A Personalized approach to Back Pain

A patient arrived in our clinic, complaining of low back pain accompanied by sciatica in both legs. During the assessment, the patient opened up about personal life stress and disclosed sleeping only an average of 2 hours per night. This information is crucial because solely applying manual therapy to alleviate pain and prescribing exercises to enhance strength and endurance, while generally effective, would overlook the importance of rest, recovery, and daily stress management.

Therefore, my initial approach to her back pain differed. Instead of focusing solely on manual therapy, I guided her through relaxation exercises and gentle upper body stretches, synchronizing them with her breathing—a simple yet effective stress management technique. Subsequently, I dug deeper into the underlying sources of her stress at home (a deeply personal issue which I won’t disclose here). We engaged in a discussion for about 15-20 minutes, exploring strategies to manage her situation. Together, we formulated a plan to be implemented over the next 2 weeks, including incorporating 25–30-minute daytime naps. I refrained from prescribing specific back exercises or stretches and avoided soft tissue release or stretching during the initial 2 weeks. Instead, I focused primarily on stress and sleep management.

After 2 weeks, the patient reported fluctuating stress levels, but unlike before, she experienced days of mental relaxation despite her back pain. This feedback indicated the opportune moment to introduce exercises and address her physical impairment more directly. With reduced stress, she could now concentrate better on the exercises, and increased rest would amplify the benefits.

Over subsequent weeks, the patient’s condition gradually improved. Although she still experienced back pain and sciatica, her overall quality of life significantly enhanced.

These cases exemplify the holistic approach of a Physical Therapy Doctor. Effective pain management involves attentive listening, crafting comprehensive plans that encompass lifestyle factors, and addressing not only physical but also mental well-being.

Sabino Cocos - Owner of Coactiv

Dr. Sabino Emil Cocos

CoActiv Physical Therapy

We Help Athletes And Active Adults Of Manatee And Sarasota County Move Better, Live Pain-Free, And Get Stronger Without Painkillers, Surgery, Or Injections