Low back pain, leg pain, sciatica, radiculopathy and your chores.


At Custom Physical Therapy we evaluate and treat multiple patients with a combination of low back pain only, low back pain with leg pain or just leg pain without back pain. The pain may be severe or tolerable, easily aggravated or relatively stable. The impact on the patients’ daily function may be substantial or minimal. How do we, at Custom Physical Therapy, approach such cases?

Looks like an angry sciatic nerve!

The first visit we do a comprehensive evaluation in which we gain insight into the potential causes of the symptoms, assess for limitations in range of motion, muscle weakness, determine where the leg pain is coming from and assess what types of movements and postures aggravate the symptoms and which ease them. We then put this information together to come up with a more specific diagnosis and determine the correct approach for treatment.

Front plank  a core exercise.

Day 1 treatment involves determining the most effective home program to begin the recovery process. This may include directional preference exercises which are used to reduce the low back pain and the leg symptoms by utilizing a single, very specific repeated movement regularly throughout the patients’ day. Other home exercises may include introductory core stabilization exercises in an effort to reactivate certain muscles that have been shown to shut down as part of the back pain process and we may incorporate stretching exercises. All our physical therapists will also use their hands-on approach for soft tissue and joint mobilizations to supplement the exercises and to help further reduce the symptoms.

Bending forward top to bottom, vertebrae by vertebrae may be home exercise given after the evaluation.

Together, the physical therapist and patient set up a specific, individualized treatment plan based on the patient’s goals and the recommendations for the best approach to achieve full recovery. It may involve progression of the treatment provided in the first visit to more advanced core stabilization exercises, functional training to simulate work or athletic activities, and temporary or permanent modification of certain postures or daily activities in an effort to prevent re-occurrence of subsequent episodes of pain.

Will it get better? Absolutely! Back pain improves and our job, as physical therapists, is to help you improve faster than you would on your own. I have seen many people figure out what to avoid and what to do based on the fact that it simply does not feel good to do things that hurt and it feels better to do things that reduce their symptoms. We utilize this approach supplemented by our advanced knowledge the spine anatomy, physiology and kinesiology – both normal and abnormal.

That deep achy back!
Alternate arm and leg extension, often called the “Bird Dog”, is frequently used to develop core muscle control and endurance.

A simple functional change can be modifying how you wash the dishes by squatting down instead of bending forward at the sink. Vacuuming is a killer sometimes but you can change how you do it so you can still keep those carpets clean. You just need to change how you do them. See the video of me washing dishes recently. In the video I change my posture to avoid sending pain down my right leg (while my wife takes the video!). I avoid sitting and presently lie on the floor in positions that reduce my symptoms. I also do my home exercises that really do help relieve the symptoms.

You should continue to live your life within the aggravating and easing factors you have learned from living with your pain on a day-to-day basis and those you discussed with the physical therapist at the time of your evaluation. No excuses to not remain active! Indeed, it is much more likely you will recover by being active and not permitting the symptoms to control your life.

A call to action!

If you have low back pain with or without leg pain or leg pain without back pain, or a radiculopathy or sciatica, the sooner you see a physical therapist about it the quicker your recovery. Call a physical therapy clinic near you and schedule an evaluation. You will be glad you did!