: I have back pain. I don't know if it's a disc problem, spinal stenosis or something else. How should I proceed?
A: Most people experience back pain at some point in their lives. At any given time, about 25 percent of people in the United States report having low back pain within the past three months.
As soon as you feel pain, it's a good idea to make an appointment to see a physical therapist for a free consultation. You don't have to see your doctor first. The patient chooses where to receive their therapy services just like we all select where to get our hair cut and eyes examined. Your therapist will discuss your issue and then send a request to your physician asking for a prescription for physical therapy explaining their findings uncovered from the free consult visit.
As soon as the prescription is received, we will schedule a thorough evaluation taking into account your unique medical history and incidents of injury/surgery involving your back. The important feature of physical therapy is that the therapist is able to determine the underlying cause of the pain. This establishes the way in which the pain is addressed. The therapist prepares a plan of care/evaluation report and sends it to your primary care physician with their findings. A program is established to educate the patient on ways to reduce their pain (lack of posture awareness if often a contributing factor) and a home exercise program is created. We do know that those who follow the guidance of their therapists are often the patients who are pleasantly surprised to see their pain significantly reduced or eliminated swiftly.
Q: I have spinal stenosis. My doctor says I need to have back surgery. Is there anything that I can do to prevent having the surgery?
A: Maybe. Spinal stenosis is a narrowing within the vertebrae of the spinal column that results in too much pressure on the spinal cord (central stenosis) or nerves (lateral stenosis). Although spinal stenosis can be painful, various exercises can substantially reduce the pain for many. Trying therapy is always a good idea. There is a chance that it may not work, but there is a strong chance that it will. The only way to know it to try it and see. If therapy is not enough to eliminate the symptoms, then surgery may be considered.
Q: My insurance company says they will not authorize an MRI until I receive physical therapy for my back. Won't that only hurt more?
A: A physical therapist is highly trained to not cause any injury. In fact, the therapist should advise their patients to discontinue doing anything that causes them more pain. Sometimes in the case of surgery, uncomfortable stretching is necessary, but it should not be painful. Go ahead and get a prescription for physical therapy from your primary care physician or specialist and schedule an evaluation. Herniated disks are most common in the neck (cervical spine) and low back (lumbar spine). In the low back, disks may become damaged by excessive wear and tear or an injury. If you do choose to try therapy, you would not be the first person who after four weeks of treatment feels so much better that the need for the MRI is now eliminated. The only way to know for sure is to try. Nothing ventured, nothing gained.