PT Classroom - Chronic Lower Back Pain: Effective Management for a Difficult Condition  ׀ by Jon Schumacher, MPT

Chronic lower back pain is one of the most perplexing disorders that we, as health care practitioners, are asked to help with. There have been countless theories and explanations regarding this topic with a lot of confusion around what exactly to do about it. Of course, everyone with chronic lower back pain would love to be 100% free of their pain, but in reality, that is not always going to be the case. There are conditions of the spine where the lower back pain is not going to disappear completely. So then it becomes a situation of how to manage this pain.

I have worked with many patients with long histories of severely debilitating lower back pain, and my focus is obviously on getting them better, but not necessarily fixing them completely. I never promise that. I believe, however, that every one of them can get better. They may not be 100%, but they can get better. The focus needs to be on finding out what stretches, techniques, or exercises make them feel “better” and do more of those, while at the same time finding out what movements, activities, or routines are contributing negatively to their condition and stop doing those. You see, I believe the body is smarter than we are as practitioners. It will tell us if it likes something or not. Seems pretty simple right? I have used this basic premise for years and have gotten some fantastic results. DO MORE OF WHAT FEELS GOOD AND LESS OF WHAT FEELS BAD.

Now by feel good, that doesn't mean doing a bunch of massage and modalities. I mean empowering the patient with knowledge on how to effectively self-treat their lower back pain and get them to do these self-treatments consistently. It's about creating new habits. Some of the most effective self-treatments are techniques that can reduce abnormal tension imbalances around the back, hip, and pelvis. Dr. Janda was one of the first to coin this issue as Pelvic Crossed Syndrome. Below are some very effective self-treatment strategies, based on Dr. Janda's principles, to try with your patients. Being consistent in doing these every day is the key to managing chronic lower back pain.

Have your patients do this routine several times a day.

Powerful self-evaluation and treatment techniques to do at home.

Hypomobility of the sacrum is a common issue for lower back pain sufferers. Here is an effective muscle energy technique that can help mobilize a stiff sacrum.