The Physical Therapy Initial Evaluation. When you go for an initial evaluation with a physical therapist (PT), you can expect the physical therapist to ask a number of questions during the interview component of your evaluation. Most likely, he or she will ask questions about:

• how your back pain developed,
• how long you've had it and if you have had episodes in the past,
• what activities aggravate it or make the pain better, and
• any medical history that may impact your treatment.

Then, the therapist will conduct a musculoskeletal exam that may include an assessment of your:

• lumbar spine movements and muscular flexibility,
• sitting and standing posture, and
• strength testing of your legs and trunk muscles.

The therapist may examine "repeated movements" and the response of your back pain to several repetitions of a particular movement in a variety of directions. Additionally, the PT may test your reflexes or sensation if indicated. A "plan of care" will then be established by your PT, which may incorporate some of the treatments described in the next section, as indicated by your symptoms and your goals.

Use of Movements, Postures, and Positions to Reduce and Stabilize Pain.
In the physical therapy examination of low back pain, the PT can often identify particular movements and positions that actually lessen or control the pain. Once identified, the PT may instruct you in those postures and movements that help to alleviate the pain. These can then be applied to the activities in which you are involved on a daily basis. A physical therapy treatment program that is active in nature and geared toward instructing the patient in self care techniques and back injury prevention are key ingredients in returning a person to a pain-free, active and healthy lifestyle.

Reprinted with Permission
Rothman Institute
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