electrical stimulation. These therapies warm and relax soft tissue and allow joints to be more easily manipulated.
Electrical Stimulation – Transcutaneous Electrical Nerve Stimulation (TENS)
Electrical stimulation or TENS delivers a painless electrical current through the skin to specific nerves. The current produces mild heat that helps to relieve stiffness and pain and may improve range of motion. This treatment is noninvasive, with no known side effects. It may be used to control acute pain and chronic pain.
Fasciae are sheaths of connective tissue that support muscles, bones, and organs. Spinal stress from poor posture or injury may cause fascia to constrict or tighten. As the fascia constricts, muscles and bones may be pulled out of place and cause pain. Using their fingers, palms, elbows and forearms, physical therapists firmly and gently stretch the fascia.
Ultrasound is a common noninvasive therapy used to treat back and neck pain, tendon and ligament injury, muscle spasms, joint problems and other spine-related conditions.
The practitioner applies gel to the patient’s skin to help transmit the ultrasound waves into underlying tissues. The ultrasound probe is gently swirled over the area. Ultrasound uses high-frequency sound waves to deliver heat deep into tissues, such as muscles. Ultrasound promotes circulation and healing, relaxes muscle spasm, decreases inflammation, and helps alleviate pain.
Cold or ice treatments are never applied directly to skin, because excessive cold can injure skin tissue. A barrier, such as a towel, is placed between the skin and the cold source. Cold sources like ice help to reduce blood flow, thereby decreasing swelling, inflammation, and pain.
Heat therapy may include a moist heat pack with protective skin barrier and ultrasound. Moist heat increases blood circulation important to delivering healing nutrients and waste removal. Heat helps to relax stiff and sore muscles.
Aquatic Therapy (Hydrotherapy)
Patients with osteoarthritis, rheumatoid arthritis, spinal stenosis, back and neck pain, and other spinal disorders may benefit from aquatic therapy. Treatment often occurs in a heated tub or pool and addresses impaired flexibility, mobility, coordination, weakness, weight-bearing intolerance, and pain.
Warm water relaxes muscles. The buoyancy of water enables joints to be moved without excessive stress. Often, what a patient is unable to do on land can be done in water.
Everyone can benefit from therapeutic exercise. The physical therapist develops an individual program to meet the patient’s special needs. Benefits often include:
Greater muscle strength and tone
Better balance, coordination, and sleep
Enhanced stimulation of the cardiovascular system
Prior to therapeutic exercise, a passive modality is often administered followed by a period of pre-exercise warm-up activities. Warm-up may include walking on a treadmill or stationary cycling.
Physical therapists teach patients how to attain and maintain good posture to protect the spine from unnecessary stress and strain. Patients learn practical skills such as how to safely lift, reach, carry, stand, sit, and get in and out of a car.
People with a wide variety of spinal conditions benefit from physical therapy. Physical therapy includes many modalities, including active and passive treatments. Most patients work with a physical therapist to tailor a specific program to meet the patients’ individual goals.