Jefferson University Hospitals

Frequently Asked Questions

What are the symptoms of a back injury?

Back injuries tend to peak between the ages of 35 and 45 in people who are still active but less fit. The injury can manifest itself in a variety of ways, and most often affects the lower back. A back problem can present as a dull ache or an excruciating stab, shooting pain or tenderness to the touch. There may be stiffness and pain in the lower back, or a person may experience pain and/or numbness radiating from the back, down into the legs.

One person may endure back discomfort all day, while another may feel fine in the morning and start to ache as the day progresses. Some people find their backs hurt more in certain positions, such as when they are bending, sitting for a prolonged period, or walking.

What causes back pain?

Four out of five of us will experience back pain at some point in our lives. Poor body mechanics (e.g. bending at the waist when lifting) is a common contributor to many types of back pain. Sitting for prolonged periods can also put excessive pressure on the spine that results in injury.

A number of people hurt their backs on the job. Any occupation that involves frequent bending, lifting, reaching, sitting, standing or repetitive motion could make you vulnerable to an injury if you are not fit and not practicing proper lifting mechanics. In the home, lifting children or other heavy loads repeatedly or improperly can cause an injury.

While many people blame their back distress on one slip, twist or heavy load, the pain is often an accumulation of years of faulty movements and small irritations to the spine. Poor flexibility and lack of control fitness can also be a major contributor to back pain.

What should I do when my back hurts?

Avoid activities that could aggravate your back further. While your inclination may be to take to your bed, however, the latest research indicates that continuing to be active can enhance recovery from back pain. Bed rest and inactivity for more than one or two days may actually be harmful, because you lose strength, flexibility and endurance.

Try these first-aid remedies at the first sign of pain:

  • Maintain physical activity, but be careful to avoid any movements which produce aggravated pain in the back.
  • Take over-the-counter pain anti-inflammatory medication.
  • Apply ice on the back for 15 to 20 minutes at a time, three to five times a day, to reduce swelling, inflammation and soreness.
  • Pursue low-impact exercise like walking or water aerobics.
  • When sleeping, find a comfortable position (perhaps on your side, with a pillow between the knees) and try to maintain it.

When should I see a doctor about the pain?

In 90 percent of people with acute lower-back pain, the symptoms disappear on their own within a few weeks. Your doctor may be able to recommend specific interventions to accelerate your recovery and may suggest measures to prevent recurrence of the injury.

If your pain doesn't subside in four or five days after following the recommendations above, you should call your physician. Also, call your doctor immediately if you have pain radiating down a leg, difficulty using limbs or raising toes, weakness in the ankle, inability to stand straight, loss of bladder or bowel control, leg numbness or tingling, loss of male erectile function, or pain accompanied by an infection and high fever. While rare, back pain can be a sign of other, more serious conditions, so pain that is not improving should be brought to the attention of a physician.

Your primary care physician may prescribe medication or a home exercise program, or refer you to a physical therapist for more intensive treatment. In situations where the back pain is not responding well, you may also be referred to someone with more specialized training in back care, such as a sports medicine specialist, a physiatrist, a pain management specialist, or a spine surgeon.

Will I need to undergo tests?

Your physician may be able to diagnose the cause of your pain simply by taking a careful medical history and performing a thorough physical exam. The physician may ask questions about your lifestyle and occupation, assess your movement patterns and posture, and determine what you were doing when the pain originated. For acute back pain, X-rays and diagnostic studies are not often helpful unless a serious accident or neurological problem has occurred. If a disc injury is suspected, your physician may order a magnetic resonance imaging (MRI) test if your pain is not improving as expected.

What kind of treatment is available for back pain?

Your physician may recommend that you see a physical therapist or certified athletic trainer to start you on an exercise regimen to accelerate your healing and prevent further injuries. Once the acute pain has diminished, a regimen of stretching, strengthening and stabilization exercises is critical to prevent a future injury.

Those with persistent pain may find relief with injections of cortisone or nerve-blocking anesthetics. A small percentage of back problems require surgery.

With treatment of acute pain, you should notice some improvement after two weeks. If not, modify your treatment plan or consider another therapy. After four weeks without progress, diagnostic tests may be indicated. Keep in mind that back injuries require dedicated time and effort to fully heal. With proper care and patience, most people will recover. The key to successful treatment is good communication between the patient, the physician, the therapist, and any consultants who are involved.

Will the pain come back?

If you simply ride out the pain and do not change the bad habits that led to the injury, the problem is likely to recur. Prevention is the cornerstone of back care, because once you've had a back problem, you're four times as likely to experience future back difficulties.

How can I prevent another back injury?

  • Condition and strengthen your leg and abdominal muscles to give your back greater support and flexibility. Exercises which strengthen your trunk and lower extremities build support of the spine, which can deter strains and tears.
  • Learn to move safely. Bend your knees when lifting, never your waist or back. Also, hold objects close to your waist, and pivot, rather than twist, when moving. Step closer or use a stool instead of reaching away from your body. If you're performing a task that requires repetitive motion, take breaks at appropriate intervals.
  • Assess your work place in terms of tasks performed and your work station. Your chair should have good lower back support if you’re sitting a lot. Always stretch and shift positions if you're sitting or standing all day. Set up your work station – phone, computer, files, etc. – so movements are minimized from your head, neck, arms and shoulders. You shouldn't have to hunch forward to your work surface.
  • Maintain a good body weight. Carrying excess weight, especially around the abdomen, strains muscles and can put undue stress on the spine.
  • Learn relaxation techniques. Emotional stress causes back muscles to tense, which may results in painful spasms.
  • Wear comfortable footwear. Heels higher than 1.5 inches throw the pelvis forward and can hurt your back. Your shoes should also have good arch support and cushioning.

At Jefferson Rehabilitation, our goal is to minimize pain, promote wellness and regain function. This will assist you in returning to work, recreation and life activities.

To maximize your outcomes in therapy, we request that you be an active participant in your recovery process. Our therapists will work with you to design an individualized program, but we encourage you to ask questions and follow through with your program at home.

In order to make your experience with us most beneficial, here are some commonly asked questions and some helpful reminders:

What should I do when I come for my next follow-up appointment?

When you arrive for each follow-up appointment please check in with the front desk, then proceed back to the outpatient clinic waiting area. Our staff will greet you and let your therapist know that you have arrived.

What should I wear?

We recommend comfortable clothing. Make sure that the body region that is being treated is easily accessible. Sneakers are recommended and open-toed shoes/sandals are discouraged.

Who will be my therapist?

Our therapists work as a team and will follow the plan that is initially established by the therapist who completed your evaluation. If changes to the plan are required, we again will come together as a team to ensure that you receive the best care possible. If you have any specific needs or requests, we will make every attempt to accommodate them.

How long will my sessions last?

The length of your treatment depends upon your diagnosis and your availability, but typical treatment sessions last from 30 to 60 minutes.

How long will I be coming to therapy?

This will depend upon your condition and the results of the initial evaluation. Re-evaluations are completed each month. You and the therapist will discuss the need for continued therapy or discharge at that time.

What happens if I am late or if I miss an appointment?

In order to maximize your benefit from therapy, it is important that you arrive on time for all of your scheduled appointments. If you arrive late, we will make every effort to see you. However, you may be asked to reschedule your appointment if your lateness impacts another patient's care. If you miss two consecutive appointments without contacting us, your remaining appointments may be canceled.

What is your level of pain before & after each therapy session?

Your therapist will ask you to rate your pain on a scale from 0 to 10. This scale is a useful tool which allows the therapist to monitor your response to treatment.

Has anything changed in your medical status, such as medications, pregnancy, hospitalizations, falls, etc.?

It is very important that you keep your therapist informed of anything that might affect your therapy or the therapist's choice of activities.

When is your next doctor's appointment?

Please let your therapist know of your next doctor's appointment so that we may send a progress report. We like to keep the doctor informed of your progress in therapy.

Is your script & referral valid?

Please ask your therapist when your prescription and, if applicable, your referral expire. Scripts are often valid for 30 days unless otherwise specified. It is important that these items are up-to-date for continued therapy services.