Diagnosis & Treatment

How is it Diagnosed?

Your physical therapist will perform a thorough evaluation that includes:

  • A review of your health history
  • Questions about your specific symptoms
  • Tests to identify any problems with posture, flexibility, muscle strength, joint mobility, and movement
  • Tests to identify signs or symptoms that could indicate a serious health problem such as broken bones or cancer
  • Assessment of how you use your body at work, at home, during sports, and at leisure

For most cases of low back pain, imaging tests such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) are not helpful for diagnosing the cause. However, if your physical therapist suspects that your low back pain might be caused by a serious health condition, the therapist will refer you to other health care professionals for evaluation.

Treatment of Low Back Pain

Individuals with low back pain are faced with a variety of treatment options, many of which do not draw upon evidence to support the selected approach. In order to actively manage your physical health, you need to know your options and your rights as a patient and healthcare consumer.

Current Treatment Paths

Common practice has been to follow the Traditional Approach, relying on several months of physician visits, prescription medication, imaging, and steroid injections. This path has proven to be costly, results in poor outcomes, and many individuals experience a recurrence in their pain. On many occasions, the patient is referred to physical therapy months later.

Physical therapists are licensed healthcare providers for the musculoskeletal system and experts in treating individuals with disabilities of the joints, muscles, and nerves. We treat these conditions in order to improve function by reducing pain and restoring motion. Physical therapists have many years of training in anatomy, kinesiology (how the body moves), and pathology (disease and injuries to the body). They can identify where the problem exists, how serious it may be, and how best to treat it.

Physical therapy is usually not what most people think of when they are restricted from normal activity due to low back pain. Yet, when we review the data, physical therapy is one of the most effective ways to decrease pain, improve function, and return people to their normal work and activity level. Studies show that the cost is significantly less and patient satisfaction is high, especially when physical therapy is provided early in the process.

The extensive education, training, and experience required of physical therapists make them your best choice for the treatment of low back pain.

The following chart details two different treatment paths healthcare consumers can choose from:

The following chart details out two different treatment paths healthcare consumers can choose from:

Treatment Paths - Low Back Pain

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How We Treat Low Back Pain

If you walk into a healthcare provider’s office, even a physical therapist’s office, with complaints of low back pain, that medical professional will select from a huge range of options to treat your condition. You could go to two (or more) different providers and get two (or more) different treatment plans. Few of these treatments actually draw upon evidence to support the selected approach.

Our treatment methodology is designed to address variability of care. Our approach follows a detailed, decision-based model in which our therapists conduct specific tests, assess the patient’s response to pain, and then follow an evidence-based path of treatment. Using clinical case studies as our guide, we have eliminated treatments that lack supporting evidence. Our physical therapists are committed to embracing only treatment we know to be effective in restoring function and decreasing pain, as supported by this research.


Treatment Classification System

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A key component of the initial evaluation includes assessing your response to pain. Indicated in the flow chart above as “Pain Response Screen,” this helps your physical therapist determine the most effective treatment approach. Our Pain Explained section will provide you with some additional insights into how the body produces pain and general treatment approaches to help mitigate the body’s response to pain.


Once your response to pain has been assessed, your physical therapist will utilize proven “Clinical Prediction Rules” to dictate which of the following Treatment Classifications and Protocols will produce the best clinical outcomes. A clinical prediction rule is defined through medical research studies in which researchers try to identify the best combination of medical signs, symptoms, and other findings to predict the probability of a specific disease or outcome. This approach will dictate which clinical treatment path has the highest probability of success for each individual patient.

Click on each to learn more:

It is important to note that about 34 percent of patients do not fall cleanly into any one of these classification categories. For these individuals, physical therapists will use their evaluation and clinical reasoning skills to develop a treatment plan to attain the best outcome in the shortest time possible.

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Note: The information on this Web site is provided as general health guidelines and may not be applicable to your particular health condition. Your individual health status and any required medical treatments can only be properly addressed by a professional healthcare provider of your choice. Remember: There is no adequate substitution for a personal consultation with your physical therapist. Neither Therapeutic Associates Inc., or any of their affiliates, nor any contributors shall have any liability for the content or any errors or omissions in the information provided by this Web site.

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