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Spine Physical Therapy

Aaron Said:

How does Physical Therapy help with 2 bones that aren't fused together????

We Answered:

Based on your description, I'm assuming you've been found to have an L-6 vertebrae...this is an anomaly where the first sacral bone is not fused with the rest and is termed a lumbar vertebrae instead.

That's going to depend highly on the approach to which you physical therapist will use. Most likely, your PT will teach you exercises to "stabilize" your "core muscles" to compensate for increase mobility that is said to occur with an L-6 anomaly.

These theories go back mostly to MM Panjabi, a surgeon who is probably the pioneer of the core stabilization movement. His landmark papers on lack of "stability" of the spine as a source of pain has been cited hundreds of times. He theorizes that increased "neurtal zone stability" of the spine can cause compensation and pain by any of the subsystems that help stabilize it.

While this certainly sounds good in theory, we must remember that is all it is...theory. While Panjabi has done many studies on biomechanics, etc. there have really been no significant studies to date that validate clinical application of "core stabilization" in the reduction of pain. Can "core stabilization" be helpful? Perhaps, but those who might benefit from it cannot be reliably identified.

That being said, PT with core stabilization may or may not benefit you. Yet, there are other paradigms by which those with back pain can be more reliably identified based on your response to movements. In other words, there may be different approaches to help you within the scope of physical therapy (I'd suggest going to www.mckenziemdt.org )

...I should also mention that presense of an L-6 vertebrae has also not been proven to be a source of pain. Therefore, your pain MIGHT not have anything to do with this at all.

Harry Said:

Should I continue with physical therapy?

We Answered:

Your physician probably ordered physical therapy for a specific time, such as "2-3 wk 9", which means "2-3 times a week for 9 weeks". You will have an evaluation visit, several weeks of therapy, then a final evaluation visit. Ask your physical therapist what was ordered for you.

You should continue your physical therapy for the full course. Not only are you strengthening your back muscles, you are assuring that there will be sufficient fluid around your discs to keep them cushioned.

Think of your therapy like antibiotics: you have a sore throat and the physician orders antibiotics. You feel better after a few days, but you must continue your antibiotics because there are "things" going on in your body that maybe don't hurt, but aren't quite fixed yet.

Last year I partly ruptured a disc in my lumbar area. The pain was so bad I had to crawl. My insurer would not pay for physical therapy, so I started my own exercises and did them for three months. Now I'm pain-free.

Please continue your therapy. After you are discharged from therapy, ask your PT for a Home Exercise Program (HEP) and do those exercises faithfully!

Mike Said:

Physical Therapy for Back: What should I expect?

We Answered:

I also have disc problems and have taken physical therapy. You get to stay in your clothes, so do not worry about that. As far as the PT side of things, you will start slowly and build your way up, mainly working on back and stomach (core) muscles. You will be doing about 45 minutes to an hour worth of exercise, so be prepared for it. If you cannot do something your therapist is teaching you, make sure you tell them. They will not make you do anything that is uncomfortable for you. Once you have learned your exercises, keep doing them at least two times a week. You will probably need to do this for the rest of your life.

Bill Said:

What do you all think about Physical Therapy?

We Answered:

Physios can fix that easily, the problem with physio is that it is really hard to mark someone through school, so pretty much anyone can get through and bring shame on the profession.
Physio's work bone aswell, and nerves.

In a lot of treatments, you need to take one step back before coming two steps foward, this is because the physio may intentionally harm your back, and facilitate proper healing (laymens terms)

Go to a new one, and if they can't do it, come to me.

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