Treatment for low back pain should be individualized

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By Jerry Moczerniuk PT, DPT
db Orthopedic Physical Therapy

In our practice we routinely see patients who come in with the complaint of low back pain. Low back pain is one of the leading causes of disability in the United States, and it will affect most adults at some point in time during their lifetime. The prevalence of low back pain increases during the aging process. An article in a 2014 issue of journal of Neuroradiology identified that 60% of 50-year-olds and 80% of 84-year-olds have bulging discs. That same article concluded that 80% of 50-year-olds and 96% of 84-year-olds have disc degeneration. Although most individuals will have low back abnormalities during their lifetime, that does not necessarily mean they will experience pain or other symptoms associated with it.

A Google search for “low back pain treatment” can quickly bring up over 550 million articles and links, however it is crucial to understand that all low back pain should not be treated the same. There are many causes of low back pain. These include disc bulging, disc herniation, lumbar stenosis, spondylolisthesis, facet joint arthritis and compression fractures just to name a few. It is also fairly common for low back pain to be accompanied by symptoms in one or both legs. Those symptoms may include weakness, numbness, tingling. It is also important to understand that low back disease does not always present with actual pain in the low back. There are instances in which leg symptoms are the only symptom of lower lumbar spine disease.

Over the last two decades there have been hundreds of highly validated studies showing effectiveness of physical therapy interventions in treatment of low back disorders and associated symptoms. Physical therapy should not however simply treat low back or leg pain, as treatment will differ greatly based on the cause of the symptoms. Likewise, general low back pain exercises without proper guidance may also be counter productive, and result in worsening symptoms if the exact cause of those symptoms is not properly established. A comprehensive evaluation must therefore be performed in order to initiate an appropriate, individualized plan of care.

A skilled physical therapist is capable of accurately identifying the cause of symptoms through comprehensive history taking and physical examination. Once an accurate cause has been established, conservative individualized physical therapy treatment may be initiated to decrease symptoms, facilitate return to normal function and improve quality of life.

Individualized physical therapy treatment may consist of modalities to control pain and swelling, specific exercises in directional preference, stabilization exercises, hands on techniques to improve joint mobility and decrease spasm, activity modification strategies and postural re-education to decrease symptoms and facilitate healing. Patient education is also crucial, as low back conditions and symptoms may become chronic and recurring. A patient’s understanding of their condition as well as what positions/activities make their symptoms worse is important to reduce the likelihood of symptom recurrence.

In New Jersey you can be evaluated and treated by a physical therapist without a referral from your doctor.


Dr. Moczerniuk is a doctor of Physical Therapy, member of American Physical Therapy Association, and a clinical director at db Orthopedic Physical Therapy of Manalapan LLC, located at 120 Craig Road, Suite 2. Dr. Moczerniuk can be reached at 732-462-2162 or via email at For more information, visit