Spinal rehabilitation

What is spinal rehabilitation?

Your recovery from spine pain or injury can be improved by learning new ways to strengthen your spine and prevent future problems. A physical therapist can teach you ways to help reduce your pain now and form new habits to keep your spine healthy.

How spinal rehabilitation works

Below is a high-level description of what you can expect when working with a physical therapist to alleviate your spinal pain.


Your physical therapist (PT) will gather information about your spine condition. You may be asked questions about when it started, where it hurts, and how your symptoms affect your day-to-day activities. This helps your PT to begin zeroing in on the source of your problem and to know what will be needed to help relieve it.


After reviewing your answers, your therapist will do an exam that may include some or all of the following checks:

  • Posture: Imbalances in the position of your spine can put pressure on sore joints, nerves, and muscles. Improving your posture can oftentimes make a big difference in easing the pain.
  • Range of motion (ROM): Measurements are taken of how far you can move in different directions. Your ROM is recorded to compare how much improvement you are making with treatment.
  • Nerve Tests: Your PT may do checks of reflexes, sensation, and strength. The results can help determine which area of the spine is causing problems and the types of treatment that will be best for you.
  • Manual Exam: Your PT will carefully move your spine in different positions to make sure that the joints are moving smoothly at each level. Muscle and soft tissue flexibility are also tested.
  • Ergonomics: Ergonomics involves where and how you do your work or hobby activities. By understanding your ergonomics, your PT can begin to learn if the way you do your activities is making your condition worse. Sometimes even simple corrections of your hobby or workstation can make a big difference in easing spine problems.
  • Palpation: this involves feeling the soft tissues around your spine. This is used to check the skin for changes in temperature or texture, which could tell if you have inflammation or nerve irritation. Palpation also checks whether there are tender points or spasms in the muscles near the spine.


The main goal of therapy is to make sure you have ways to take care of future spine pain or problems. You’ll be shown ways to help control pain or symptoms if they don’t go completely away and if they return in the future. Because you’ve experienced spine pain, there is a possibility you may have soreness in the future. You may be encouraged to continue with some of the exercises to help keep your spine healthy over time. Your therapist may choose from one or more of the following treatment interventions to help you control your pain and symptoms:

    • Rest: avoiding activity or movement that cause irritation/pain.
    • Specific rest: select exercises that encourage the safe movement of the shoulders and upper back.
    • Positioning: using special pillows or special ways to rest your head and neck
    • Ice: using ice can help control inflammation
    • Heat: using heat can help to flush away chemicals that are causing pain and can help speed up healing by bringing nutrients and oxygen to the problem area.
    • Ultrasound: the use of ultrasound causes friction and warmth to pass through tissues. This heating effect helps flush the sore area and bring in a new supply of nutrient and oxygen-rich blood.

Electrical stimulation: Electrical stimulation is a gentle treatment used to stimulate nerves. Electrical stimulation can ease pain by sending impulses that are felt instead of pain. Once the pain eases, muscles that are in spasm begin to relax, letting you move and exercise with less discomfort.

  • Soft tissue mobilization/massage: Massage has been shown to calm pain and spasm by helping muscles relax, by bringing in a fresh supply of oxygen and nutrient-rich blood, and by flushing the area of chemical irritants that come from inflammation. Soft tissue treatments can help tight muscles relax, getting them back to a normal length.
  • Joint mobilization: These are graded pressures and movements that are done by skilled physical therapists. Gently graded pressures help lubricate joint surfaces, easing stiffness and helping you begin moving with less pain.
  • Traction: Sore joints and muscles in the neck often feel better when a traction “pull” is used. Your therapist will test at first to see if you can get relief with this type of treatment.


Therapeutic exercise

Specialized treatments and exercises can help maximize your physical abilities, including flexibility, stabilization, coordination, and fitness conditioning.

  • Flexibility: Exercises that increase flexibility help to reduce pain and make it easier to keep your spine in a healthy position.
  • Stabilization: The “core” muscles you’ll be working on are closer to the center of the body and act as stabilizers. These key muscles are trained to help you position your spine safely and to hold your spine steady as you perform routine activities.
  • Coordination: Strong muscles need to be coordinated. As the strength of the spinal muscles increases, it becomes important to train these muscles to work together. Spine muscles that are trained to control safe movement help reduce the chance of reinjury.
  • Fitness conditioning: Improving overall fitness levels aids in the recovery of spine problems. Fitness conditioning involves safe forms of aerobic exercise.

Functional training

Therapists use functional training when you need help doing specific activities with greater ease and safety. Examples include posture, body mechanics, and ergonomics.

  • Posture: Using healthy posture keeps the spine in safe alignment, reducing strain on the joints and soft tissues around your spine.
  • Body Mechanics: Think of body mechanics as putting safe posture into action. It’s one thing to sit or stand with good posture, it’s another to keep safe posture as you actually move through routine activities such as getting out of a chair, taking out the trash, brushing your teeth, and more.
  • Ergonomics: Ergonomics looks at the way people do work. It’s possible that even minor changes in the way you do your work or hobby activities could keep your pain and symptoms in check while protecting your spine from further injury.

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