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The lumbar spine is made up of five vertebrae (bones) that are separated by intervertebral discs. These vertebrae's articulations form facet joints and foramen (holes) for the nerve roots of the spine to travel and innervate our lower extremities. In addition to the vertebrae and discs, there are many strong ligaments and muscles that help support and stabilize the spine.
The spine must have the flexibility for movement but also be strong to support external loads. When there is a weakness in the spine, this area can be vulnerable to injury. Disc herniations can occur when the spine is loaded in a flexed and rotated position. Foraminal stenosis is the narrowing of the foramen where a nerve root exits, causing irritation to the nerve. Symptoms can travel down to the leg and foot in some cases. Women may experience low back pain during and after pregnancy with additional stress at the sacroiliac joint.
The physical therapy examination of the lumbar spine consists of a thorough analysis of the muscles, nerves, and joints of the spine. The thoracic spine and hip complex must also be examined to assess for any impairments in those areas that could be contributing to back pain. Physical therapy interventions include lumbopelvic strengthening, joint and soft tissue mobilizations, and neuromuscular re-education to improve low back strength and stability.
Whether back pain is new or has been persistent for years, physical therapy treatment can help decrease pain and improve mobility. According to an article in the Archives of Physical Medicine and Rehabilitation, patients who started physical therapy soon after their low back pain began had significantly improved symptoms compared to those who waited. Another article in the Clinical Rehabilitation Journal found that specific hip strengthening exercises help reduce low back pain and improve function when added to physical therapy programs. Physical therapy is critical for long term management of low back pain to improve overall function and decrease pain.
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