Physical Therapy

General therapy vs. spine-specialized therapy

The only way to permanently relieve pain involves changing the physiology of the back by using exercise to make it stronger, more flexible and resistant to injury. While a general physical therapist may spend weeks attempting to mask pain using heat, ice or ultrasound, research has shown that using these passive treatments is not the best way to return someone to activity efficiently. This general physical therapist often sees a wide variety of patients each day who suffer problems related to sore elbows, knees or shoulders. General physical therapists typically have a very limited understanding of the best ways to treat specific types of back problems. At best, they may have taken a couple courses on therapy for a back or neck injury.

On the other hand, a spine-specialized therapist’s primary goal is to enable the patient to perform a customized home exercise program as early as their first visit. The therapist’s second goal is to make the patient independent of therapy within a short period of time.

Manual therapy

Manual therapy relates to the use of a therapist’s hands to achieve pain relief. By using specific techniques, the spine therapist can relieve pain through hands-on movements applied to vertebrae and soft tissue areas. This is achieved not passively, with a modality such as ice or heat, but through actively moving the joints and tissues. Spine-specialized therapy can involve techniques taught by schools including Paris, Ola Grimsby, Cyriax and the Maitland therapy school in Australia.

A manual therapist’s background typically begins with physical therapy training, followed by advanced education in spine that sets them apart from general physical therapists. This specialized education can be within a host of manual therapy philosophies, each involving unique pain-relieving techniques that help patients return to function as quickly as possible. Regardless of the particular school of thought, the best spine therapists avoid the use of passive modalities, which do not provide permanent relief. 

It is important to note, however, that any time you have symptoms that involve radiating pain or numbness into a leg or arm, consider these serious emergency symptoms that need to be seen by a spine surgeon or spine physiatrist to determine if they are worsening, or if they can be managed with therapy. If you ignore these symptoms, such symptoms can cause permanent nerve damage. Another emergency symptom is any loss of control of bowel or bladder.