How is rehabilitation used to treat neck and back pain?

In Physical Therapy we treat neck and back pain by the following interventions:

1. Examination: Take a thorough subjective and physical examination to determine the causes and severity of pain. The examination helps determine what specific interventions need to be done. Each patient is unique in the medical history and interventions should also be individualized to the patient's progress.

2. Reduce Pain: Especially in more severe pain complaints, it is important to reduce the symptoms to allow for the patient to simply feel less pain. This can include manual therapy to decrease muscle spasms, restricted joint mobility, or decrease nerve irritation. Modalities such as ultrasound, electrical stimulation and traction can also be used.

3. Restore Motion: As pain decreases, it is the goal for rehabilitation specialists to restore patients back to their functional activities. Mobility / range of motion is important to allow the patient to move again. Manual therapy, exercises including stretches and stability training, posture and gait/walking education are all necessary to improve the patient.

4. Improve Stability and Strength: In the neck and back there are key muscles that are designed to stabilize the spine, while others provide power and torque. In chronic pain conditions, it is important to improve the efficiency of muscle function rather than just 'get people stronger'. Such muscles as the longus colli in the neck, shoulder blade / scapular stabilizers - such as the lower trapezius, or trunk stabilizers -including the transversus abdominis, multifidus, obliques, and gluteal muscles are all necessary to provide proper stability for dynamic function. Rehabilitation specialists have strategies to improve the stability of these muscles.

5. Function / Sports Specific Training: Once basic stability has been established, it is important to provide the patient the tools to return to full work, functional, and sports-related activities.

Rehabilitation is often central to treatment for back and neck pain. It may be one of the first measures doctors prescribe in treatment, and it is often used to help people recover from neck or back surgery. Rehabilitation programs may include:

• Exercise programs to improve range of motion, increase muscle strength, improve flexibility and mobility, and increase endurance
• Identifying and obtaining assistive devices to promote independence
• Pain management exercise techniques
• Gait (walking) and movement retraining
• Stress management
• Ergonomic assessments and work-related injury prevention programs