3. Prepare to Exercise
If a patient has significant pain that’s limiting them from moving and doing exercise, the first step might be an injection of anti-inflammatory and/or pain-relieving medication. “There are different types of injections we could use,” says Dr. Erosa. “An epidural steroid injection, for instance, helps to reduce irritation and inflammation around spinal nerves, while a facet joint injection is meant to diagnose and/or treat pain related to arthritis of the spine. Either way, we’ll use this targeted approach to help reduce the symptoms enough so the person can manage their pain, and then monitor the patient’s progress now that the injection allows them to do the physical therapy.”
4. Start Moving
Exercise and physical therapy help to restabilize the spine and, ideally, take pressure off some of the areas where the pain is originating. For instance, if someone has a herniated disk, where a disk in the spine is touching a nerve, physical therapy will strengthen the muscles around the disk and increase the support of the spine while alleviating some of the pressure points. “Exercise won’t necessarily help the disk move back to its original spot, but strengthening your core and restabilizing your spine can help your symptoms improve,” says Dr. Erosa.
5. Stick With Your Plan
The goal of physical therapy for back issues is to strengthen the core muscles, as well as the muscles in the buttocks and pelvis to support the spine. When those muscles are stronger, it helps take pressure off the areas that may be causing pain. “If patients stick with it, we will often see gains in mobility and pain reduction,” says Dr. Erosa. “Think of exercise as a pill that you have to take every day for your lower back or spine health. It’s not as easy as a pill, but if you keep up with your exercise regimen you’ll have a better chance of preventing not only the pain, but also the progression of whatever is causing problems in the first place.”
6. Try Different Exercises
There are plenty of gentle exercises patients can do that are both enjoyable and can help with flexibility and strength. “If a patient wants to do more than the exercises provided by the physical therapist, they can also try aerobics, yoga, Pilates, or tai chi,” suggests Dr. Erosa. “Those are great ways to maintain flexibility and strengthen the core and lower back, and they offer a way to socially engage while exercising. We only caution that patients tell their physical therapist and listen to their body and not push themselves to where they exacerbate the problem.”
Outside of exercises, there is evidence that alternative methods such as massage therapy, acupuncture, and mindfulness-based stress reduction can also help in relieving low back pain.
7. Be Mindful of Posture and Routine Movements
In addition to exercise or physical therapy, learn from your physical therapist the proper way to do the things you might do every day, like maintaining good posture or bending down to pick things up. “Poor posture can place a great amount of stress on the back and neck, so while engaging your core and keeping up with exercises is good, you should also be mindful of how you are moving your body,” says Dr. Erosa.
8. Stay in Close Touch With Your Doctor
If you’ve seen someone for conservative treatment of back pain and it’s not improving — for instance if mobility isn’t improving or there’s more stenosis — the person may be a candidate for surgery. “At that point we’ll consult a surgical colleague from Och Spine at NewYork-Presbyterian to get their perspective,” says Dr. Erosa. “The nonoperative specialists have a highly collaborative relationship with the spine surgeons at Och Spine. The patient may not want surgery, but hearing from a surgeon can be informative and give an idea of alternative options if medications, injections, or exercises aren’t working.”