Back Pain

Spondylolisthesis is misalignment problem of the spinal bones (vertebrae). It is most common in the very low back (4th or 5th lumbar) where one of the vertebrae has slipped forward because the ligaments that hold the bones together have been stretched or there has been a fracture. Poor posture, weakened abdominal and spinal muscles, and an increased angle in the spine all put pressure on the low back joints until misalignment occurs.

Symptoms can be mild like general fatigue in the low back area or achy pain. They can also be severe if the nerves that exit the spine or spinal cord in that area are compressed. If your symptoms are mild to moderate, we can provide therapy to stabilize the area, improve posture and strengthen the muscles. In severe cases surgery may be necessary. The most common approach is a fusion to bring stability back.

The good news is that physical therapy is one of the best options to treat spondylolisthesis. Your Proliance Physical & Hand Therapy expert will work with you and your doctor to develop a personalized program based on careful assessment of your specific issues to bring stability and support which will allow your muscles to create more support for the overstretched ligaments. At the same time, we will work to improve mobility in other areas of your spine that lack flexibility to take pressure off the misaligned joint. Your therapist will also assess whether you have other issues that are contributing to the spinal misalignment such as weakness in your hips, poor balance, or radiation pain to your legs. We’ll treat the issues causing pain and the root issues that are causing the spinal instability. Our goal is to eliminate the pain and get you back to doing the activities you love.

While osteoporosis is a common condition for women who are forty or older, men can also experience it. Osteoporosis is a thinning of the bones due to the change in calcium depositing and uptake. As we age, the body can remove more calcium than it deposits in our bones. The most common area in the body for osteoporosis is the spine and hips. The primary problem with osteoporosis is that it makes fractures more likely, even while doing ordinary activities. When it gets severe bones can just crumble. If you are susceptible to osteoporosis your need a treatment plan to improve your bone strength through strengthening exercises, an active walking program, medication, and proper nutrition.

The good news is that physical therapy is one of the best options to treat back pain and restore normal back movement and strength. Your Proliance Physical & Hand Therapy expert will start with a thorough assessment of your posture, strength, flexibility, spinal mobility, and how you move your body (also known as “body mechanics”). With careful observation and measurement your therapist will precisely identify the areas of weakness and sources of your primary problems. This information will be used in collaboration with your doctor’s recommendations to develop a treatment plan based on your specific core issues to relieve your back pain, sooth sore muscles, restore proper posture, and improve your range of motion and strength. At Proliance Physical & Hand Therapy our goal is to help you keep your back healthy and strong into the future, so your therapist will also educate and provide exercises you can continue after your therapy sessions at Proliance Physical & Hand Therapy have been completed to ensure you can keep doing the things you love without pain.

A disc is a jelly-like, fluid filled sac that acts as a cushion between the bones of your back (vertebrae). Your discs change as you age, drying out and becoming more brittle. As discs dry out with age, they get thinner which reduces the height between your vertebrae. This shrinking causes changes in your posture and can start impacting the nerves that exit between the vertebrae. The center of a healthy disc (nucleus) is held in place by many rings of the disc (picture a cross section of a tree trunk). With minor or major injuries, poor posture and strain, these rings can rupture allowing the disc nucleus to press outward. If not taken care of, eventually the nucleus will reach the outer edges and the disc can begin to bulge. This can rub and irritate the nerve roots exiting your spine. If the disc continues to be untreated the next step is herniation as the outside of the disc ruptures which presses even further in the spaces where the nerves exit.

The symptoms of a bulging or herniated disc can range from localized pain to numbness and tingling down your arms and legs. Eventually complete lack of nerve sensation, muscle weakness and paralysis of the extremities can occur.

The good news is that most bulging and herniated discs can be treated effectively with physical therapy. Your Proliance Physical & Hand Therapy expert will review your medical history, talk with your doctor, evaluate your symptoms, perform tests to determine range of motion, and identify posture problems. From this careful assessment your therapist will identify the root causes of your disc problems and develop a comprehensive plan to eliminate the pain and restore function. Step one is to relieve pressure on the disc by improving joint function, muscle strength and posture. Once the pain is under control and the muscles stop spasming, your therapist will focus on recovering lost strength and range of motion. At Proliance Physical & Hand Therapy our goal is to help you keep your back healthy and strong into the future, so your therapist will also train you on the correct exercises you can continue to do to maintain good posture and reduce the risk of future episodes. We look forward to helping you get back to doing the things you love without pain.

Osteoarthritis and rheumatoid arthritis are common spinal issues. Both types of arthritis can cause pain, muscular weakness, and impact your daily activities.

• Rheumatoid arthritis happens when your immune system attacks the membranes that surround the joints in your back. This causes inflammation which can result in persistent discomfort and weakness
• Osteoarthritis is the result of wear and tear. When cartilage on the joints thins, the bones in your back can rub against one another and this causes osteoarthritis to develop.

When arthritis sets in, movement of the back can become painful, and you may experience chronic, achy pain. Much like an arthritic knee, the spinal joints can be helped by restoring natural movement, improving support from the spinal muscles, and improving posture.

Physical therapy is one of the best options to treat arthritic related back pain and restore normal back movement and strength. Your Proliance Physical & Hand Therapy expert will start with a thorough assessment of your posture, strength, flexibility, spinal mobility, and how you move your body (also known as “body mechanics”). With careful observation, measurement, and input from your doctor, your therapist will precisely identify the areas of weakness and sources of your primary problems. This information will be used to develop a treatment plan based on your specific core issues to relieve your back pain, sooth sore muscles, restore proper posture, and improve your range of motion and strength. At Proliance Physical & Hand Therapy our goal is to help you keep your back healthy and strong into the future, so your therapist will also educate and provide exercises you can continue after your therapy sessions at Proliance Physical & Hand Therapy have been completed to ensure you can keep doing the things you love without pain.

Many people experience Spinal Stenosis in combination with spinal arthritis. Spinal stenosis is a condition where the central spinal canal or the channels where the nerves exit the spine to the lower legs (called foramen) start narrowing. These pathways the nerves travel through are made up of overlapping spinal bones (vertebrae). When spinal joints deteriorate, or the space between vertebrae narrows due to disc degeneration, or you experience abnormal bone growth due to arthritis, it can cause the canals your nerves travel through to narrow. This can put pressure on these key spinal nerves and cause irritation and inflammation by rubbing on them. When that happens a cascade of pain and problems can begin.

The good news is that physical therapy is one of the best ways to treat spinal stenosis and restore normal back movement and strength if your condition isn’t severe. While we cannot undo any arthritis degeneration your Proliance Physical & Hand Therapy expert can work with you to minimize pain, restore more natural movement to your spinal joints, improve your flexibility to increase joint fluid circulation, and improve your spinal muscle strength. At Proliance Physical & Hand Therapy our goal is to help you keep your back healthy and strong into the future, so your therapist will also educate you on correct posture and prevention techniques, and provide exercises to help you do more, with less pain. Many of our patients report significant improvement after just a few weeks of following their personalized treatment plan at Proliance Physical & Hand Therapy.

Pain that travels into the buttocks and down the back of the thigh is called sciatica, because that is the specific nerve that is the source of this type of radiating pain. Pain in your leg doesn’t automatically mean you have sciatica, but if it happens with any regularity, it is important to figure out what’s going on before it gets worse. Sharp, stabbing pain with numbness or tingling is more typical of nerve irritation or compression occurring in the low back or leg. Achy pain that spreads out through the buttocks and the back of your thigh is more indicative of sciatica. The sciatic nerve, travels through the buttock and down the back of the leg. The sciatic nerve typically goes under the piriformis muscle, but in one out of five people it goes through the piriformis muscle instead. These people are especially susceptible to sciatic pain because any time the piriformis muscle tightens up (e.g. due to prolonged sitting) it can cause pressure and irritation to their sciatic nerve and trigger sciatic pain.

The good news is that physical therapy is one of the best things you can do to eliminate the pain of sciatica. Your Proliance Physical & Hand Therapy expert will start with a thorough evaluation in collaboration with your doctor to determine where your problem is starting. Your therapist will carefully examine the movement of your spine, hips, and legs. They will examine your range of motion, strength, joint mobility, and muscle condition. Identifying the precise root causes of your pain is essential for your therapist to develop the best treatment plan to quickly relieve your pain, improve your range of motion, improve your strength, and help you prevent future leg pain.

Back sprains and strains are common, but “sprain” and “strain” identify different problems.

Sprains refer to injuries of the ligaments (connect bone to bone) and strains refer to injuries of the muscles or tendons (connect muscle to bone). Sprains and strains occur from quick over-stretching of the tissues causing micro-tearing and subsequent injury. Swelling begins as part of the inflammation process, causing pain and difficulty with movement.

Hundreds of small muscles and ligaments surround your spine, working in complex synchronicity to control all the bones and joints in your back. Sprains and strains typically occur when people combine lifting and twisting. When you get a back sprain or strain it causes micro-tears in the affected muscles and tissues. While it usually isn’t a full tear, it can cause significant swelling, inflammation, and pain deep in the back. Full healing can take two to three months and the sooner we see you and start treatment, the faster you will recover.

Physical therapy is very important to expedite recovery from a back sprain or strain. Sustained inflammation will delay healing, so it is important to start with treatment to reduce the inflammation as quickly as possible. In addition to eliminating your pain and getting you back to the things you love as quickly as possible, your Proliance Physical & Hand Therapy expert will also do a thorough assessment in collaboration with your doctor to determine if there are other problems that contributed to your back sprain or strain that we can resolve to make it less likely that you will hurt your back in the future. For instance, in many cases we find that the root cause of a patient’s problem was that they have limited motion in the hips, pelvis, or mid-back. When those body parts don’t move properly it increases the stress and pressure on your low back. This means you can hurt your back even when lifting lighter weights that should be no problem.

Two recommendations to help you avoid back sprains and strains in the future:

1. Studies have shown that people who do not properly retrain their core muscles after a back sprain or strain are more likely to re-injure their back again. Chronic back pain makes can make life miserable and greatly restrict your activities. So, it is important to complete the full treatment program your therapist puts together for you to ensure you don’t suffer the same injury again and again.
2. To avoid injury to your low back use your legs when you lift, bend at your knees and keep your back straight and upright. Any time you need to turn while lifting, always move your feet rather than twisting your back.

Compression fractures in the low back are most common with people who are older and those who suffer from osteoporosis. Another common cause is an accident that sudden, severe force on the bones of the spine (vertebrae). Thanks to advancements in minimally invasive surgical techniques there are very successful procedures like kyphoplasty that can stabilize the broken vertebrae with minimal additional trauma. Compression fractures can be painful, and any kind of movement can be affected. The goal is to stabilize the pieces of bone so they don’t move around and can heal.

At Proliance Physical & Hand Therapy our physical therapists work closely with your doctor to develop a personalized treatment program designed to address your specific needs. Your therapist will be a specialist in back injuries and will work with you to relieve your pain, gently restore your spinal movement and strength, and promote healing.

If you have a pinched nerve or inflammation of the spine, you may receive a diagnosis of lumbar radiculopathy. This can be caused by an injury, or progressive deterioration. The risk of radiculopathy problems increases as you get older or if you have a family history of degenerative bone problems. If you have the following symptoms the root cause may be lumbar radiculopathy:

• Numbness or weakness in the leg and foot
• Tingling in the legs
• Pain that begins in the back and moves to the foot

If you notice that these symptoms increase the longer you sit or stand, that is another indication that lumbar radiculopathy is a potential cause.

The good news is that lumbar radiculopathy can usually be relieved with therapy and doesn’t require surgery. However, a careful diagnosis is essential to determine that this is the problem and not something more severe. Also, there may be other postural or functional problems that are contributing to your pain. Your Proliance Physical & Hand Therapy expert will thoroughly evaluate your movement in collaboration with your doctor to pinpoint the exact source of the trouble so they can develop the best treatment plan for your needs. Our goal is to get you back to the activities you love as quickly as possible, so your therapist will start with therapies to eliminate the pain and swelling then transition to exercises focused on strengthening the muscles around the source of the pain to prevent recurrence.

Inflammation of one or both of your sacroiliac joints (this is where your lower spine and pelvis connect) is called sacroiliitis. Many things can cause sacroiliac pain, including injury, arthritis, pregnancy, or an infection in the sacroiliac joints. If you have the following symptoms the root cause may be sacroiliitis:

• Pain that is stabbing, sharp, or dull in the pelvis or low back area, groin, or tailbone
• Pain that is worse when standing and walking and gets better when you sit or lie down
• Pain that radiates down to the knee
• Muscle tightness and tenderness in your hips or buttocks
• Difficulty walking, standing, or sitting for prolonged periods of time

The good news is that sacroiliitis can usually be relieved with therapy and doesn’t require surgery. However, a careful diagnosis is essential to determine that sacroiliitis is the problem and not something more severe. Also, there may be other postural or functional problems that are contributing to sacroiliac pain. Your Proliance Physical & Hand Therapy expert will thoroughly evaluate your movement in collaboration with your doctor to pinpoint the exact source of the trouble so they can develop the best treatment plan for your needs. Our goal is to get you back to the activities you love as quickly as possible, so your therapist will start with therapies to eliminate the pain and swelling then transition to exercises focused on strengthening the muscles around the source of the pain to prevent recurrence.

If you have surgery on your back, your surgeon will recommend physical therapy because it plays an important role in recovery. Your Proliance Physical & Hand Therapy expert will closely with your surgeon to identify the ideal combination of therapies to maximize your recovery.

• The first phase focuses on pain-relief and expediting healing. Your therapist will teach you how to move in ways that protect your surgery site.
• When your surgeon gives approval to proceed to the next stage your therapist will begin gentle strengthening and stabilization exercises to rehabilitate the core muscles that support your spine. You will also receive physical therapy for walking, balance, and spinal coordination.

Our goal is to reduce your back pain quickly, protect your spine during recovery, and properly rehabilitate your spine to allow you to resume your favorite activities as quickly as possible.