Physiotherapy and Exercise Therapy
What is it?Physiotherapy helps people of all ages who are in pain, injured, ill or disabled.
Physiotherapists help to promote movement and function back into the body using a range of techniques, which can include manual therapy, massage, exercise therapy and acupuncture (5). Critically, they can also provide advice and education. All of these interventions are recommended by national and international guidelines.
Who are physiotherapists?Physiotherapists are trained healthcare professionals who work in many health care areas including neurology, orthopaedics, and musculoskeletal rehabilitation (bones, joints and muscles). They can help if you had an injury, experience pain and want to get back to an active lifestyle.
Physiotherapy for low back painBack pain is very common and affects 8 out of 10 people during their lifetime (Hoy 2010). Most people recover quickly from back pain if it is properly managed. It is the most common reason people are unable to work and unable to do their activities. Back pain can often come back during one’s lifetime. It is well known that (musculoskeletal) physiotherapy and education works well for managing back pain.
Back pain has many causes, which include sitting for too long in one position, picking up heavy things incorrectly and getting injured. Stress and anxiety can make the pain worse. A physiotherapist will work with the cause of your back problem, explain what it is and what he/she can do to help for the back pain to get better.
ExerciseDoing exercise and staying active are important ways to treat and prevent back pain from becoming a more serious problem. It is important to keep moving which prevents stiffness, tightness and more pain. Some common exercises for back pain are here.
Physiotherapists will give specific exercises that can really help with back pain. Generally this will include stretching areas that are tight and strengthening areas, which are weak. Safe activities for back pain include walking, swimming and cycling.
Manual therapy techniquesPhysiotherapists use many manual techniques including manipulation and mobilisation, which work on releasing stiff joints. This helps to get more blood flow to an injured part of the body and helps recovery. Manual therapy is only recommended alongside exercise.
Complementary and alternative medicine (CAM)The use of alternative treatments for back pain is increasing and becoming more popular. Some of these treatments include yoga, acupuncture, massage, herbal medicine, homeopathy, meditation, mindfulness, Tai Chi and many more. Some are more effective preventative measures (eg. Tai chi) and others are more directed to treatment (eg., Pilates).
A survey of nearly 70 000 adults in Canada found that the use of CAM is highest in people with chronic low back pain who also report that thanks to the treatments, they are more active, more sociable, healthier and manage their condition better (Foltz et al, 2005).
MassagePhysiotherapists use massage to release tight muscles and take pressure off stiff and painful joints. Having flexible muscles and joints is important to reduce the chance of injury, plus recovery is faster.
There are many types of massage but they all improve circulation to the area, release tight muscles, improve alignment, help recovery and reduce pain (1).
The benefits of massage therapy in patients with chronic low back pain can last up to 1 year which makes this treatment beneficial for people with back troubles, especially if it is combined with exercise and education (Furlan 2009).
AcupunctureMany physiotherapists also use acupuncture, which means inserting very thin needles into muscles or tendons. This acts through the nervous system to relax those specific areas. Acupuncture is recommended for early management of back pain (NICE guidelines, 2) and can be helpful in reducing pain levels and improving function (Lam 2013).
YogaYoga is a type of physical exercise and also a form of mind-body medicine. It consists of various postures combined with breathing techniques which can help create inner, physical and emotional balance. Yoga also has the potential to alleviate pain (Posadzski 2011).
Some of the benefits of yoga include increased flexibility, better oxygen flow to muscles and joints, relaxation effects and release of happy hormones (Slade 2007). All of this may help reduce pain, anxiety and depression (Tekur 2012). Compared to physiotherapy exercises, it seems that a regular yoga programe can achieve all these effects and also improve movement of the spine in people with chronic back pain (Tekur 2012).