Treating back pain: how does physiotherapy help? Types of therapy

Pain and burning in the middle of the back between the shoulder blades or in the lower part, in the sacrum and above the buttocks? For nerve inflammation or other ailments? What will help?

Have you tried physical therapy or physiotherapy?

It is actually a system of treatment using the action of a number of physical phenomena and its effects on the human body. It is used in treatment and rehabilitation centers or even in spa houses.

The aim of physiotherapy is to relieve pain by inducing changes in various systems of the body. This is done with the help of physical stimuli such as heat, cold or pressure.

Physical therapy is one of the most widely used treatment methods.

There are several types of such treatment. They are divided according to the stimuli:

• thermotherapy - treatment by cold or heat
• mechanotherapy - uses mechanical stimuli, for example, by applying various types of massage, including ultrasound
• hydrotherapy - uses the action of water, for example by pressing it
• balneotherapy - treatment using natural resources such as healing muds and waters
• climate therapy - therapy using climatic factors
• electrotherapy - using electric currents, TENS (transcutaneous electrical neurostimulation), magnetotherapy
• phototherapy - treatments that use the light spectrum, such as biolamps or lasers

Physical treatment methods have a positive effect on the human body. However, this effect depends on the correct diagnosis and type of therapy.

Aspects and objectives of physical therapy

The frequency of physical therapy and the patient's initial state of health are also important factors. In addition, the intensity and location of the therapy must also be correctly determined.
This factor is very important for the success of the treatment. If the therapy is applied to the wrong location, the treatment will not be successful and the problem will remain. Thus, the pain will not subside.

For example, even spinal pain can be a result of a problem in the patient's knee.

The principle or goal of physical therapy is to get blood flowing to the problem area of the human body. This activates the healing processes. It does not matter if it is joints, tendons or muscle tissues. This treatment affects all structures of the body.

The focus of physical therapy

It is used for a variety of musculoskeletal disorders, from back pain to rehabilitation of post-injury conditions. It also has a positive effect on the treatment of chronic problems and on the overall correct functionality of the musculoskeletal system as a whole.
It eliminates and relieves acute or chronic back, joint or limb pain.

Read the article on effective help for back pain using various exercise methods.

As in other cases, it is better to prevent a problem than to solve it. In prevention, one should take care not to overestimate his abilities. He should engage in activities for which his physiological abilities are sufficient. A good example of sports that relieve the joints and the overall musculoskeletal system and spine is swimming or cycling. Likewise, they stimulate the cardiovascular system, increase lung capacity, and most importantly, spare the joints and spine.

See also:
Thermotherapy
Mechanotherapy
Hydrotherapy
Balneotherapy
Climatotherapy
Electrotherapy
Phototherapy

Types of physical therapy

Physical therapies are divided according to the type of action they produce, i.e. the stimuli they induce. All of them use therapeutic agents that come from different sources.

The table below shows the source area and the actual sources used in physical therapy

Physical therapy uses the influence of different types of energy on the body. These then induce the desired changes. The treatment itself depends on the correct identification of the procedures used during the therapy, their duration, frequency and localisation to the affected area.

During the treatment, physical stimuli are applied to the body to induce a response. This is actually a defensive reaction that the therapy uses to activate the body's organs to adapt to the changes induced.

Physical stimuli tend to induce the following changes:

• better blood supply to the tissue in question
• a reduction in excessive blood flow
• improved blood circulation regulation
• improved thermoregulation (maintenance of body temperature)

Reactions to physical stimuli are varied. They are usually divided into three groups: nervous system reactions, hormonal reactions and humoral reactions involving body fluids.

The rule is that...

Weak stimuli stimulate vital activity, moderate stimuli condition vital activity and very strong stimuli have the opposite effect.

Hyperemia in physical therapy

In most treatments, there is a blood supply to the tissue (hyperemia). It improves the nutrition and function of the organs involved. It has an anti-inflammatory effect and increases the supply of defensive substances to the affected area of the body. This is due to the increased distribution of blood and lymph. It has an analgesic (pain-relieving) effect and relieves spasms of the striated muscles.

There are four types of hyperemia, we list them and their reactions in the table below

Like other physical therapies, it has its contraindications:

• bleeding conditions
• cachexia (severe weight loss)
• febrile conditions
• cardiac and respiratory insufficiency
• sensitivity disorders
• implanted pacemaker

Some contraindications only apply to certain procedures. These and any other contraindications should be discussed with your doctor or therapist.

Thermotherapy

Thermotherapy is treatment by heat or cold.
Thermotherapy circulates blood to the affected area. It creates what is known as hyperemia, which causes regenerative processes in the area. This improves function and nutrition in the area affected. Muscle tension is relieved and healing is accelerated.

Thermotherapy has anti-inflammatory and analgesic effects.

The normal reaction of the body to heat or cold treatment is a deterioration after the first application. This is only a temporary condition. The body is defending itself against the change.

This treatment is used to treat many ailments, to relieve pain and to enhance overall health.

Types of thermotherapy

There are two types of thermotherapy:

• Positive - heat is brought into the body.
• negative - heat is removed from the body, called cryotherapy

Each type is chosen according to the requirements and type of problem and has different effects.

This treatment method uses the exchange of heat between the body and its surroundings.

A. This is done by conducting when the heat is transferred to a cooler environment.

B. By radiation, heat is exchanged through the peripheral (acral) parts of the body. It is converted into energy that escapes into the environment.

C. By conduction, heat is carried by the blood from active organs to other parts of the body.

D. Evaporation is another type of heat exchange between the body and the environment.

Effects of positive and negative thermotherapy

During positive thermotherapy, the body's vascular system primarily responds to warming. Heat has a positive effect on muscles. It relaxes them and removes spasms and tension in them. Heat therapy has a positive effect on the immune system and pain management.

The means used in positive thermotherapy include paraffin wraps, sauna, hot compresses or lavatherm.

Negative thermotherapy is mainly used to slow down the metabolism and calm the general feeling of calm. It is also good for pain, slowing down the heart and breathing. It is beneficial for inflammation and swelling.
Cold compresses or cryochamber are used as remedies.

Mechanotherapy

Mechanotherapy is one of the common branches of physical therapy. It is performed through massage, patient positioning, passive exercise and manipulation.

In mechanotherapy, energy is applied through the application of mechanical forces.

It is implemented by ultrasound, by means of devices or directly by the physiotherapist. For this reason, mechanotherapy is divided into: ultrasound therapy, instrumental mechanotherapy and manual therapy.

The therapeutic procedures it includes include:

• therapeutic massage
• extension or traction
• point applications
• manipulation
• passive movements
• joint positioning

The principle of mechanotherapy is the application of mechanical energy to the human body. Manual force is applied to problems in the cervical or lumbar spine. By applying pressure or traction to the shortened muscles, the soft tissues and joints are released. This removes blockages and improves mobility. Massage relaxes the patient not only physically but also mentally.

Indications and contraindications for mechanotherapy are listed in the table below

Massage techniques of mechanotherapy

There are several types of massage used in mechanical energy therapy.

Roller massage (rolling) prevents back pain by relieving the pressure between the discs of the spine. It reduces the load on the back and prevents back pain.

Pulse massage, also known as tapping, improves circulation by tapping. It warms up the muscles and relaxes them. Heading massage uses finger pressure to relax stiff back muscles. It significantly increases blood circulation, thereby promoting metabolism.

Pressure massage (air press) cleanses the lymphatic system through lymphatic drainage.
Vibration (oscillating) massage uses a vibrating device to cause blood circulation and overheating of the tissues. This relaxes the body. The massage chair is also used.

Shiatsu massage (human touch massage) uses special massage techniques that stimulate acupressure points located on the back. These are used to achieve optimal relaxation.

In this article you will find exercises for a pain-free back.

Hydrotherapy

hydrotherapy is used as a therapy or as part of the regeneration of the body. Its effect is to improve the range of motion of a body part, its muscular components during active exercise.

The basic condition for the beneficial effect of hydrotherapy is the correct selection and dosage.

Water is used to stimulate and relax the body. Cold water stimulates and starts the body and warm water relaxes it.

The external use of water improves blood and lymphatic circulation. It relieves tension in the muscles, reduces pain and calms the nervous system.

Classic types of hydrotherapy include bubble baths, underwater massage, mineral baths, scotch splashes, whirlpool baths of the upper and lower limbs.
Various additives are also used, which are mixed with the water. For example, essential oils, peat additives, dead sea products, spa oils or salts.

One of the main elements of hydrotherapy is the bath. In this process, the water exerts its pressure and temperature on the body. The nervous, endocrine, cardiovascular, respiratory or immune systems are activated. The chemical effect of the water depends on its composition.

In a subaqual massage (water massage), certain parts of the body are targeted. The therapist uses a stream of water whose pressure and temperature are precisely determined to apply targeted movements to these parts of the body's musculoskeletal system.

Warm water is alternated with cold water, which has a positive effect on the immune system.

Water massage using water jets stimulates the tactile receptors located in the skin. This helps to promote blood circulation, which delivers more nutrients to the stimulated area.

A contrast bath is one that alternates the action of hot and cold water on the body. This stimulates it and supports its immunity.

A bubble bath is used to relax the body. It relaxes the muscles and mental tension. It is useful for diseases of the musculoskeletal system or for healing scars. It has a significant effect on insomnia or is used to improve blood circulation to the limbs. It also has a relaxing effect after physical exertion, whether sporting or work-related.

Positive effects of hydrotherapy

Hydrotherapy has many beneficial effects. Among the most important are:

• It maintains the proper functioning of autonomic reflexes and balances tension in both parts of the autonomic nervous system
• Trains thermoregulation and eliminates disturbances in the blood circulation of parts of the body
• Promotes the breakdown of pollutants from the body through the skin
• Slightly lowers blood pressure and thus facilitates the cardiovascular system
• Circulates the peripheral parts of the body
• Improves the immune properties of the skin, its blood circulation and the transformation of substances in it

Balneotherapy

This healing method uses the resources provided by nature. Simply put, healing waters, muds or gases.

Natural healing resources are divided into the following groups:

• gases
• peloids
• waters
• climate

Waters and peloids are intended for external application and also for internal use (drinking or inhalation).
For this reason, balneotherapy is divided into external and internal.

External balneotherapy mainly involves the use of peloids, which are artificially mineralised for a stronger therapeutic effect. It also uses iodine, sulphur, carbonate and sulphate waters. It includes a variety of different spa treatments.

Internal balneotherapy consists of drinking medicinal water. Its intake must be regular and determined by the doctor. The dosage, type and duration of the drinking treatment is determined by the doctor. The type of medicinal water is determined according to its properties and taking into account the patient's health problem.

Medicinal peloids

Otherwise referred to as mud, they are formed by various natural geological processes. In therapy, they are mixed with water. Their thermophysical effect is particularly exploited.

One of the best known peloids is peat. Because it has a low pH, even lower than the pH of the skin, it has good bacteriostatic effects. It also has an anti-inflammatory effect, due to its high humic acid and bitumen content.

Peat contains approximately 90 % organic matter.

Peat, which is also a peloid, has about 50 to 95 % of these substances. It has excellent thermophysical properties.

Therapeutic muds are classified according to their place of occurrence. They are mainly known as river muds, lake muds and sea muds. Like other peloids, they are used mainly for their thermophysical effects.

Medicinal waters

Their therapeutic effect depends mainly on their chemical composition and physical properties. They are considered medicinal when they have a scientifically proven healing effect.

Medicinal waters differ from each other in terms of their natural temperature, mineralisation, osmotic pressure, gas content, etc.

The standard temperature of medicinal waters is taken to be the temperature at their source. Accordingly, they are divided into:

• thermal, with a temperature above 20 °C
• cold, with a temperature below 20 °C
• lukewarm, with a temperature between 20 °C and 35 °C
• warm, with a temperature between 35 and 42 °C
• hot, with a temperature above 42 °C

All waters whose temperature at the source is above 20 °C are considered thermal waters.

According to mineralisation, thermal waters are classified as simple, weakly, moderately or strongly mineralised.
According to soluble gas content, sulphur or carbonic.
According to osmotic pressure, hypotonic, isotonic and hypertonic.

The therapeutic effects of these waters consist in the action of their chemical, pressure and thermal stimuli.

Indications and contraindications for balneotherapy are listed in the table below

Read our article on how back pain can be helped.

Climatotherapy

It belongs to physical healing methods in which the body is exposed to the effects of a certain climatic environment. This includes, for example, seaside environments, caves or alpine environments. Climate therapy accelerates the healing and recovery processes.

One aspect of this is walking by the sea, especially in the morning or after a wave, when the air is ionised and saturated with iodine. Salt caves are often used to create this climate.

A climatically suitable environment is considered to be one that has little thermal fluctuation, plenty of sunshine and contains few allergens.

Climate therapy is divided into:

• aerotherapy - staying and moving in the fresh air
• heliotherapy - using sunlight for treatment
• thalassotherapy - staying by the sea
• speleotherapy - staying in a cave

The characteristics of the environment in climate therapy must be different from those of the environment in which the patient is most often found. This is important for the maximum effect of such treatment. If a person is suddenly in climatic conditions different from those to which he is accustomed, this affects his illness. Processes are stimulated in the organism which increase its defences.

Nowadays, climate chambers are also often used. In them, different conditions can be created with a certain temperature, humidity and partial pressure of gases.

Electrotherapy

Electrotherapy is mainly used in physical therapy for rehabilitation purposes.

Its principle is to stimulate nerve and muscle tissue by means of alternating electric currents of different frequency and waveform. It uses the action of low, medium and high frequency currents on the human body.

It stimulates physiological processes in the tissues, reduces pain, favourably affects metabolism and blood circulation. It reduces swelling and relaxes or stimulates the muscles.

The indications for electrotherapy are various:

• nerve or muscle pain
• joint disorders
• rheumatism
• scoliosis
• headaches, migraines

Improves blood circulation and thus tissue nourishment. Suppresses inflammatory processes and pain. Improves the body's motor functions.

Types of electrotherapy

There are several types of electrotherapy. Some of the most common are: rebox, diathermy, TENS currents, diadynamic currents, magnetotherapy or ultrasound.

Rebox is a device invented in the former Czechoslovakia. This procedure, like most, is painless. During it, the patient holds one electrode in his or her hand and the therapist applies the other to the affected area.

Diathermy is a method that uses a high-frequency, low-voltage electric current. It is used to overheat deeper tissues of the body without adverse effects on the skin.

TENS currents is a treatment that uses electrical impulses to relieve pain and alter its perception. It does this by stimulating nerves at different levels of the nervous system. This is why it is also called transcutaneous electrical neurostimulation.

Diadynamic currents use a combination of electrical, galvanic, impulse and faradic currents. Their effects are mutually supportive, resulting in better blood circulation to the tissue and an analgesic (pain-relieving) effect. Diadynamic currents were discovered in 1929 by the French dentist Bernard.

Magnetotherapy uses magnetic fields for treatment. Biological changes occur in the tissues. These change under the influence of the low-frequency pulsed magnetic field, creating a micro-massage.

Ultrasound produces waves that vibrate through the skin. The properties of sound waves are used. This increases the temperature, particularly in collagen tissue. This is the main component of tendons and ligaments. It also stimulates the formation of this tissue.

Phototherapy

It is a light treatment that uses the influence of electromagnetic radiation. In phototherapy, light of a certain wavelength with high luminosity is emitted. During its application, the patient feels warmth.

A laser or biotron lamp is used for light therapy.

Its use is wide-ranging. It even helps with psychological problems or insomnia.

The effects of phototherapy are divided into three groups.

• analgesic - pain relief
• anti-inflammatory - suppression of inflammatory processes
• biostimulating - promoting and stimulating cell regeneration

Phototherapy treatments

Laser uses pulses of monochromatic light. It emits coherent, continuous, electromagnetic waves. It is used to relieve joint inflammation or chronic diseases that cause severe pain. It regenerates damaged tissues such as scars, ligaments or cartilage.

The biolamp emits monochromatic or polychromatic polarised light. It regenerates tissues and has anti-inflammatory effects.

Solux is a method of phototherapy in which infrared light is applied to the affected area. It increases the body's immune system. It has applications in chronic diseases of the respiratory or musculoskeletal system.

Uses of phototherapy

In neurology, it is applied in paresis or nerve pain, headaches or shoulder pain from the cervical spine.

In dermatology, it is beneficial for better healing of wounds or scars. It is used in the treatment of bedsores, burns, ulcers, acne and other problems.

Orthopedics uses phototherapy for arthritis, arthrosis, lumbar or sacral pain, bursitis, hematomas, post-traumatic conditions, spinal pain, joint injuries and musculoskeletal pain.

It is also used in cosmetics to correct wrinkles, stretch marks and other problems.