What order and when to do treatments prescribed??

[bobilishious]

Hello everyone,

I've been struggling with low back pain for some time now and I think it is down to a lower back ligament problem.

I've been advised to do strengthening exercises (yoga type things), stretch, cross friction therapy and hot/cold therapy at various times in addition to taking anti-inflammatory medicines.

My question was more on the timing of these things.

Do i exercise first, then stretch, then do cross friction, then do hot & cold therapy?? Or an entirely different order? I am aware i'm only to do the cross friction every couple of days (3 times per week), but the others I can do daily but i'm struggling to figure out what will be of most benefit.

I've tried to get some input from the physio (NHS) but i've not been able to get any answers unfortunately!

Any help would be greatly appreciated.

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[physiobob]

Usually your therapist who prescribed your program would tell you the order and when to do ALL vs. only some of the exercises. Usually the hot/cold type therapies are post exercise or for pain relief so can be done in isolation or post exercise. One could argue that heat might be useful in some cases to help relax things ahead of exercise. I would suggest with no direct input from your therapist to write down the order and see what works, varying it according to symptoms. I would also get on the list for another outpatient assessment and treatment where someone can assess what is of use, what to progress or change and give you the preferred order for you as an individual.

[finchr]

Across the world, including where I am in the USA there is a school of spine specialists that can be searched out by country. You can access providers by going to Mckenziemdt.org.
Why do you think it is a ligament problem? Other than spinal stenosis caused by a thickened ligamentum flavin,I do not see many isolated lumbar ligament problems.I assume it is your lower back.

Is it worse to walk or bend, to sit 10 minutes or stand the same time, is it worse if you sit unsupported (slouch) or with back support? The spine and supporting elements behave fairly consistently. If your back is worse with bending then you need to not provoke it with stretches in the same direction, i.e. knees to chest or standing hamstring stretches. The evaluation is meant to show the therapist or consultant, which directions aggravate and relieve it