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    • Larry L. Teuber, M.D.
    • Marius Maxwell, M.D., Ph.D.
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Physical Therapy

The Spine Center at Rapid City works closely with ProMotion Physical Therapy to help patients return to activity in the best way possible.

Home Remedies

When your back is hurting, the last thing you want to do is exercise, but in most cases, gentle exercise is exactly what you need to relieve your pain. The best way to treat back pain is to stay active. Inactivity makes rehabilitation difficult.

Passive treatments, such as bed rest and over-the-counter pain relievers, can temporarily relieve pain. In the long run, however, you will need to strengthen the back and make it more flexible to recover from an injury or strain.

Before beginning any exercises, it is wise to have a spine specialist examine and evaluate you and determine the cause of your pain. Many people incorrectly assume that severe pain is an indication of a ruptured disc. Localized, excruciating pain is usually the result of a muscle strain, not a ruptured disc. A herniated disc will radiate pain down into your leg, past your knee. Home remedies are effective when used properly, but do not diagnose yourself - visit a spine specialist first.

Why does exercise work?

The back is composed of vertebrae which are separated by soft discs that act as shock absorbers. These discs resemble jelly donuts in that they have a jelly-like center. In some cases the wall of the disc may rupture, allowing the center of the disc to herniate outward, which in turn causes painful pressure on the nearby nerves that branch off from the spinal cord.

There are specific, special extension exercises that cause the back to arch backward compress the back side of the disc. The compression creates a vacuum toward the front of the disc, sucking the herniation inward and relieving pressure on the adjacent nerve root. The herniation is not "fixed" but the pain is usually decreased.

When exercising, do not hold your breath. Just breathe normally. When stretching, move smoothly and slowly, rather than bouncing or jerking. Never do any exercise to the point that it causes pain. Back exercises can be done several times during the day. Many exercises are easy to perform and can even be done standing or sitting at a desk. If your job requires you to sit at a desk for long periods of time, try to take a break every hour. Stand up, walk around, and do some stretching to relieve your back muscles. For more information on how the back works, visit the anatomy lesson. You can visit our exercise library to view specific examples of back exercises.

Learn more about home remedies and physical therapy by reading The Spine Center's Home Remedy Book available free at The Spine Center Rapid City.

Physical Therapy FAQs

How is physical therapy used in the nonsurgical treatment of back and neck pain?

Your doctor has a number of options available in the treatment of spinal pain, prior to the final option of surgery. These include medications, injections, and physical therapy. Basically, there are three primary reasons to use PT.

Pain: Pain will cause spasms in the muscles surrounding the area. These spasms create additional pain and stress, which perpetuate the original pain in a cycle of events that must be broken. To break this "pain-spasm cycle" physical agents such as heat, cold, electrical stimulation, or ultrasound, are used. Once the cycle has been interrupted, more active therapy can be implemented. Pain reduction is an important component of physical therapy.

Loss of mobility: The underlying cause of the original pain can vary. Our physical therapists identify the tissue causing the restricted motion and "mobilize" (stretch) the tissues involved. Our therapists also teach patients how to mobilize themselves at home as well.

Loss of strength: Many back and neck problems have weakness in specific muscle groups as an underlying factor. These muscles must be addressed in order to gain normal movement and support to the region, as well as preventing future problems from occurring. For example, 50% of the support for the lumbar spine comes by way of the abdominal muscles. Lack of strength reduces this support and increases the risk for injury.

Muscle strength may also be lost in the arms or legs as a result of nerve root compression at the spine. After the nerve root compression is addressed, strength must be restored to the muscles involved. Again, your therapist works with you developing an exercise program tailored to your specific needs.

How do the therapists at ProMotion work with my surgeon at the Spine Center?

Our therapists have worked in conjunction with your surgeon to design post-operative rehabilitation guidelines. If you are from out of town, our therapists forward these guidelines to the therapist within your area, and we are available to answer any specific questions your therapist may have when interpreting these guidelines. If you spend a night at the hospital, our therapists assess your mobility needs and begin some light post-operative exercises and education right away!

What is the difference between physical therapy and chiropractic treatment?

While physical therapy and chiropractic offer many of the same treatment tools, such as ultrasound, electrical stimulation, etc., their approach to mobilizing your spine can be different. Our therapists use mobilization techniques, specifically selecting the segment of the spine to move. Physical therapy regularly incorporates muscle re-education, strengthening, and stretching exercises as a way to maintain the mobility achieved through the manual treatment. Chiropractic and physical therapy can compliment each other in the treatment of spinal problems.

Why is it important to undergo therapy after spinal surgery?

Following surgery, pain, loss of motion, and strength may all be factors in preventing you from reaching the activity level you need to attain for work or recreation. Pain prior to surgery will result in loss of motion and strength of the structures around the spine (even though you may not notice it). Mobility and strength must be addressed after surgery, to prevent additional problems from developing. You may be up to 4 times more likely of developing a second disc problem if you have had surgery. Teaching you how to care for your back is also an important factor in reducing your chances of another surgery.

Do I need a prescription from my doctor in order to see a PT at ProMotion?

While the state of South Dakota permits a patient to be evaluated and treated by a physical therapist, some insurance company policies may require a physician's prescription in order to cover physical therapy. Please refer to your specific policy or call the number on your insurance card for details of your PT coverage.

How do I know when it is safe to return to work after an injury or after surgery?

After the pain has been reduced, your therapist will proceed with an exercise program tailored to meet your specific needs. Your goals for therapy will be developed depending on the type of activities you are going to return to. Sometimes, a work conditioning program will be implemented which bridges the gap between what your current abilities are and what you must be able to do when you return to work. These activities simulate the movements and forces required at work, but progress them gradually. Then, when you return to work you are less likely to injured. A functional capacity evaluation is often used to determine specifically what your capabilities and limitations are for performing work. We use the Physical Work Performance Evaluation (PWPE), a 4-hour test simulating all of the work activities from the Dictionary of Occupational Titles. This test is the only test available with built in validity measures and has been peer reviewed.

Does insurance cover physical therapy services?

Most insurance companies cover physical therapy. However, in this era of managed care, coverage usually has limitations. You can find out what these limitations are by referring to your policy or by contacting your insurance company. We also have staff available to assist you in determining what insurance restrictions may apply.