Q: I've had lower back pain for six months and I'm not sure what's causing it. Should I see my doctor or a physical therapist?

A: Physical therapists are well suited to treat both acute and chronic lower back pain (LBP) and are an excellent first line of care. Patients with LBP constitute the largest percentage of people seeking care from physical therapists in the United States. In 2013, nearly a third of patients seen by outpatient physical therapists at Mercy Fitzgerald Hospital and its satellite locations had LBP. For 70 percent to 80 percent of people, symptoms of LBP will resolve within three months of onset. But as many as 30 percent develop chronic LBP. Generally, the longer the symptoms last, the poorer the outcome. But patients shouldn't be discouraged. Recent research shows more than one third of patients with chronic LBP have substantial to full recovery within 12 months of onset.

LBP can be caused by soft-tissue trauma, joint dysfunction, arthritis, disc injury, and nerve irritation. Physical therapy can be key to recovering from these conditions, because each cause is separately treated. On initial examination, a therapist will assess the musculoskeletal system and do tests to identify sources of symptoms.

Treatments include spinal-manipulative therapy, strengthening, motor control, and position-based exercises.

The goal is to control pain, restore function, and decrease disability.

When goals are achieved, a therapist will assist in developing a plan of prevention through education and exercise.

Prevention is important because recurrences of LBP are common.

Matt Petruccelli is a physical therapist at Mercy Fitzgerald Hospital. 610-237-4231