I have low back pain, now what?

When it comes to low back pain, there is no shortage of providers you can go see. You can see your primary care physician, a chiropractor, a massage therapist, a physical therapist, a yoga instructor, an orthopedic physician and even a neurosurgeon.

You may be asking, how do I then decide who is the right choice for me?


Who do I go see and more importantly how much does each option cost?

Who do I go see and more importantly how much does each option cost?

Some people want to avoid medications, surgery, and injections at all costs. This narrows the field of potential practitioners off the bat. If you are to see a physician, very likely you will be prescribed medication, given some kind of diagnostic test (X-ray or MRI) and then prescribed physical therapy. The involvement of specialists (orthopedic spine physicians and neurosurgeons is often not the first line of defense).


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Some practitioners offer more conservative approaches to treatment of low back pain. Massage therapists offer soft tissue work and stretching to address pain and limitations. Yoga instructors offer movement based interventions. Some pure Chiropractors believe that disease processes stem from a malalignment of the vertebrae (bones in your spine.) Their treatment is thus geared toward adjusting the spine so that the nervous system can function properly.

I can speak the most intelligently about physical therapists. We are movement specialists who address our patient’s impairments to help them stay active and pain free. A good physical therapist looks at the movements of your whole body to see if there are compensations in the normal patterns of movement, to find muscle weakness, to find joint restrictions, tight muscles, poor balance, and assess how a patient’s environment and activities may be affecting their pain and limitations. From there, we start to address those impairments and very often pain subsides and we can ramp activity back up.

Another difference I see in good practitioners is the ability to help patients with low back pain become independent. If you are constantly receiving care and are not taking an active role in your own recovery and health, I think you are not being properly cared for. I don’t know too many practitioners that you can take on vacation with you to help you when your back gets flared up. Because there are so many factors that play a role in a patient’s pain a very multimodal approach to intervention is indicated.

Brian, what do you mean by multi-modal approaches in low back pain treatment? I mean that there has to be a combination of manual therapy (hands on techniques) and active exercise. I do not believe in passive approaches to care. I am not going to stick you on a TENS unit (thing that makes your skin tingle) with an ice pack for 15 minutes while I catch up on notes. What in life has come easy to you without having to put in work or effort? I am telling you now that dealing with your body is no different and in fact often is harder work.

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I don’t like to give generic advice and exercises, but there are recommendations and movements that are well researched that can help reduce the risk of injury and also help alleviate current pain that may be stemming from your back. This advice does not mean that you should not go see a skilled medical provider that will employ the above mentioned approaches to your care.

Over the next weeks I will be providing this information on how you can get back to doing the things you love, after all, we can all live with some pain, but when it starts to interfere with our hobbies and interests, we have to say enough!

If this advice and these movements help you, please feel free to let me know. Write it in the comments below.

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I appreciate you reading and let me know if I can be of further service to you.

Here’s to helping you reach your PINNACLE!

Dr. Brian Murphy , DPT, OCS, ATC, PES, TPI II Medical

Owner of PInnacle Physical Therapy

5507 Ranch Dr Suite 203

Little Rock, AR 72223

501-529-2010

Brian@pinnacledpt.com

Aging Gracefully: The benefits of resistance training

As we age unfortunately we loose muscle mass, which means we get weaker. You can’t avoid this decline but you can make it more gradual. Do you know the recommendations, the frequency, the specifics, the science, and do you have a resource you can talk to in order to find out more. Now you do. Read this article and let me know if you have any questions.

Read More

Orthopedic Physical Therapy

Orthopedic physical therapy is the specialty practice of evaluating the patient’s body and its movements. As a physical therapist we specialize in optimizing movement which may be altered from a variety of circumstances. One way happens to people who maintain habitual postures. When you think of someone who sits at a desk or performs repetitive tasks, they are predisposed to abnormal forces which can lead to musculo-skeletal pain or limitation. Physical therapists can help modify the work environment to help minimize forces while at the same time make the patient more tolerant to those forces so that there is not tissue breakdown and therefore pain.

What impairments do you have that keep you away from your passions?

What impairments do you have that keep you away from your passions?

As an orthopedic physical therapist we also specialize in helping people who are having joint issues. As we age there can be degenerative changes that occur in our joints. The joints that come to mind first are of course the knee and hip. In those situations, physical therapists help a patient to develop a plan that will prevent limitation in daily activities as well as hobbies while at the same time help them with pain management and prevention of surgery in a very holistic way which is proven by research to help in most cases.

Not interested in taking medications, getting injections, or having surgery. A physical therapist is a great option to help you get back to doing the things you love. 

Not interested in taking medications, getting injections, or having surgery. A physical therapist is a great option to help you get back to doing the things you love. 

Another way an orthopedic physical therapist can help a patient, which in my opinion is the most effective is in injury prevention. We are trained to do thorough assessments of your nervous and musculo-skeletal systems to see if they are performing optimally. I bring up the example of doing your yearly physical with your primary care doctor. We all know the value of having a physician listen to our heart, check our blood pressure, perform blood work and check in on our internal systems to ward off disease and help cure our ailments. Why not also have a yearly checkup with your movement specialist who can help you stay active in a noninvasive way by warding off potential injuries before they happen and sideline you from doing the things you enjoy.

There is a great resource for consumers of health to educate themselves on their options when it comes to treating pain and limitation. There is a movement called GetPT1st which highlights in more detail the benefits of seeing an orthopedic physical therapist. I urge you to check out this resource and see if physical therapy will be right for you.

http://getpt1st.com/why-physical-therapy/

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If you are in the Little Rock area, there is an orthopedic clinic specialist which is a credential that very few physical therapists have in the country let alone the state. He is willing to help analyze your movement, educate you on a specific plan of care catered to your needs, and empower you by teaching you what you need to do at home to get the best timely outcome. 

Check out www.pinnacledpt.com and Dr. Brian Murphy for more information. 

Dr. Brian Murphy, DPT, OCS, ATC, PES   Owner of Pinnacle Physical Therapy in West Little Rock, AR

Dr. Brian Murphy, DPT, OCS, ATC, PES 

Owner of Pinnacle Physical Therapy in West Little Rock, AR

Prevention Strategies for the Injured Swimmer

"Coach, I just did my thousand warm up and my shoulder is killing me, what should I do?"

There are a lot of factors that go into determining why a swimmer is injured. I wanted to give you some tips and ideas on what you can do to try and treat these injuries on your own. 

Tip 1: The best strategy is to avoid injury before it comes! You must have a solid flexibility, strengthening, and endurance training program under your belt that you are performing consistently! 

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*Stay tuned for my video series that is going to give you this exact program! 

Tip 2: Careful monitoring of training volume, intensity, and duration will go a long way in calming down an injury. Complete rest is rarely indicated because of the deconditioning that develops. Certainly looking at adjusting the above parameters for a short time will give the athlete time to allow the healing process to be effective. 

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Tip 3: Specifically for the shoulder, avoidance of using hand paddles is a good idea as these put more stress on the shoulder. Avoiding or limiting the painful stroke is also a good idea. Modification of the dry land training program will prevent continued stress to the injured area. 

Thank you Lord, I don't have to use paddles today! 

Thank you Lord, I don't have to use paddles today! 

Tip 4: Application of ice to the affected area helps to reduce pain and inflammation as well as proper use of anti-inflammatory drugs when appropriate will help reduce pain and improve function. 

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Tip 5: Have your coach take a look at your swim mechanics. Ensuring that you are swimming with correct technique goes a long way in avoiding increased stress to structures in your body that can cause pain. 

I hope these tips are helpful for you and keep you swimming and performing at your best. 

If you are still struggling to get your injury under control please reach out to me anytime at brian@pinnacledpt.com, or call me at 501-529-2010.

Come back next week for the start of the video series on exercises that you MUST be performing!

Thanks and Here's to Helping you Reach your Pinnacle! 

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