Physiotherapy, or physical therapy, deals with rehabilitating any ailing or injured parts of the body, whether a patient can exercise independently or not. When confronted with spinal cord injuries, skeletal disorders or even recurrent back pain, therapists turn to the sub-speciality of spinal physiotherapy. Armed with knowledge of orthopedic and neurological treatments in the field, they can develop treatment regimens and exercises aimed at improving, or at least sustaining, a patient's mobility, circulation and pursuit of happiness. Often, patients perform these exercises with assistance, particularly those who lack sensation in some or most of the body.
Before therapists know which of the many physical therapy exercises, movements and stationary treatments to employ, patients will go through a thorough examination of their medical history and physical capabilities. The regimen for an adolescent paraplegic with neurological damage, for instance, will consist of drastically different exercises than those for a fully cognizant paraplegic adult. By poring over each patient's particulars — each with a unique age, level of coherence, prognosis for recovery and level of physical acumen — therapists can best tailor a plan to improve each patient's range of motion, strength, mobility and flexibility.
Some of the treatments used in spinal physiotherapy do not involve patients performing any movements. When a regimen of transcutaneous electrical nerve stimulation (TENS) is prescribed for spinal physiotherapy, the patient remains still while a TENS unit passes electrical pulses to various stick-on electrodes along the muscles adjoining the spinal column, but not directly over it. As with other uses, therapists are hoping to stimulate damaged muscles and nerve centers to promote overall spinal health. This technique is used just as much to help regenerate tissue and sensation in major cases of paralysis as it is to ease back pain for athletes at peak physical condition.
Many of the other approaches in spinal physiotherapy involve physical manipulation, with or without therapist support. For a patient with back pain but no physical disability, after confirming no other causes but strain, a therapist might recommend an exercise routine focused on building core muscle strength. This new muscle tissue, in turn, helps to better support the skeletal structure. For paraplegics, intensive exercise of the upper body will help in recovery and adjustment, while therapist manipulation of the legs will keep paralyzed areas well-circulated and limber. Quadriplegics, of course, will have a therapist leading them through most of the movements.
Patients in need of spinal physiotherapy may have just undergone spinal surgery or suffered a serious accident. Learning to adjust to minor or major paralysis and improve overall mobility could be a major part of the recovery process. A range of ailments also may have triggered paralysis or spinal ineffectiveness, ranging from stroke, cancer, seizures and rabies to multiple sclerosis and Parkinson's disease. Many others merely seek the advice of a physical therapist when a sore back will not go away.