Doctor, Should I Do Physiotherapy?

Back and neck pain issues are amongst the most common patient problems consulted by a spine doctor or spine surgeon. The most common question that pops up during our conversations with patients is about physiotherapy.

Doctor, when should I do physiotherapy...?

I did physiotherapy also, but it didn’t help..

Will physiotherapy help?

It thus appears as though the general population thinks of this as a panacea – a one stop destination. It is not.

So what exactly is physiotherapy? Let’s visit this from a spine surgeon’s perspective.

Whenever you have incapacitating pain in the spine, and you visit the spine doctor, his job is to tell you, after examining you, the origin of the pain in the spine and whether it is something that needs urgent investigation and surgical attention. This is generally necessary ONLY for 10% of the patients. The remaining 90% of patients need further counseling, investigations and a follow-up visit. After tests, the doctor needs you to get back to your daily activities and stay pain-free. Here, the doctor needs you to get the services of the physiotherapist.

physio_patient_flyer_copyThe physiotherapist’s job begins after the spine doctor has ruled out dangerous signs related to the spine. The physiotherapist should preferably be located in your local area, near your home. He/she is the one, with the directions from the attending spine doctor, who slowly gets you back to normalcy and helps you stay normal. They might use some machine-based deep heat treatment (SWD) or electrical stimulation (TENS) for a short while, but these modalities just cut the pain for a short period only. This is not treatment of your spine problem.

I am not saying that this is harmful, but it needs to be understood by the patient that the natural history of a majority of spine problems (and especially slipped discs) is to get better with TIME, within 2-3 weeks from the start of the pain.

The physiotherapist helps you negotiate this period with his/her personalized attention, preventing you from any re-injury and guiding you to normalcy. This is essential because no one exercise regimen fits all, hence there is no one exercise chart for ALL spine issues. The treatment has to be tailor-made to suit your requirement/lifestyle. Then, physios, depending on your requirement and your resolve to be fit, can introduce you to advanced methods of training your muscles, posture, etc., again in consultation with your spine doctor.

So physiotherapy is an ongoing process to avoid pain for the short term and prevent re-injury, always in sync with your spine doctor and the physiotherapist. The surgeon decides on a recovery plan, based on your examination and investigations – the physiotherapists then execute the plan.

Golden Tip: Avoid any sort of exercises when in pain! (In the back or neck.) Pain is there for a purpose. It’s trying to protect you.

Pawar Dr. Uday Pawar is a spine surgeon, marathon runner, and a trekker. He was recently attached to Global Hospitals, Mumbai, bringing almost 10 years of only spine-related consulting and surgical expertise. His areas of interest are minimally-invasive spine surgery and day care spine surgery. He is also interested in the use of technology to help patients and doctors alike.
Educating patients, and thus helping them to arrive at an informed decision-making process, is what he likes. He also writes spine related blogs to help spine patients to this end.
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