(This guest piece is by Curt Smothers, a freelance contributor. Curt is a retired Navy Officer who had a second successful career as a Vocational Education Specialist and adjunct instructor at a California community college. He now lives with his wife in Colorado.)
Years ago, as I was walking across my college campus, my back began to ache to the point where I needed to find somewhere to sit. When the problem became chronic and interfered with my normal functioning, my first step was weekly visits to a chiropractor.
Lower back pain often develops gradually and can begin to limit everyday movement over time. In my case, physical therapy for lower back pain helped improve my strength, mobility, and daily function, as core strength and mobility support spinal alignment.
My Chiropractor Visits Brought Only Temporary Relief
Spine adjustments and manipulations brought noticeable temporary relief, especially during the first few days after each appointment. The visits helped me in the short term, but they also made it clear that I needed to focus on turning some of my mid-section flab into muscles that support my back.
I did so, and as the weight came off, the symptoms went into remission—that is, until recently when I discovered I could not walk more than a few hundred yards without lower back pain emanating down my leg to my calf muscle. This restriction severely limited my lifestyle here in Colorado, where my wife and I enjoy walks on local mountain paths.
I Did Some Research
According to the National Institute of Neurological Disorders and Stroke, lower back pain, “is one of the most common reasons people see a doctor or miss days at work. Even school-age children can have back pain.” For many adults—like me—the problem appears gradually, rather than from a single injury or cause.
My Turning Point Was Physical Therapy
I finally told my family doctor. Under no circumstances would I submit to surgery. I would rather stay inactive and take anti-inflammation medication than subject myself to the possible complications and the uncertain outcomes of back surgery.
This was when I began physical therapy for lower back pain, focusing on rebuilding strength around my spine and improving my lower body mobility. My insurance covered the next step, which was visits with a licensed physical therapist.
My Therapist Helped Set Expectations
Physical therapist told me to expect the following:
1. I needed to commit to the program.
I was to schedule physical therapy sessions twice a week for the next four to six (and possibly eight) weeks. The human body, my therapist pointed out, is a very efficient machine. Physical therapy consists of placing new positive stresses on the body. Its goal is to take the body from a ”below-par” state to an optimum strengthened state.
2. I was to expect more soreness and symptoms in the beginning.
The old “no-pain, no-gain” adage is at work here. I did experience muscle soreness in the lower back and legs at the outset. Undergoing physical therapy exercises breaks down the muscle tissue at the stress areas, and soreness results.
As physical therapy continued, those symptoms would increase; they did in my case. My therapist emphasized that this is not negative. My body was changing, and the change resulted from the exercise methods the therapist employed and the ones he recommended that I continue on my own at home.
3. Improving range of motion would be my best indicator of healing.
As the body heals, what comes first is more ease of motion. The therapist played close attention and measured my range of motion as the prime indicator of how well the therapy is proceeding.
4. Function comes next and then my strength would follow.
As range of motion improved, function followed. As I could move more, I could do more. During the first three weeks I was already experiencing diminished symptoms. Strength came about as the pain tapered off. Strength building is the focus of one of the phases of physical therapy.
The Four Phases of My Physical Therapy
Phase 1 – Controlling the pain and inflammation
The goal of this phase is to reduce and eliminate the symptoms. My therapist used electric massage and joint manipulation.
Phase 2 – Improving my general mobility and flexibility
This phase helped me to become more resilient and able to tolerate motion and movement without recreating pain. The therapists constantly questioned me to make sure the exercise program addressed my specific needs to correct body alignment and problems with pain and function.
Phase 3 – Improving the body’s overall endurance and aerobic condition
The therapist employed this approach to improve my body’s oxygen supply to the problem area to promote long-term healing. The goal was to strengthen my heart, lungs, and supporting muscles through light aerobic exercise.
During therapy I gripped cable handles attached to the wall while doing slow (at first, agonizing) squats. The squats were followed by pulling movements. Both exercises were designed to strengthen my lower back and core muscles.
Phase 4 – Improving strength, core stability, balance, and coordination through an exercise regimen
A key part of physical therapy for lower back pain is learning simple exercises that can be continued at home. During my first visit, my therapist gave me an illustrated information sheet on exercises I can do at home to augment my weekly visits. The entire routine takes fewer than 10 minutes and for maximum effect should be done twice per day.
Exercises I Learned and Practiced During Physical Therapy
These are the exercises I continue to use at home.
Stop any movement that increases pain or causes sharp discomfort. A physical therapist can help adjust these exercises based on individual needs.
1. The prone “windshield wiper”
I begin by laying on my back with bent knees bent and feet flat on the floor. With a pillow or rubber ball placed between my knees, Keeping my core engaged, I swing my knees together to the right until they gently touch the floor (or as far as I can comfortably stretch them). Then I bring them back through the center and swing them to the left. The exercise stretches the lower back and groin muscles and is much like the motion of windshield wipers.
Do 20 reps on each side.
2. The “Core March”
While laying on my back with my knees bent and feet flat, I tighten my abdominals and roll my hips backwards as my lower back presses downwards towards the floor. Keeping my abdominals tight, I alternate lifting my feet in a “marching” motion off the floor keeping my knees bent.
Do 10 reps each leg.
3. The Straight Leg Raise
Again, lying on my back with knees bent and feet flat on the floor lift my leg until the knee is at the height of the other knee and straighten the leg I need to exercise. Concentrate on keeping the stomach muscles tight and the knee straight.
Do 10 reps each leg.
4. The Seated Sciatic Nerve Glide
This one is for anyone experiencing sciatic nerve pain down the leg. It should not be done if it worsens sciatic nerve symptoms. Sitting on the edge of a chair with my knees and feet at a 90/90 degree angle with the floor, I straighten the knee of my affected leg. Once the leg is straight, I slowly bend my ankle back towards myself. As I start to feel the beginning of gentle tension, I keep my ankle at that angle while I bend and straighten my knee.
Do 10 reps.
5. The Prone Waist Lift
Lying on my back, I bend my knees and keep my feet flat on the floor. I tighten my stomach and clench my glutes. With my palms down I lift my waist keeping my back flat and hold the position for five seconds.
Do 3 sets of 8 reps.
My Therapist’s Discharge Criteria
After 16 sessions, my therapy ended a when I met the following criteria:
- I had no pain or symptoms during activities of daily living. My pain has lessened significantly. Continued home exercises have solidified my progress.
- I have full range of motion and strength within reasonable norms.
- All my goals and the therapist’s plan-of-care goals have been met.
The Bottom Line
At this stage in my life, I’m not considering taking up weight lifting or training to run a marathon. My goal at the outset was to stay active and take the occasional stroll in Colorado’s beautiful outdoors. Physical therapy for lower back pain helped me get back to that.
My experience has taught me that back pain doesn’t have to define my daily life. With the right guidance and persistence, I have regained a reasonable level of comfort, mobility, and confidence.
Explore More
Explore more ways to support movement and reduce discomfort in our Fitness & Exercise and Healthy Aging sections.
Get practical health and wellness insights delivered each month by subscribing to our newsletter. Follow us on Facebook and Instagram for more everyday ideas that support healthy living.
This post may contain affiliate links. If you click a link and make a purchase, Healthy Living – Today may earn a small commission at no additional cost to you. We only feature products, programs, or services we’ve researched and believe may support a healthy lifestyle. Prices are subject to change and may vary from what’s listed. This content is for informational purposes only and is not intended as medical advice. Individual results may vary, and we do not guarantee any specific outcome.
