Many people experience low back pain at some point in their lives. Even if it has been present for a long period of time, there are excellent treatments that work to greatly diminish or eliminate low back pain. It's important to have a PT who carefully evaluates what is causing the pain. Treating the offended structure with various techniques of manual therapy followed by core stabilization exercises is often very effective. One study showed the benefits of low back surgery for sciatica disappeared after 6 months; patients did better with physical therapy.


The neck typically responds very well to simple mobilizations. Neck pain and low back pain sometimes occur together. If low back pain comes first, the neck occasionally becomes sore from overwork, as the upper back tries to make up for the lack of strength and movement that should be coming from the low back. Treatment sometimes includes mobilizations to the spine, soft tissue massage, electrical stimulation, gentle exercises, and postural correction.


The cervical-thoracic spine can refer pain to many different areas including the jaw, shoulder, elbow, wrist, and hand. Careful evaluation will help determine the most effective treatment which may include joint mobilization to the spine or the joints where the pain is felt. Exercises and stretches also play a role in eliminating pain, weakness and numbness in these areas.


The shoulder is a very complex joint, with movement coming from the coordinated work of 4 joints. The neck and upper back can refer pain to the shoulder. So careful evaluation of where the pain is coming from will lead to more effective treatment. Mobilizations of various structures, exercises, electrical stimulation, and stretches are often the most beneficial treatments for the shoulder.


Much hip pain is referred from the back, but certainly not all. Before undergoing a hip replacement, a trial treatment of manual therapy is certainly a valid consideration. The hip also responds well to mobilizations, stretches, strengthening and working on any muscle imbalances in the legs, low back and pelvis.


Gait analysis and identifying muscle imbalances in the leg gives valuable information in determining a treatment protocol that works with the knee. The knee benefits from stretching, strengthening, electrical stimulation, balance work, and mobilizations. Before undergoing a total knee replacement, a trial of PT is often recommended. The low back can refer pain to the knee and sometimes mobilizations will effectively eliminate the pain making surgery unnecessary.


Careful evaluation will determine if the pain is local or referred, and the treatment options will vary depending on what the offended structure actually is. Mobilizations, stretching, strengthening, gait training, and balance work all help restore the ankle to pain-free status.