Your lower back started to throb a few weeks ago, and you’re not sure why. You can still climb the stairs — but it hurts. And you can still bend over, but that hurts even more.
If the pain hasn’t gone away on its own and it’s starting to affect your quality of life and function, what’s your next step? Your first reaction might be to see your doctor.
And while your doctor might be able to find the source of the pain through important diagnostic imaging tests and offer surgical interventions to correct it, there might be a collaborative route to consider.
A physical therapist has a different toolkit, one assembled specifically to manage pain by helping your body heal and get back to the most optimal strength, balance and function.
“Physical therapists are probably one of the best front-line providers for pain management and improving movement,” says Jason Cirolia, PT, DPT, OCS, a Florida Hospital physical therapist.
This is because a physical therapist’s expertise and training focus on empowering you and your own body to address and correct the root problem.
“I don’t get you better,” Cirolia says. “You get you better. We work together to develop a therapeutic alliance based on collaborative goals.”
Here are four ways a physical therapist can uniquely help relieve your pain and improve your complete health.
1. Drug-free pain care
While traditional means of treating pain certainly have a place in some cases of chronic pain management, physical therapy itself can be a very effective treatment option.
But treating pain by changing how you move requires an attitude shift. Some patients prefer procedures or medication because they assume their pain will end if their bones or muscles are repaired.
But Cirolia cautions that a procedure might not mean an end to pain. After all, the link between a physical ailment and pain is not as solid as we might assume.
“We’re finding that things that you would consider scary, like arthritis and disk bulges, are quite normal in people without pain,” he says. In other words, there’s another problem, one that surgery might not fix.
Cirolia also pays close attention to how he talks about pain, because he knows that a simple word choice can have a dramatic effect on how a patient perceives their pain. This is called the “nocebo effect,” the reverse of its better-known cousin, the placebo effect.
Instead of using language that can scare patients, he tries to be reassuring.
“It’s OK,” he says. “Everybody gets a little bit of back pain.”
Compare that with being told you have “degenerative disk disease.”
“That will elicit fear in someone, but it’s a common condition and we start to see signs of it in our 20s,” Cirolia says. “It’s not an emergency, and often doesn’t require anything more than changes in movement and graded exercise.”
2. Get an exercise plan tailored to your goals
Instead of using lab tests and imaging to investigate a patient’s health, Cirolia asks his patients what they want to accomplish.
“It’s going to start with a patient’s goals,” he says. For example, some patients want to be able to lift their grandchildren, or walk with friends.
Each patient starts out in a different place, so Cirolia meets them where they are and takes small steps.
“We don’t follow the ‘no pain, no gain’ mantra because it’s not effective and as far as ‘if it hurts don’t do it’ — we don’t do that either,” he says. Instead, he finds a middle ground.
With long-term pain, the underlying injury has healed; the pain is likely coming from an overactive nervous system that needs to be eased back in activity.
“Even if you start with a five-minute walk, every day you add a minute,” he says.
Most patients begin to see significant reductions in their pain within five visits. Some patients come to accept a level of pain that does not interfere with their overall quality of life.
“Instead of a lion in the room you’ve got a housecat,” he says.
3. Bounce back from injury
In his work as a physical therapist, Cirolia often sees patients who have only recently started experiencing pain. The first goal, especially for back pain, is to ensure that the problem isn’t another condition masquerading as muscular or skeletal pain.
As physical therapy increasingly becomes patients’ first choice, its practitioners have become more adept at identifying pain’s source. If a physical therapist believes your pain is coming from an ailment of the kidney, bladder or other organ, he or she is likely to refer you to a doctor for further investigation.
Physical therapists are well suited to treat sudden injuries, as they provide appropriate movement and reassurance during this painful phase of recovery.
Cirolia says physical therapists know recovery is a process; follow-up treatment of an injury can be just as important as initial care.
He says that follow-up should include one or two visits a week for at least a few weeks. He’ll want to ensure you’re healing as expected and if the progression back to normal is slow he’ll figure out why.
4. Education for the long-term
Many physical therapists have the luxury to schedule initial visits for an hour, Cirolia says.
Longer visits mean more time to establish a relationship and get to the bottom of your concerns as well as thoroughly screen for diseases and illness outside the scope of physical therapy.
Even when it originates from a muscle or bone, pain is often about more than just physical ailments.
Nutritionists who partner with Florida Hospital’s physical therapists can help you build a diet that makes it easier to exercise and control weight.
Depression can also worsen pain, and Cirolia can provide a recommendation for mental health treatment.
“If patients are coming to us before they see a doctor, we need to be prepared to guide them to the resources they need throughout our network of care,” Cirolia says of physical therapists.
One of the benefits of learning about your body means you can take steps to heal at home — or even at work.
Because so much of our time is spent at desks, Cirolia has some suggestions on how to get your blood flowing at work.
- To help yourself move, place your water bottle at a place where you have to get up and walk to get it.
- Don’t eat lunch at your desk. Make taking a brief walk at lunchtime a part of your routine.
- Resistance bands are easy to use while seated and are a versatile tool to help you get moving. Try some mid-back exercises.
- Stretch your pectoral muscles (your chest) by standing in a doorway and placing your forearm against the door frame so that your elbows form an “L” shape. Walk or lean forward until you feel a slight stretch.
Just as your rear end can fall asleep if you sit for too long, the rest of your body will feel better if it’s moved every once in a while. That said, it’s no replacement for routine cardiovascular exercise.
“If someone were to engage in a basic cardiovascular routine three to five times a week, they will feel better,” he says.
We offer physical therapy services at 18 Sports Medicine and Rehabilitation locations throughout Central Florida. Our licensed physical therapists have the experience to help you tackle your aches and pains head on. To make an appointment, call (407) 303-8080 or reserve a time online at our website.
A visit to a physical therapist is an opportunity to take control of your pain and learn about how to recover with a movement plan crafted to fit your life.