A physical therapist is a specialist who helps the patient restore activity, strengthen muscles, and improve range of motion following an injury or surgery, or to improve a particular chronic condition. Physical therapy involves pain management techniques, such as electrical stimulation, massage, ultrasound therapy, and heat/cold therapies.
The physical therapist is trained to identify deficiencies in body biomechanics. The patient works with the therapist who targets specific regions of weakness. This helps the body function and relieves stress on certain body parts. The therapist is knowledgeable about treatment goals, surgical procedures, anatomy and physiology, and chronic pain conditions. After surgery, the physical therapist knows the body limitations, which prevents injury and ensures a successful recovery.
The physical therapist uses a variety of techniques to achieve pain relief and assist with recovery following an injury or to alleviate pain related to a chronic condition. Therapies include:
Spinal manipulation – This involves use of the hands for controlling force to a joint of the spine. The amount of force is dependent on the type of manipulation used. The goal of this is to improve function and relieve pain.
Stretching tight joints and muscles – A component of physical therapy is stretching exercises. Stretching is important for maintenance of joint range of motion, as well as flexibility of muscles. For tight muscles and stiff joints, normal activities are difficult (climbing stairs, riding in a car, and using exercise equipment). Another important reason for stretching is that it prevents scar tissue formation.
Exercises for strengthening – Strengthening exercises improve muscle function. The goal of physical therapy is to maintain or improve endurance, strength, and range of motion. After surgery, post-operative exercises help with recovery and prevent complications.
Core strengthening and stability – The body’s “core” is the trunk (abdomen, back, pelvis, and chest). This region is the foundation of the body, and when muscles are weak, it is difficult to perform certain maneuvers. Also, injury to the spine is more likely when back, chest, pelvis, and abdominal muscles are weakened. Core strengthening exercises include pilates and yoga.
Ultrasound – High frequency sound waves are used with ultrasound. These sound waves stimulate the deep tissues of the body. The physical therapist passes the ultrasound probe over the body to achieve tissue stimulation. In addition, this increases blood flow to the injured or degenerated area by dilating blood vessels.
Heat/cold therapies – Ice is used to cool off muscles and reduce inflammation. Heat is used to warm up muscles and soothe pain. These therapies are often used in physical therapy.
Electrical stimulation – This therapy involves passing electrical current to an affected area. When nerve conduction is altered in a particular region, this can change muscle contractility. In addition, blood flow is increased with electrical stimulation, which is useful for blocking pain signal transmission.
In a large 2009 review of studies, for symptomatic degenerative disc disease with chronic low back pain, researchers found the most effective treatment to be physical therapy. In this same review, researchers found that exercise improved function and decreased pain in patients with back pain. In another 2011 review, spinal manipulation was found to be effective as other interventions for improving joint and body function, as well as reducing pain.